Drug interactions
Nortriptyline + Posaconazole
Severity: Major
Nortriptyline and Posaconazole: 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
Both drugs can prolong the QT interval, so combined use raises the risk of torsades de pointes. Posaconazole may also raise nortriptyline levels through inhibition of CYP3A4.
What this interaction means in plain words
Nortriptyline and Posaconazole 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.
Nortriptyline belongs to Central Nervous System; Posaconazole belongs to Anti Fungals.
Why it happens
Additive QT prolongation, with possible metabolic inhibition raising nortriptyline exposure.
What to do
Check a baseline ECG and correct electrolytes, then monitor the QTc during co-therapy. Consider checking nortriptyline levels or choosing an alternative agent if risk factors are present.
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 Posaconazole
- Artemether + Posaconazole Contraindicated
- Avanafil + Posaconazole Contraindicated
- Cobimetinib + Posaconazole Contraindicated
- Conivaptan + Posaconazole Contraindicated
- Dihydroergotamine intranasal + Posaconazole Contraindicated
- Dihydroergotamine + Posaconazole Contraindicated
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 Posaconazole?
MediHelp rates the interaction as major. Nortriptyline and Posaconazole 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. Both drugs can prolong the QT interval, so combined use raises the risk of torsades de pointes. Posaconazole may also raise nortriptyline levels through inhibition of CYP3A4.
How serious is the interaction between Nortriptyline and Posaconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check a baseline ECG and correct electrolytes, then monitor the QTc during co-therapy. Consider checking nortriptyline levels or choosing an alternative agent if risk factors are present.
What other medicines interact with Posaconazole?
MediHelp also lists interactions of Posaconazole with, for example, Artemether, Avanafil, Cobimetinib. The full list is on the Posaconazole page.
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