Drug interactions
Hydroxychloroquine + Nortriptyline
Severity: Major
Hydroxychloroquine 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
Nortriptyline can prolong the QRS and QT intervals, and hydroxychloroquine adds to the repolarization effect. The combination may increase the risk of ventricular arrhythmia, particularly in patients with cardiac disease or at higher tricyclic doses.
What this interaction means in plain words
Hydroxychloroquine 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.
Hydroxychloroquine belongs to Musculoskeletal; Nortriptyline belongs to Central Nervous System.
Why it happens
Additive cardiac ion channel effects leading to QT prolongation.
What to do
Obtain a baseline ECG and keep the nortriptyline dose as low as effective; consider an alternative antidepressant in patients with QT risk factors.
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 Hydroxychloroquine
- Arsenic trioxide + Hydroxychloroquine Contraindicated
- Cisapride + Hydroxychloroquine Contraindicated
- Dronedarone + Hydroxychloroquine Contraindicated
- Hydroxychloroquine + Pimozide Contraindicated
- Hydroxychloroquine + Thioridazine Contraindicated
- Hydroxychloroquine + Vandetanib 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 Hydroxychloroquine with Nortriptyline?
MediHelp rates the interaction as major. Hydroxychloroquine 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. Nortriptyline can prolong the QRS and QT intervals, and hydroxychloroquine adds to the repolarization effect. The combination may increase the risk of ventricular arrhythmia, particularly in patients with cardiac disease or at higher tricyclic doses.
How serious is the interaction between Hydroxychloroquine 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: Obtain a baseline ECG and keep the nortriptyline dose as low as effective; consider an alternative antidepressant in patients with QT risk factors.
What other medicines interact with Hydroxychloroquine?
MediHelp also lists interactions of Hydroxychloroquine with, for example, Arsenic trioxide, Cisapride, Dronedarone. The full list is on the Hydroxychloroquine page.
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