Drug interactions
Lithium + Nortriptyline
Severity: Moderate
Lithium 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
Combined use may increase serotonergic effects and neurotoxicity, with tremor, confusion and rarely serotonin syndrome. Both drugs may affect cardiac conduction and QT interval.
What this interaction means in plain words
Lithium 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.
Lithium belongs to Central Nervous System; Nortriptyline belongs to Central Nervous System.
Why it happens
Additive serotonergic effects and cardiac conduction effects through pharmacodynamic mechanisms.
What to do
Monitor for tremor, neuromuscular excitability and serotonin toxicity, and check serum lithium levels. Obtain an ECG in patients with cardiac risk factors.
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 Nortriptyline
- Disopyramide + Nortriptyline Contraindicated
- Dofetilide + Nortriptyline Contraindicated
- Dronedarone + Nortriptyline Contraindicated
- Ibutilide + Nortriptyline Contraindicated
- Isocarboxazid + Nortriptyline Contraindicated
- Methylene blue + Nortriptyline Contraindicated
Other interactions of Lithium
- Lithium + Thioridazine Contraindicated
- Lithium + Vandetanib Contraindicated
- Aceclofenac + Lithium Major
- Acemetacin + Lithium Major
- Amisulpride + Lithium Major
- Amlodipine-benazepril + Lithium Major
Frequently asked questions
Can I take Lithium with Nortriptyline?
MediHelp rates the interaction as moderate. Lithium 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. Combined use may increase serotonergic effects and neurotoxicity, with tremor, confusion and rarely serotonin syndrome. Both drugs may affect cardiac conduction and QT interval.
How serious is the interaction between Lithium 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: Monitor for tremor, neuromuscular excitability and serotonin toxicity, and check serum lithium levels. Obtain an ECG in patients with cardiac risk factors.
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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