Drug interactions
Haloperidol + Nortriptyline
Severity: Major
Haloperidol and Nortriptyline: major 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
Haloperidol can increase nortriptyline exposure through CYP2D6 inhibition, and both drugs can prolong the QT interval. Together they increase the risk of arrhythmia, sedation and anticholinergic effects.
What this interaction means in plain words
Haloperidol and Nortriptyline can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Haloperidol belongs to Central Nervous System; Nortriptyline belongs to Central Nervous System.
Why it happens
Additive QT prolongation combined with CYP2D6 inhibition by haloperidol that reduces nortriptyline clearance.
What to do
Check a baseline ECG and electrolytes, and monitor QTc after starting. Reduce the nortriptyline dose if toxicity appears, or select a less QT-active agent.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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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 Haloperidol
- Dofetilide + Haloperidol Contraindicated
- Dronedarone + Haloperidol Contraindicated
- Haloperidol + Ibutilide Contraindicated
- Haloperidol + Levoketoconazole Contraindicated
- Haloperidol + Panobinostat Contraindicated
- Haloperidol + Pimozide Contraindicated
Frequently asked questions
Can I take Haloperidol with Nortriptyline?
MediHelp rates the interaction as major. Haloperidol and Nortriptyline can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Haloperidol can increase nortriptyline exposure through CYP2D6 inhibition, and both drugs can prolong the QT interval. Together they increase the risk of arrhythmia, sedation and anticholinergic effects.
How serious is the interaction between Haloperidol and Nortriptyline?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check a baseline ECG and electrolytes, and monitor QTc after starting. Reduce the nortriptyline dose if toxicity appears, or select a less QT-active agent.
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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