Drug interactions
Mifepristone + Nortriptyline
Severity: Major
Mifepristone 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
Both drugs can prolong the QT interval, and mifepristone at the higher doses used for Cushing's syndrome carries a labeled QT warning. Combined use raises the risk of torsades de pointes, and mifepristone may also inhibit CYP2D6, raising nortriptyline levels.
What this interaction means in plain words
Mifepristone 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.
Mifepristone belongs to Endocrine; Nortriptyline belongs to Central Nervous System.
Why it happens
Additive QT prolongation, plus CYP2D6 inhibition by mifepristone increasing nortriptyline exposure.
What to do
Prefer an alternative antidepressant. If combined, monitor ECG and electrolytes and consider reducing the nortriptyline dose with level monitoring.
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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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 Mifepristone
- Apixaban + Mifepristone Contraindicated
- Argatroban + Mifepristone Contraindicated
- Cisapride + Mifepristone Contraindicated
- Cortisone + Mifepristone Contraindicated
- Cyclosporin + Mifepristone Contraindicated
- Dabigatran etexilate + Mifepristone Contraindicated
Frequently asked questions
Can I take Mifepristone with Nortriptyline?
MediHelp rates the interaction as major. Mifepristone 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. Both drugs can prolong the QT interval, and mifepristone at the higher doses used for Cushing's syndrome carries a labeled QT warning. Combined use raises the risk of torsades de pointes, and mifepristone may also inhibit CYP2D6, raising nortriptyline levels.
How serious is the interaction between Mifepristone 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 an alternative antidepressant. If combined, monitor ECG and electrolytes and consider reducing the nortriptyline dose with level monitoring.
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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