Drug interactions
Nortriptyline + Sufentanil sl
Severity: Major
Nortriptyline and Sufentanil sl: 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
Sublingual sufentanil with nortriptyline may increase sedation and respiratory depression. Serotonin syndrome is also possible, as labeling warns for opioids with serotonergic drugs.
What this interaction means in plain words
Nortriptyline and Sufentanil sl 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.
Why it happens
Additive CNS and respiratory depression, with possible serotonergic effects from combining an opioid and a tricyclic.
What to do
Monitor sedation, respiration and signs of serotonin syndrome, especially at initiation and after dose changes. Reduce doses or choose alternatives if symptoms develop.
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 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 Sufentanil sl?
MediHelp rates the interaction as major. Nortriptyline and Sufentanil sl 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. Sublingual sufentanil with nortriptyline may increase sedation and respiratory depression. Serotonin syndrome is also possible, as labeling warns for opioids with serotonergic drugs.
How serious is the interaction between Nortriptyline and Sufentanil sl?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor sedation, respiration and signs of serotonin syndrome, especially at initiation and after dose changes. Reduce doses or choose alternatives if symptoms develop.
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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