Drug interactions
Nortriptyline + Pitolisant
Severity: Moderate
Nortriptyline and Pitolisant: 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
Pitolisant works by increasing brain histamine release, while nortriptyline has strong central H1 antagonist activity. This may reduce pitolisant's wake-promoting effect. Both drugs also have QT-related liability.
What this interaction means in plain words
Nortriptyline and Pitolisant 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; Pitolisant belongs to Central Nervous System.
Why it happens
Pharmacodynamic antagonism of central histaminergic activity by the tricyclic's H1 blockade.
What to do
Monitor for loss of efficacy and consider an alternative to the tricyclic; check ECG if both are continued.
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 Pitolisant
- Alfuzosin + Pitolisant Major
- Amiodarone + Pitolisant Major
- Amisulpride + Pitolisant Major
- Anagrelide + Pitolisant Major
- Asenapine + Pitolisant Major
- Bupropion + Pitolisant Major
Frequently asked questions
Can I take Nortriptyline with Pitolisant?
MediHelp rates the interaction as moderate. Nortriptyline and Pitolisant 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. Pitolisant works by increasing brain histamine release, while nortriptyline has strong central H1 antagonist activity. This may reduce pitolisant's wake-promoting effect. Both drugs also have QT-related liability.
How serious is the interaction between Nortriptyline and Pitolisant?
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 loss of efficacy and consider an alternative to the tricyclic; check ECG if both are continued.
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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