Drug interactions
Buprenorphine + Nortriptyline
Severity: Moderate
Buprenorphine and Nortriptyline: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Nortriptyline can prolong QRS and QT intervals, and buprenorphine may add to QT effects. Additive sedation and some serotonergic risk may also occur.
What this interaction means in plain words
Buprenorphine and Nortriptyline can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Buprenorphine belongs to Musculoskeletal; Nortriptyline belongs to Central Nervous System.
Why it happens
Additive effects on cardiac repolarization and additive CNS depression.
What to do
Obtain an ECG in patients with heart disease or other QT risks, and monitor for sedation and serotonin toxicity. Use the lowest effective doses.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Buprenorphine
- Alvimopan + Buprenorphine Contraindicated
- Buprenorphine + Calcium / magnesium / potassium / sodium oxybates Contraindicated
- Buprenorphine + Olanzapine / samidorphan Contraindicated
- Buprenorphine + Phenelzine Contraindicated
- Buprenorphine + Pimozide Contraindicated
- Buprenorphine + Thioridazine Contraindicated
Other interactions of Nortriptyline
- Disopyramide + Nortriptyline Contraindicated
- Dofetilide + Nortriptyline Contraindicated
- Dronedarone + Nortriptyline Contraindicated
- Ibutilide + Nortriptyline Contraindicated
- Isocarboxazid + Nortriptyline Contraindicated
- Methylene blue + Nortriptyline Contraindicated
Frequently asked questions
Can I take Buprenorphine with Nortriptyline?
MediHelp rates the interaction as moderate. Buprenorphine and Nortriptyline can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Nortriptyline can prolong QRS and QT intervals, and buprenorphine may add to QT effects. Additive sedation and some serotonergic risk may also occur.
How serious is the interaction between Buprenorphine and Nortriptyline?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain an ECG in patients with heart disease or other QT risks, and monitor for sedation and serotonin toxicity. Use the lowest effective doses.
What other medicines interact with Buprenorphine?
MediHelp also lists interactions of Buprenorphine with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Olanzapine / samidorphan. The full list is on the Buprenorphine page.
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