Drug interactions
Nortriptyline + Sertraline
Severity: Moderate
Nortriptyline and Sertraline: 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
Sertraline mildly inhibits CYP2D6 and can raise nortriptyline levels, particularly at higher doses. Both drugs are serotonergic and may add to QT effects, so serotonin syndrome and arrhythmia are possible.
What this interaction means in plain words
Nortriptyline and Sertraline 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; Sertraline belongs to Central Nervous System.
Why it happens
Additive serotonergic effects with modest CYP2D6 inhibition by sertraline.
What to do
Monitor for serotonin toxicity and consider nortriptyline plasma levels and an ECG. Adjust the tricyclic dose as needed.
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 Sertraline
- Isocarboxazid + Sertraline Contraindicated
- Methylene blue + Sertraline Contraindicated
- Phenelzine + Sertraline Contraindicated
- Pimozide + Sertraline Contraindicated
- Selegiline transdermal + Sertraline Contraindicated
- Selegiline + Sertraline Contraindicated
Frequently asked questions
Can I take Nortriptyline with Sertraline?
MediHelp rates the interaction as moderate. Nortriptyline and Sertraline 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. Sertraline mildly inhibits CYP2D6 and can raise nortriptyline levels, particularly at higher doses. Both drugs are serotonergic and may add to QT effects, so serotonin syndrome and arrhythmia are possible.
How serious is the interaction between Nortriptyline and Sertraline?
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 serotonin toxicity and consider nortriptyline plasma levels and an ECG. Adjust the tricyclic dose as needed.
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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