Drug interactions
Netupitant-palonosetron + Nortriptyline
Severity: Moderate
Netupitant-palonosetron 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
Serotonin syndrome has been reported with 5-HT3 antagonists and tricyclics such as nortriptyline. Netupitant may also modestly increase tricyclic exposure, and both have QT effects.
What this interaction means in plain words
Netupitant-palonosetron 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.
Netupitant-palonosetron belongs to Gastrointestinal Tract; Nortriptyline belongs to Central Nervous System.
Why it happens
Additive serotonergic effects with possible minor CYP-mediated and QT contributions.
What to do
Monitor for serotonin syndrome and consider an ECG in patients with cardiac risk factors.
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 Netupitant-palonosetron
- Apomorphine + Netupitant-palonosetron Contraindicated
- Flibanserin + Netupitant-palonosetron Contraindicated
- Apalutamide + Netupitant-palonosetron Major
- Avapritinib + Netupitant-palonosetron Major
- Carbamazepine + Netupitant-palonosetron Major
- Cobimetinib + Netupitant-palonosetron 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 Netupitant-palonosetron with Nortriptyline?
MediHelp rates the interaction as moderate. Netupitant-palonosetron 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. Serotonin syndrome has been reported with 5-HT3 antagonists and tricyclics such as nortriptyline. Netupitant may also modestly increase tricyclic exposure, and both have QT effects.
How serious is the interaction between Netupitant-palonosetron 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 for serotonin syndrome and consider an ECG in patients with cardiac risk factors.
What other medicines interact with Netupitant-palonosetron?
MediHelp also lists interactions of Netupitant-palonosetron with, for example, Apomorphine, Flibanserin, Apalutamide. The full list is on the Netupitant-palonosetron page.
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