Drug interactions
Nalbuphine + Nortriptyline
Severity: Moderate
Nalbuphine 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
Both agents can cause sedation, and together they may produce marked drowsiness, dizziness and impaired thinking. Anticholinergic effects of nortriptyline, such as constipation and urinary retention, may also add to opioid effects.
What this interaction means in plain words
Nalbuphine 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.
Nalbuphine belongs to Musculoskeletal; Nortriptyline belongs to Central Nervous System.
Why it happens
Additive central nervous system depression from opioid activity and the antihistaminic and anticholinergic effects of the tricyclic antidepressant.
What to do
Start with low doses and titrate carefully, particularly in older adults. Monitor for oversedation, constipation and urinary retention.
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 Nalbuphine
- Alvimopan + Nalbuphine Contraindicated
- Nalbuphine + Olanzapine / samidorphan Contraindicated
- Alprazolam + Nalbuphine Major
- Amobarbital + Nalbuphine Major
- Benzhydrocodone / acetaminophen + Nalbuphine Major
- Brexanolone + Nalbuphine 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 Nalbuphine with Nortriptyline?
MediHelp rates the interaction as moderate. Nalbuphine 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. Both agents can cause sedation, and together they may produce marked drowsiness, dizziness and impaired thinking. Anticholinergic effects of nortriptyline, such as constipation and urinary retention, may also add to opioid effects.
How serious is the interaction between Nalbuphine 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: Start with low doses and titrate carefully, particularly in older adults. Monitor for oversedation, constipation and urinary retention.
What other medicines interact with Nalbuphine?
MediHelp also lists interactions of Nalbuphine with, for example, Alvimopan, Olanzapine / samidorphan, Alprazolam. The full list is on the Nalbuphine page.
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