Drug interactions
Nortriptyline + Same
Severity: Moderate
Nortriptyline and Same: 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
S-adenosylmethionine (SAMe) may have serotonergic activity, and with a tricyclic antidepressant it could contribute to serotonin toxicity. Case reports are limited, but the combination may also alter antidepressant response.
What this interaction means in plain words
Nortriptyline and Same 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.
Why it happens
Possible additive serotonergic effects; the mechanism is not firmly established.
What to do
Avoid combining unless supervised, and counsel the patient on symptoms of serotonin toxicity such as agitation, tremor, sweating and hyperthermia. Stop SAMe if these occur.
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
Frequently asked questions
Can I take Nortriptyline with Same?
MediHelp rates the interaction as moderate. Nortriptyline and Same 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. S-adenosylmethionine (SAMe) may have serotonergic activity, and with a tricyclic antidepressant it could contribute to serotonin toxicity. Case reports are limited, but the combination may also alter antidepressant response.
How serious is the interaction between Nortriptyline and Same?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combining unless supervised, and counsel the patient on symptoms of serotonin toxicity such as agitation, tremor, sweating and hyperthermia. Stop SAMe if these occur.
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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