Drug interactions
Donepezil + Nortriptyline
Severity: Moderate
Donepezil 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
Donepezil enhances cholinergic transmission while nortriptyline blocks muscarinic receptors, so the two may offset each other and reduce the benefit of donepezil. Both can also affect cardiac conduction, with QT prolongation and bradycardia reported with donepezil.
What this interaction means in plain words
Donepezil 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.
Donepezil belongs to Central Nervous System; Nortriptyline belongs to Central Nervous System.
Why it happens
Opposing cholinergic effects and additive QT prolongation.
What to do
Prefer a less anticholinergic antidepressant in dementia patients. If combined, monitor cognition, heart rate and ECG.
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 Donepezil
- Donepezil + Dronedarone Contraindicated
- Donepezil + Pimozide Contraindicated
- Donepezil + Thioridazine Contraindicated
- Donepezil + Vandetanib Contraindicated
- Amiodarone + Donepezil Major
- Amisulpride + Donepezil Major
Frequently asked questions
Can I take Donepezil with Nortriptyline?
MediHelp rates the interaction as moderate. Donepezil 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. Donepezil enhances cholinergic transmission while nortriptyline blocks muscarinic receptors, so the two may offset each other and reduce the benefit of donepezil. Both can also affect cardiac conduction, with QT prolongation and bradycardia reported with donepezil.
How serious is the interaction between Donepezil 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: Prefer a less anticholinergic antidepressant in dementia patients. If combined, monitor cognition, heart rate and ECG.
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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