Drug interactions
Nortriptyline + Tipranavir
Severity: Moderate
Nortriptyline and Tipranavir: 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
Tipranavir, given with ritonavir, may raise nortriptyline concentrations, increasing anticholinergic effects, sedation and cardiac conduction effects. Effects may be unpredictable because ritonavir-boosted tipranavir has mixed inhibitory and inducing effects on enzymes.
What this interaction means in plain words
Nortriptyline and Tipranavir 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; Tipranavir belongs to Anti Virals.
Why it happens
Ritonavir-boosted tipranavir inhibits CYP2D6, reducing nortriptyline clearance.
What to do
Monitor for tricyclic toxicity and consider nortriptyline serum level monitoring and dose reduction. Obtain an ECG if cardiac risk factors are present.
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 Tipranavir
- Alfuzosin + Tipranavir Contraindicated
- Amiodarone + Tipranavir Contraindicated
- Atorvastatin + Tipranavir Contraindicated
- Avanafil + Tipranavir Contraindicated
- Cisapride + Tipranavir Contraindicated
- Colchicine + Tipranavir Contraindicated
Frequently asked questions
Can I take Nortriptyline with Tipranavir?
MediHelp rates the interaction as moderate. Nortriptyline and Tipranavir 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. Tipranavir, given with ritonavir, may raise nortriptyline concentrations, increasing anticholinergic effects, sedation and cardiac conduction effects. Effects may be unpredictable because ritonavir-boosted tipranavir has mixed inhibitory and inducing effects on enzymes.
How serious is the interaction between Nortriptyline and Tipranavir?
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 for tricyclic toxicity and consider nortriptyline serum level monitoring and dose reduction. Obtain an ECG if cardiac risk factors are present.
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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