Drug interactions
Nefopam + Nortriptyline
Severity: Moderate
Nefopam 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
Nefopam has anticholinergic and sympathomimetic properties and inhibits monoamine reuptake, so combining it with a tricyclic may increase tachycardia, dry mouth, urinary retention and seizure risk. Nefopam labeling advises caution with tricyclic antidepressants.
What this interaction means in plain words
Nefopam 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.
Nefopam belongs to Central Nervous System; Nortriptyline belongs to Central Nervous System.
Why it happens
Additive anticholinergic and monoaminergic effects, with possible lowering of seizure threshold.
What to do
Monitor heart rate and anticholinergic effects and use the lowest effective nefopam dose. Avoid in patients with seizure history or significant cardiac disease.
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 Nortriptyline
- Disopyramide + Nortriptyline Contraindicated
- Dofetilide + Nortriptyline Contraindicated
- Dronedarone + Nortriptyline Contraindicated
- Ibutilide + Nortriptyline Contraindicated
- Isocarboxazid + Nortriptyline Contraindicated
- Methylene blue + Nortriptyline Contraindicated
Other interactions of Nefopam
- Amitriptyline + Nefopam Moderate
- Clomipramine + Nefopam Moderate
- Desipramine + Nefopam Moderate
- Imipramine + Nefopam Moderate
- Maprotiline + Nefopam Moderate
- Nefopam + Trazodone Moderate
Frequently asked questions
Can I take Nefopam with Nortriptyline?
MediHelp rates the interaction as moderate. Nefopam 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. Nefopam has anticholinergic and sympathomimetic properties and inhibits monoamine reuptake, so combining it with a tricyclic may increase tachycardia, dry mouth, urinary retention and seizure risk. Nefopam labeling advises caution with tricyclic antidepressants.
How serious is the interaction between Nefopam 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: Monitor heart rate and anticholinergic effects and use the lowest effective nefopam dose. Avoid in patients with seizure history or significant cardiac disease.
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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