Drug interactions
Nortriptyline + Tacrolimus
Severity: Moderate
Nortriptyline and Tacrolimus: 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
Both drugs can prolong the QT interval, so together they may increase arrhythmia risk, particularly with electrolyte abnormalities. Nortriptyline may also affect tacrolimus handling in some patients.
What this interaction means in plain words
Nortriptyline and Tacrolimus 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; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive QT prolongation through pharmacodynamic effects.
What to do
Monitor ECG and keep potassium and magnesium within normal range. Check tacrolimus trough levels if the antidepressant is started or changed.
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 Tacrolimus
- Adenovirus types 4 and 7 live + Tacrolimus Contraindicated
- Bcg vaccine live + Tacrolimus Contraindicated
- Cidofovir + Tacrolimus Contraindicated
- Cyclosporin + Tacrolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Tacrolimus Contraindicated
- Measles mumps and rubella vaccine live + Tacrolimus Contraindicated
Frequently asked questions
Can I take Nortriptyline with Tacrolimus?
MediHelp rates the interaction as moderate. Nortriptyline and Tacrolimus 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. Both drugs can prolong the QT interval, so together they may increase arrhythmia risk, particularly with electrolyte abnormalities. Nortriptyline may also affect tacrolimus handling in some patients.
How serious is the interaction between Nortriptyline and Tacrolimus?
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 ECG and keep potassium and magnesium within normal range. Check tacrolimus trough levels if the antidepressant is started or changed.
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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