Drug interactions
Nortriptyline + Olanzapine
Severity: Moderate
Nortriptyline and Olanzapine: 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 drugs cause sedation and can prolong the QT interval, and both have anticholinergic effects. Combined use may increase drowsiness, anticholinergic effects and arrhythmia risk, particularly with other risk factors.
What this interaction means in plain words
Nortriptyline and Olanzapine 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.
Nortriptyline belongs to Central Nervous System; Olanzapine belongs to Central Nervous System.
Why it happens
Additive CNS depression, anticholinergic effects and QT prolongation through pharmacodynamic synergy.
What to do
Obtain a baseline ECG and correct potassium and magnesium abnormalities. Monitor for sedation, anticholinergic effects and QTc changes, and use the lowest effective doses.
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 Olanzapine
Frequently asked questions
Can I take Nortriptyline with Olanzapine?
MediHelp rates the interaction as moderate. Nortriptyline and Olanzapine 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 drugs cause sedation and can prolong the QT interval, and both have anticholinergic effects. Combined use may increase drowsiness, anticholinergic effects and arrhythmia risk, particularly with other risk factors.
How serious is the interaction between Nortriptyline and Olanzapine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain a baseline ECG and correct potassium and magnesium abnormalities. Monitor for sedation, anticholinergic effects and QTc changes, and use the lowest effective doses.
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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