Drug interactions
Methamphetamine + Nortriptyline
Severity: Major
Methamphetamine and Nortriptyline: major interaction.
Last updated Sources: US FDA label
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
Tricyclics can potentiate the cardiovascular effects of amphetamines, with a risk of hypertension, tachyarrhythmia and agitation. Tricyclics may also raise amphetamine exposure through CYP2D6 inhibition.
What this interaction means in plain words
Methamphetamine 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.
Methamphetamine belongs to Central Nervous System; Nortriptyline belongs to Central Nervous System.
Why it happens
Additive noradrenergic effects and CYP2D6 inhibition by nortriptyline raising methamphetamine levels.
What to do
Avoid if possible; otherwise monitor blood pressure, heart rate and ECG and use the lowest effective doses.
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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References
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 Methamphetamine
- Isocarboxazid + Methamphetamine Contraindicated
- Linezolid + Methamphetamine Contraindicated
- Methamphetamine + Phenelzine Contraindicated
- Methamphetamine + Procarbazine Contraindicated
- Methamphetamine + Rasagiline Contraindicated
- Methamphetamine + Safinamide Contraindicated
Frequently asked questions
Can I take Methamphetamine with Nortriptyline?
MediHelp rates the interaction as major. Methamphetamine 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. Tricyclics can potentiate the cardiovascular effects of amphetamines, with a risk of hypertension, tachyarrhythmia and agitation. Tricyclics may also raise amphetamine exposure through CYP2D6 inhibition.
How serious is the interaction between Methamphetamine 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: Avoid if possible; otherwise monitor blood pressure, heart rate and ECG and use the lowest effective doses.
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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