Drug interactions
Nortriptyline + Pilocarpine
Severity: Moderate
Nortriptyline and Pilocarpine: 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
Nortriptyline's anticholinergic effects can oppose the muscarinic agonist action of pilocarpine. This may reduce its effect on dry mouth or intraocular pressure.
What this interaction means in plain words
Nortriptyline and Pilocarpine 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; Pilocarpine belongs to Miscellaneous.
Why it happens
Pharmacodynamic antagonism between muscarinic blockade and muscarinic agonism.
What to do
Monitor for reduced pilocarpine effect, such as persistent dry mouth. Consider a less anticholinergic antidepressant if efficacy is lost.
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 Pilocarpine
- Amitriptyline + Pilocarpine Moderate
- Atenolol-chlorthalidone + Pilocarpine Moderate
- Atenolol + Pilocarpine Moderate
- Atropine + Pilocarpine Moderate
- Betaxolol + Pilocarpine Moderate
- Bethanechol + Pilocarpine Moderate
Frequently asked questions
Can I take Nortriptyline with Pilocarpine?
MediHelp rates the interaction as moderate. Nortriptyline and Pilocarpine 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's anticholinergic effects can oppose the muscarinic agonist action of pilocarpine. This may reduce its effect on dry mouth or intraocular pressure.
How serious is the interaction between Nortriptyline and Pilocarpine?
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 reduced pilocarpine effect, such as persistent dry mouth. Consider a less anticholinergic antidepressant if efficacy is lost.
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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