Drug interactions
Iloperidone + Nortriptyline
Severity: Major
Iloperidone 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
Both drugs can prolong the QT interval, raising the risk of torsades de pointes, and both cause sedation and orthostatic hypotension. Nortriptyline may also raise iloperidone levels through CYP2D6 inhibition.
What this interaction means in plain words
Iloperidone 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.
Iloperidone belongs to Central Nervous System; Nortriptyline belongs to Central Nervous System.
Why it happens
Additive QT prolongation and CNS depression, with possible CYP2D6 inhibition increasing exposure.
What to do
Obtain a baseline ECG, correct electrolytes, and monitor QTc during co-therapy. Consider an alternative agent in patients with cardiac risk factors, and monitor for sedation and hypotension.
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 Iloperidone
- Iloperidone + Thioridazine Contraindicated
- Alfuzosin + Iloperidone Major
- Amiodarone + Iloperidone Major
- Amisulpride + Iloperidone Major
- Amitriptyline + Iloperidone Major
- Anagrelide + Iloperidone Major
Frequently asked questions
Can I take Iloperidone with Nortriptyline?
MediHelp rates the interaction as major. Iloperidone 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. Both drugs can prolong the QT interval, raising the risk of torsades de pointes, and both cause sedation and orthostatic hypotension. Nortriptyline may also raise iloperidone levels through CYP2D6 inhibition.
How serious is the interaction between Iloperidone 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, correct electrolytes, and monitor QTc during co-therapy. Consider an alternative agent in patients with cardiac risk factors, and monitor for sedation and hypotension.
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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