Drug interactions
Epinephrine inhaled + Nortriptyline
Severity: Moderate
Epinephrine inhaled 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
Tricyclic antidepressants can enhance the cardiovascular response to sympathomimetics such as epinephrine. This may produce hypertension, tachycardia and arrhythmias, although the systemic exposure from inhaled epinephrine is usually limited.
What this interaction means in plain words
Epinephrine inhaled 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
Tricyclics block neuronal reuptake of catecholamines, potentiating adrenergic stimulation.
What to do
Monitor heart rate and blood pressure when inhaled epinephrine is used, and use the lowest effective dose. Watch for palpitations or arrhythmia 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
Frequently asked questions
Can I take Epinephrine inhaled with Nortriptyline?
MediHelp rates the interaction as moderate. Epinephrine inhaled 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. Tricyclic antidepressants can enhance the cardiovascular response to sympathomimetics such as epinephrine. This may produce hypertension, tachycardia and arrhythmias, although the systemic exposure from inhaled epinephrine is usually limited.
How serious is the interaction between Epinephrine inhaled 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 heart rate and blood pressure when inhaled epinephrine is used, and use the lowest effective dose. Watch for palpitations or arrhythmia 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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