Drug interactions
Nortriptyline + Tolbutamide
Severity: Minor
Nortriptyline and Tolbutamide: minor 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
Tricyclic antidepressants have been reported to alter glycemic control, and nortriptyline may modestly enhance the glucose-lowering effect of sulfonylureas such as tolbutamide. Clinically significant hypoglycemia is uncommon but possible, particularly in patients with tight control.
What this interaction means in plain words
Nortriptyline and Tolbutamide have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Nortriptyline belongs to Central Nervous System; Tolbutamide belongs to Endocrine.
Why it happens
Possible additive pharmacodynamic effect on glucose homeostasis; the mechanism is not well established.
What to do
Monitor blood glucose when nortriptyline is started or stopped in a patient taking tolbutamide, and adjust the sulfonylurea dose if glucose control changes.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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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 Tolbutamide
- Glyburide-metformin + Tolbutamide Major
- Insulin degludec-liraglutide + Tolbutamide Major
- Aceclofenac + Tolbutamide Moderate
- Acemetacin + Tolbutamide Moderate
- Acetylsalicylic acid + Tolbutamide Moderate
- Albiglutide + Tolbutamide Moderate
Frequently asked questions
Can I take Nortriptyline with Tolbutamide?
MediHelp rates the interaction as minor. Nortriptyline and Tolbutamide have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Tricyclic antidepressants have been reported to alter glycemic control, and nortriptyline may modestly enhance the glucose-lowering effect of sulfonylureas such as tolbutamide. Clinically significant hypoglycemia is uncommon but possible, particularly in patients with tight control.
How serious is the interaction between Nortriptyline and Tolbutamide?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood glucose when nortriptyline is started or stopped in a patient taking tolbutamide, and adjust the sulfonylurea dose if glucose control changes.
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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