Drug interactions
Fentanyl + Nortriptyline
Severity: Moderate
Fentanyl 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 is sedating and anticholinergic, and with fentanyl it increases CNS and respiratory depression. Tricyclic antidepressants also carry some serotonergic potential with opioids such as fentanyl.
What this interaction means in plain words
Fentanyl 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.
Fentanyl belongs to Musculoskeletal; Nortriptyline belongs to Central Nervous System.
Why it happens
Additive CNS depression, with a possible serotonergic contribution.
What to do
Use the lowest effective doses and monitor for sedation, respiratory depression and signs of serotonin toxicity. Advise patients to avoid alcohol and hazardous activities.
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 Fentanyl
- Alvimopan + Fentanyl Contraindicated
- Fentanyl + Isocarboxazid Contraindicated
- Fentanyl + Olanzapine / samidorphan Contraindicated
- Fentanyl + Phenelzine Contraindicated
- Fentanyl + Tranylcypromine Contraindicated
- Alfentanil + Fentanyl Major
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 Fentanyl with Nortriptyline?
MediHelp rates the interaction as moderate. Fentanyl 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 is sedating and anticholinergic, and with fentanyl it increases CNS and respiratory depression. Tricyclic antidepressants also carry some serotonergic potential with opioids such as fentanyl.
How serious is the interaction between Fentanyl 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 the lowest effective doses and monitor for sedation, respiratory depression and signs of serotonin toxicity. Advise patients to avoid alcohol and hazardous activities.
What other medicines interact with Fentanyl?
MediHelp also lists interactions of Fentanyl with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Fentanyl page.
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