Drug interactions
Dexfenfluramine + Nortriptyline
Severity: Major
Dexfenfluramine and Nortriptyline: major interaction.
Last updated Sources: UK SmPC
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
Dexfenfluramine is a serotonergic agent, and combining it with a tricyclic antidepressant can raise the risk of serotonin toxicity. Sympathomimetic effects may also be altered. Dexfenfluramine has been withdrawn from most markets.
What this interaction means in plain words
Dexfenfluramine and Nortriptyline can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive serotonergic activity plus altered adrenergic uptake.
What to do
Avoid the combination. If it occurs, monitor for serotonin syndrome signs and blood pressure changes.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
- Nortriptyline 10 mg Film-coated Tablets - SmPC sections 4.3/4.5 (class statement: serotonin enhancing medications; "The “serotonin syndrome” (changes in cognition, behaviour, function of the automatic nervous system and neuromuscular activity) have been reported when nortript") — electronic medicines compendium (UK SmPC)
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 Dexfenfluramine with Nortriptyline?
MediHelp rates the interaction as major. Dexfenfluramine and Nortriptyline can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Dexfenfluramine is a serotonergic agent, and combining it with a tricyclic antidepressant can raise the risk of serotonin toxicity. Sympathomimetic effects may also be altered. Dexfenfluramine has been withdrawn from most markets.
How serious is the interaction between Dexfenfluramine and Nortriptyline?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination. If it occurs, monitor for serotonin syndrome signs and blood pressure changes.
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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