Drug interactions
Cocaine + Nortriptyline
Severity: Moderate
Cocaine 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
Cocaine blocks catecholamine reuptake and tricyclics also do, so combined exposure may augment sympathomimetic effects, producing hypertension, tachycardia and arrhythmias. With topical medical use, systemic absorption is low but can be relevant at larger doses.
What this interaction means in plain words
Cocaine 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.
Cocaine belongs to Central Nervous System; Nortriptyline belongs to Central Nervous System.
Why it happens
Additive inhibition of norepinephrine reuptake, enhancing adrenergic stimulation.
What to do
Monitor blood pressure and ECG if cocaine is applied in a patient on nortriptyline, and use the lowest effective topical dose. Avoid use in patients with cardiac disease.
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 Cocaine
- Cocaine + Isocarboxazid Contraindicated
- Cocaine + Phenelzine Contraindicated
- Cocaine + Procarbazine Contraindicated
- Amitriptyline + Cocaine Major
- Bisoprolol + Cocaine Major
- Citalopram + Cocaine Major
Frequently asked questions
Can I take Cocaine with Nortriptyline?
MediHelp rates the interaction as moderate. Cocaine 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. Cocaine blocks catecholamine reuptake and tricyclics also do, so combined exposure may augment sympathomimetic effects, producing hypertension, tachycardia and arrhythmias. With topical medical use, systemic absorption is low but can be relevant at larger doses.
How serious is the interaction between Cocaine 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 blood pressure and ECG if cocaine is applied in a patient on nortriptyline, and use the lowest effective topical dose. Avoid use in patients with cardiac disease.
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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