Drug interactions
Nalbuphine + Protriptyline
Severity: Moderate
Nalbuphine and Protriptyline: 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
Tricyclic antidepressants can cause sedation and anticholinergic effects that add to opioid CNS depression. Protriptyline is less sedating than many tricyclics, so the effect is generally modest.
What this interaction means in plain words
Nalbuphine and Protriptyline 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.
Why it happens
Additive CNS depression from opioid receptor agonism and tricyclic antihistaminic and anticholinergic effects.
What to do
Monitor for increased drowsiness, confusion and constipation, and reduce doses if over-sedation occurs.
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
Frequently asked questions
Can I take Nalbuphine with Protriptyline?
MediHelp rates the interaction as moderate. Nalbuphine and Protriptyline 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. Tricyclic antidepressants can cause sedation and anticholinergic effects that add to opioid CNS depression. Protriptyline is less sedating than many tricyclics, so the effect is generally modest.
How serious is the interaction between Nalbuphine and Protriptyline?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for increased drowsiness, confusion and constipation, and reduce doses if over-sedation occurs.
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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