Drug interactions
Carbamazepine + Nortriptyline
Severity: Moderate
Carbamazepine 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
Carbamazepine can lower nortriptyline concentrations and may reduce antidepressant effect. Carbamazepine is also structurally related to tricyclics, so additive anticholinergic and cardiac conduction effects are possible.
What this interaction means in plain words
Carbamazepine 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.
Carbamazepine belongs to Central Nervous System; Nortriptyline belongs to Central Nervous System.
Why it happens
Carbamazepine induces CYP enzymes, including CYP3A4 and CYP1A2, increasing nortriptyline clearance.
What to do
Monitor clinical response and consider nortriptyline plasma concentration measurement, increasing the dose if needed. Reassess the dose if carbamazepine is stopped.
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 Nortriptyline
- Disopyramide + Nortriptyline Contraindicated
- Dofetilide + Nortriptyline Contraindicated
- Dronedarone + Nortriptyline Contraindicated
- Ibutilide + Nortriptyline Contraindicated
- Isocarboxazid + Nortriptyline Contraindicated
- Methylene blue + Nortriptyline Contraindicated
Other interactions of Carbamazepine
- Artemether / lumefantrine + Carbamazepine Contraindicated
- Cabotegravir + Carbamazepine Contraindicated
- Carbamazepine + Delamanid Contraindicated
- Carbamazepine + Dienogest / estradiol valerate Contraindicated
- Carbamazepine + Doravirine Contraindicated
- Carbamazepine + Elbasvir / grazoprevir Contraindicated
Frequently asked questions
Can I take Carbamazepine with Nortriptyline?
MediHelp rates the interaction as moderate. Carbamazepine 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. Carbamazepine can lower nortriptyline concentrations and may reduce antidepressant effect. Carbamazepine is also structurally related to tricyclics, so additive anticholinergic and cardiac conduction effects are possible.
How serious is the interaction between Carbamazepine 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: Monitor clinical response and consider nortriptyline plasma concentration measurement, increasing the dose if needed. Reassess the dose if carbamazepine is stopped.
What other medicines interact with Nortriptyline?
MediHelp also lists interactions of Nortriptyline with, for example, Disopyramide, Dofetilide, Dronedarone. The full list is on the Nortriptyline page.
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