Drug interactions
Nortriptyline + Opium tincture
Severity: Major
Nortriptyline and Opium tincture: major 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
Opium tincture contains morphine, so combining it with nortriptyline increases sedation and may add to respiratory depression. Anticholinergic effects on gut and bladder can also be worsened, with greater risk of constipation and urinary retention.
What this interaction means in plain words
Nortriptyline and Opium tincture can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive CNS and respiratory depression, plus additive anticholinergic effects.
What to do
Use the lowest effective doses and monitor for sedation and slowed breathing. Counsel patients to avoid alcohol and other depressants.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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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
Frequently asked questions
Can I take Nortriptyline with Opium tincture?
MediHelp rates the interaction as major. Nortriptyline and Opium tincture can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Opium tincture contains morphine, so combining it with nortriptyline increases sedation and may add to respiratory depression. Anticholinergic effects on gut and bladder can also be worsened, with greater risk of constipation and urinary retention.
How serious is the interaction between Nortriptyline and Opium tincture?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective doses and monitor for sedation and slowed breathing. Counsel patients to avoid alcohol and other depressants.
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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