Drug interactions
Mefloquine + Nortriptyline
Severity: Major
Mefloquine 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
Nortriptyline, a tricyclic antidepressant, can prolong QRS and QT intervals and lower the seizure threshold. Mefloquine adds QT prolongation and seizure risk, increasing the potential for arrhythmia.
What this interaction means in plain words
Mefloquine 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.
Mefloquine belongs to Anti Parasitic; Nortriptyline belongs to Central Nervous System.
Why it happens
Additive QT prolongation and additive lowering of the seizure threshold.
What to do
Prefer a different antimalarial. If the combination is needed, obtain a baseline ECG, correct electrolytes and monitor for arrhythmia, seizures and neuropsychiatric effects.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Mefloquine 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 Mefloquine
- Arsenic trioxide + Mefloquine Contraindicated
- Dronedarone + Mefloquine Contraindicated
- Ibutilide + Mefloquine Contraindicated
- Levoketoconazole + Mefloquine Contraindicated
- Mefloquine + Nilotinib Contraindicated
- Mefloquine + Pimozide Contraindicated
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 Mefloquine with Nortriptyline?
MediHelp rates the interaction as major. Mefloquine 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. Nortriptyline, a tricyclic antidepressant, can prolong QRS and QT intervals and lower the seizure threshold. Mefloquine adds QT prolongation and seizure risk, increasing the potential for arrhythmia.
How serious is the interaction between Mefloquine 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: Prefer a different antimalarial. If the combination is needed, obtain a baseline ECG, correct electrolytes and monitor for arrhythmia, seizures and neuropsychiatric effects.
What other medicines interact with Mefloquine?
MediHelp also lists interactions of Mefloquine with, for example, Arsenic trioxide, Dronedarone, Ibutilide. The full list is on the Mefloquine 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.
