Drug interactions
Nortriptyline + Tetrabenazine
Severity: Major
Nortriptyline and Tetrabenazine: 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
Both drugs can prolong the QT interval, so combined use may raise the risk of ventricular arrhythmia such as torsades de pointes. Both may also cause sedation, and depression is a concern with tetrabenazine.
What this interaction means in plain words
Nortriptyline and Tetrabenazine 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.
Nortriptyline belongs to Central Nervous System; Tetrabenazine belongs to Central Nervous System.
Why it happens
Additive QT prolongation and CNS depression.
What to do
Obtain baseline and follow-up ECGs and correct potassium and magnesium. Avoid the combination in patients with long QT or other risk factors, or use an alternative antidepressant.
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
Other interactions of Tetrabenazine
- Dronedarone + Tetrabenazine Contraindicated
- Isocarboxazid + Tetrabenazine Contraindicated
- Linezolid + Tetrabenazine Contraindicated
- Phenelzine + Tetrabenazine Contraindicated
- Pimozide + Tetrabenazine Contraindicated
- Procarbazine + Tetrabenazine Contraindicated
Frequently asked questions
Can I take Nortriptyline with Tetrabenazine?
MediHelp rates the interaction as major. Nortriptyline and Tetrabenazine 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. Both drugs can prolong the QT interval, so combined use may raise the risk of ventricular arrhythmia such as torsades de pointes. Both may also cause sedation, and depression is a concern with tetrabenazine.
How serious is the interaction between Nortriptyline and Tetrabenazine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain baseline and follow-up ECGs and correct potassium and magnesium. Avoid the combination in patients with long QT or other risk factors, or use an alternative antidepressant.
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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