Drug interactions
Nortriptyline + Tolterodine
Severity: Moderate
Nortriptyline and Tolterodine: 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 have anticholinergic activity, so combining them can intensify dry mouth, constipation, urinary retention, blurred vision and confusion, especially in older adults. Nortriptyline may also inhibit CYP2D6 modestly.
What this interaction means in plain words
Nortriptyline and Tolterodine 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; Tolterodine belongs to Genitourinary.
Why it happens
Additive antimuscarinic effects, with possible minor CYP2D6 inhibition by nortriptyline.
What to do
Monitor for anticholinergic toxicity, cognitive changes and urinary retention, particularly in elderly patients. Reduce the dose or choose a non-anticholinergic alternative if symptoms develop.
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 Tolterodine
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 Tolterodine?
MediHelp rates the interaction as moderate. Nortriptyline and Tolterodine 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 have anticholinergic activity, so combining them can intensify dry mouth, constipation, urinary retention, blurred vision and confusion, especially in older adults. Nortriptyline may also inhibit CYP2D6 modestly.
How serious is the interaction between Nortriptyline and Tolterodine?
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 anticholinergic toxicity, cognitive changes and urinary retention, particularly in elderly patients. Reduce the dose or choose a non-anticholinergic alternative if symptoms develop.
What other medicines interact with Tolterodine?
MediHelp also lists interactions of Tolterodine with, for example, Clarithromycin, Clozapine, Cobicistat. The full list is on the Tolterodine page.
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