Drug interactions
Marijuana + Nortriptyline
Severity: Moderate
Marijuana 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
Cannabis adds to the sedating and cognitive effects of nortriptyline and can also cause tachycardia, which adds to TCA cardiac effects. Cannabinoids may modestly inhibit CYP2D6 and raise tricyclic levels.
What this interaction means in plain words
Marijuana 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 CNS depression and tachycardia, with possible CYP2D6 inhibition by cannabinoids.
What to do
Advise patients about increased drowsiness and impaired driving, and monitor heart rate and anticholinergic effects. Review tricyclic dose if toxicity symptoms arise.
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
Frequently asked questions
Can I take Marijuana with Nortriptyline?
MediHelp rates the interaction as moderate. Marijuana 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. Cannabis adds to the sedating and cognitive effects of nortriptyline and can also cause tachycardia, which adds to TCA cardiac effects. Cannabinoids may modestly inhibit CYP2D6 and raise tricyclic levels.
How serious is the interaction between Marijuana 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: Advise patients about increased drowsiness and impaired driving, and monitor heart rate and anticholinergic effects. Review tricyclic dose if toxicity symptoms arise.
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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