Drug interactions
Escitalopram + Nortriptyline
Severity: Moderate
Escitalopram 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 raise serotonergic activity, so serotonin syndrome is possible, and both can affect the QT interval. Escitalopram has weak CYP2D6 inhibition that may modestly increase nortriptyline levels.
What this interaction means in plain words
Escitalopram 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.
Escitalopram belongs to Central Nervous System; Nortriptyline belongs to Central Nervous System.
Why it happens
Additive serotonin reuptake inhibition and QT effects, with weak CYP2D6 inhibition.
What to do
Monitor for serotonin toxicity and consider an ECG and nortriptyline levels, especially with other QT risk factors. Use the lowest effective doses.
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 Escitalopram
- Cisapride + Escitalopram Contraindicated
- Citalopram + Escitalopram Contraindicated
- Escitalopram + Isocarboxazid Contraindicated
- Escitalopram + Methylene blue Contraindicated
- Escitalopram + Phenelzine Contraindicated
- Escitalopram + Pimozide Contraindicated
Frequently asked questions
Can I take Escitalopram with Nortriptyline?
MediHelp rates the interaction as moderate. Escitalopram 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 raise serotonergic activity, so serotonin syndrome is possible, and both can affect the QT interval. Escitalopram has weak CYP2D6 inhibition that may modestly increase nortriptyline levels.
How serious is the interaction between Escitalopram 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 and consider an ECG and nortriptyline levels, especially with other QT risk factors. Use the lowest effective doses.
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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