Drug interactions
Dihydroergotamine intranasal + Nortriptyline
Severity: Moderate
Dihydroergotamine intranasal 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
Both drugs have serotonergic activity, so combining them may raise the risk of serotonin syndrome. Tricyclics may also affect ergot exposure and vasoconstrictive effects.
What this interaction means in plain words
Dihydroergotamine intranasal 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.
Why it happens
Additive serotonergic activity, with possible CYP3A4-related pharmacokinetic effects.
What to do
Monitor for serotonin toxicity such as agitation, tremor, clonus and hyperthermia, especially after dose changes. Stop one agent 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 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 Dihydroergotamine intranasal with Nortriptyline?
MediHelp rates the interaction as moderate. Dihydroergotamine intranasal 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. Both drugs have serotonergic activity, so combining them may raise the risk of serotonin syndrome. Tricyclics may also affect ergot exposure and vasoconstrictive effects.
How serious is the interaction between Dihydroergotamine intranasal 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 for serotonin toxicity such as agitation, tremor, clonus and hyperthermia, especially after dose changes. Stop one agent if symptoms appear.
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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