Drug interactions
Nortriptyline + Suvorexant
Severity: Moderate
Nortriptyline and Suvorexant: 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
Suvorexant and nortriptyline both cause sedation, so combined use can increase daytime drowsiness and impair psychomotor performance and next-day driving. Falls risk is greater in older adults.
What this interaction means in plain words
Nortriptyline and Suvorexant 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; Suvorexant belongs to Central Nervous System.
Why it happens
Additive CNS depression from orexin receptor antagonism and sedative antihistaminic effects of nortriptyline.
What to do
Use the lowest effective suvorexant dose and monitor for excessive sedation and impaired alertness. Counsel the patient about driving and avoid alcohol.
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 Suvorexant
Frequently asked questions
Can I take Nortriptyline with Suvorexant?
MediHelp rates the interaction as moderate. Nortriptyline and Suvorexant 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. Suvorexant and nortriptyline both cause sedation, so combined use can increase daytime drowsiness and impair psychomotor performance and next-day driving. Falls risk is greater in older adults.
How serious is the interaction between Nortriptyline and Suvorexant?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective suvorexant dose and monitor for excessive sedation and impaired alertness. Counsel the patient about driving and avoid alcohol.
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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