Drug interactions
Nortriptyline + Rifabutin
Severity: Moderate
Nortriptyline and Rifabutin: 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
Rifabutin induces hepatic enzymes and may lower nortriptyline concentrations. This can reduce antidepressant effect, though induction is weaker than with rifampicin.
What this interaction means in plain words
Nortriptyline and Rifabutin 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; Rifabutin belongs to Anti Bacterial.
Why it happens
Induction of CYP-mediated metabolism of nortriptyline.
What to do
Monitor clinical response and consider nortriptyline plasma levels. Adjust the dose if response falls, and reassess after rifabutin is stopped.
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 Rifabutin
- Cabotegravir + Rifabutin Contraindicated
- Lorlatinib + Rifabutin Contraindicated
- Rifabutin + Voriconazole Contraindicated
- Apixaban + Rifabutin Major
- Axitinib + Rifabutin Major
- Brexpiprazole + Rifabutin Major
Frequently asked questions
Can I take Nortriptyline with Rifabutin?
MediHelp rates the interaction as moderate. Nortriptyline and Rifabutin 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. Rifabutin induces hepatic enzymes and may lower nortriptyline concentrations. This can reduce antidepressant effect, though induction is weaker than with rifampicin.
How serious is the interaction between Nortriptyline and Rifabutin?
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 clinical response and consider nortriptyline plasma levels. Adjust the dose if response falls, and reassess after rifabutin is stopped.
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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