Drug interactions
Hydromorphone + Nortriptyline
Severity: Moderate
Hydromorphone 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 a sedating tricyclic antidepressant with anticholinergic effects. Combined with hydromorphone it increases the risk of sedation, psychomotor impairment, constipation and urinary retention.
What this interaction means in plain words
Hydromorphone 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.
Hydromorphone belongs to Musculoskeletal; Nortriptyline belongs to Central Nervous System.
Why it happens
Additive CNS depression and additive anticholinergic effects.
What to do
Use the lowest effective doses and monitor for sedation, constipation and urinary retention. Counsel patients on avoiding driving and alcohol.
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 Hydromorphone
- Alvimopan + Hydromorphone Contraindicated
- Bupropion-naltrexone + Hydromorphone Contraindicated
- Hydromorphone + Isocarboxazid Contraindicated
- Hydromorphone + Olanzapine / samidorphan Contraindicated
- Hydromorphone + Phenelzine Contraindicated
- Hydromorphone + Tranylcypromine Contraindicated
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 Hydromorphone with Nortriptyline?
MediHelp rates the interaction as moderate. Hydromorphone 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 a sedating tricyclic antidepressant with anticholinergic effects. Combined with hydromorphone it increases the risk of sedation, psychomotor impairment, constipation and urinary retention.
How serious is the interaction between Hydromorphone 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, constipation and urinary retention. Counsel patients on avoiding driving and alcohol.
What other medicines interact with Hydromorphone?
MediHelp also lists interactions of Hydromorphone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydromorphone page.
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