Drug interactions
Lisdexamfetamine + Nortriptyline
Severity: Major
Lisdexamfetamine 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
Amphetamines can increase the cardiovascular effects of tricyclics, and tricyclics may raise amphetamine levels. This can cause hypertension, tachycardia, arrhythmia and, rarely, serotonin toxicity.
What this interaction means in plain words
Lisdexamfetamine 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.
Lisdexamfetamine belongs to Central Nervous System; Nortriptyline belongs to Central Nervous System.
Why it happens
Combined noradrenergic and serotonergic enhancement, with CYP2D6 inhibition by the tricyclic increasing amphetamine exposure.
What to do
Monitor blood pressure, heart rate and mental status, and use lower starting doses of each drug. Consider an alternative if cardiovascular or serotonergic signs appear.
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 Lisdexamfetamine
- Isocarboxazid + Lisdexamfetamine Contraindicated
- Linezolid + Lisdexamfetamine Contraindicated
- Lisdexamfetamine + Phenelzine Contraindicated
- Lisdexamfetamine + Procarbazine Contraindicated
- Lisdexamfetamine + Rasagiline Contraindicated
- Lisdexamfetamine + Safinamide Contraindicated
Frequently asked questions
Can I take Lisdexamfetamine with Nortriptyline?
MediHelp rates the interaction as major. Lisdexamfetamine 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. Amphetamines can increase the cardiovascular effects of tricyclics, and tricyclics may raise amphetamine levels. This can cause hypertension, tachycardia, arrhythmia and, rarely, serotonin toxicity.
How serious is the interaction between Lisdexamfetamine 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: Monitor blood pressure, heart rate and mental status, and use lower starting doses of each drug. Consider an alternative if cardiovascular or serotonergic signs appear.
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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