Drug interactions
Memantine-donepezil + Nortriptyline
Severity: Moderate
Memantine-donepezil 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
Nortriptyline has anticholinergic activity that can oppose the cholinergic benefit of donepezil, reducing its cognitive effect. Both drugs can also prolong the QT interval, and donepezil can cause bradycardia, which adds to arrhythmia risk.
What this interaction means in plain words
Memantine-donepezil 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.
Memantine-donepezil belongs to Central Nervous System; Nortriptyline belongs to Central Nervous System.
Why it happens
Pharmacodynamic antagonism at muscarinic receptors plus additive QT prolongation.
What to do
Prefer an antidepressant with low anticholinergic activity in dementia patients. If used together, obtain an ECG and monitor cognition, heart rate and electrolytes.
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 Memantine-donepezil
- Dronedarone + Memantine-donepezil Contraindicated
- Memantine-donepezil + Thioridazine Contraindicated
- Amantadine + Memantine-donepezil Major
- Amiodarone + Memantine-donepezil Major
- Amisulpride + Memantine-donepezil Major
- Amitriptyline + Memantine-donepezil Major
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 Memantine-donepezil with Nortriptyline?
MediHelp rates the interaction as moderate. Memantine-donepezil 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. Nortriptyline has anticholinergic activity that can oppose the cholinergic benefit of donepezil, reducing its cognitive effect. Both drugs can also prolong the QT interval, and donepezil can cause bradycardia, which adds to arrhythmia risk.
How serious is the interaction between Memantine-donepezil 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: Prefer an antidepressant with low anticholinergic activity in dementia patients. If used together, obtain an ECG and monitor cognition, heart rate and electrolytes.
What other medicines interact with Memantine-donepezil?
MediHelp also lists interactions of Memantine-donepezil with, for example, Dronedarone, Thioridazine, Amantadine. The full list is on the Memantine-donepezil page.
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