Drug interactions
L-tryptophan + Nortriptyline
Severity: Moderate
L-tryptophan 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
L-tryptophan is a serotonin precursor, and with a tricyclic antidepressant it may precipitate serotonin syndrome, with agitation, tremor, diaphoresis and hyperthermia.
What this interaction means in plain words
L-tryptophan 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.
Why it happens
Additive serotonergic effects from increased serotonin synthesis and reuptake inhibition.
What to do
Avoid combining where possible, or use low doses and monitor for serotonin toxicity. Discontinue tryptophan if symptoms occur.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for L-tryptophan and Nortriptyline, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
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 L-tryptophan with Nortriptyline?
MediHelp rates the interaction as moderate. L-tryptophan 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. L-tryptophan is a serotonin precursor, and with a tricyclic antidepressant it may precipitate serotonin syndrome, with agitation, tremor, diaphoresis and hyperthermia.
How serious is the interaction between L-tryptophan 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: Avoid combining where possible, or use low doses and monitor for serotonin toxicity. Discontinue tryptophan if symptoms occur.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
