Drug interactions
Dextromethorphan + Nortriptyline
Severity: Moderate
Dextromethorphan 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 combined with dextromethorphan may add to serotonergic effects, and both are CYP2D6 substrates that may compete for metabolism. Clinically significant serotonin syndrome is uncommon but possible.
What this interaction means in plain words
Dextromethorphan 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.
Dextromethorphan belongs to Respiratory; Nortriptyline belongs to Central Nervous System.
Why it happens
Additive serotonergic effects and competition for CYP2D6 metabolism.
What to do
Use standard short-course doses of dextromethorphan and monitor for serotonin toxicity and nortriptyline adverse effects. Change antitussive if symptoms appear.
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 Dextromethorphan
- Dextromethorphan + Isocarboxazid Contraindicated
- Dextromethorphan + Linezolid Contraindicated
- Dextromethorphan + Phenelzine Contraindicated
- Dextromethorphan + Rasagiline Contraindicated
- Dextromethorphan + Safinamide Contraindicated
- Dextromethorphan + Selegiline 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 Dextromethorphan with Nortriptyline?
MediHelp rates the interaction as moderate. Dextromethorphan 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 combined with dextromethorphan may add to serotonergic effects, and both are CYP2D6 substrates that may compete for metabolism. Clinically significant serotonin syndrome is uncommon but possible.
How serious is the interaction between Dextromethorphan 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: Use standard short-course doses of dextromethorphan and monitor for serotonin toxicity and nortriptyline adverse effects. Change antitussive if symptoms appear.
What other medicines interact with Dextromethorphan?
MediHelp also lists interactions of Dextromethorphan with, for example, Isocarboxazid, Linezolid, Phenelzine. The full list is on the Dextromethorphan page.
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