Drug interactions
Nortriptyline + Tiotropium-olodaterol
Severity: Moderate
Nortriptyline and Tiotropium-olodaterol: 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
Nortriptyline has anticholinergic activity that adds to tiotropium, and tricyclics can prolong the QT interval and potentiate the cardiovascular effects of beta2-agonists. This may increase tachycardia, arrhythmias and anticholinergic adverse effects.
What this interaction means in plain words
Nortriptyline and Tiotropium-olodaterol 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; Tiotropium-olodaterol belongs to Respiratory.
Why it happens
Additive antimuscarinic effects plus additive cardiovascular and QT effects with the beta2-agonist.
What to do
Monitor heart rate, rhythm and anticholinergic symptoms, and obtain an ECG in patients with cardiac disease. The olodaterol label advises caution with tricyclic antidepressants.
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 Tiotropium-olodaterol
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 Tiotropium-olodaterol?
MediHelp rates the interaction as moderate. Nortriptyline and Tiotropium-olodaterol 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 has anticholinergic activity that adds to tiotropium, and tricyclics can prolong the QT interval and potentiate the cardiovascular effects of beta2-agonists. This may increase tachycardia, arrhythmias and anticholinergic adverse effects.
How serious is the interaction between Nortriptyline and Tiotropium-olodaterol?
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 heart rate, rhythm and anticholinergic symptoms, and obtain an ECG in patients with cardiac disease. The olodaterol label advises caution with tricyclic antidepressants.
What other medicines interact with Tiotropium-olodaterol?
MediHelp also lists interactions of Tiotropium-olodaterol with, for example, Amisulpride, Arformoterol, Arsenic trioxide. The full list is on the Tiotropium-olodaterol page.
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