Do not take nortriptyline with
- any of the other medicines listed in the table Medicines that may increase risk of serotonin toxicity, unless under careful medical supervision
- illegal drugs
- moclobemide and wait at least 2 days after stopping moclobemide before taking nortriptyline, because it may cause serotonin toxicity or a serious reaction with severe high blood pressure.
Tell your doctor if you are taking any of the following
Always tell your doctor about all other medicines you are taking, including over-the-counter and complementary or alternative medicines. You may need careful monitoring or a change in dose to avoid side effects if you are taking other medicines, including:
- cimetidine (Magicul, Tagamet), a medicine used to treat stomach ulcers and gastric reflux
- carbamazepine (Tegretol, Teril), a medicine used to treat epilepsy
- blood pressure medicines
- thyroid medicines
- cough and cold products including nose drops, such as those containing diphenhydramine (e.g. in some Benadryl products), chlorpheniramine (e.g. in some Demazin and Codral cold and flu products) and brompheniramine (e.g. in some Demazin and Dimetapp cough and cold products)
- antihistamines, medicines for allergy, hayfever or travel sickness (e.g. Travacalm)
- medicines to relieve stomach and bowel cramps or spasms, such as hyoscine (Buscopan, Donnatab, Kwells, Setacol, Stomex) and mebeverine (Colese, Colofac)
- antipsychotic medicines used to treat certain mental health conditions such as schizophrenia, e.g. olanzapine (e.g. Lanzek, Ozin, Zylap, Zypine, Zyprexa) and risperidone (e.g. Ozidal, Resdone, Risperdal)
- medicines used to control an irregular heart beat, such as flecainide (Tambocor, Flecatab)
- bupropion (Prexaton, Zyban), for quitting smoking
- antibiotics such as erythromycin (e.g. EES, Eryc) and clarithromycin (Clarac, Klacid)
- fluconazole (Caneserol, Diflucan One), for fungal infections.
Nortriptyline and alcohol
Nortriptyline can make the effects of alcohol stronger. Talk to your doctor about safe limits for you.
Who can I ask about interactions?
Call the NPS Medicines Line on 1300 MEDICINE (1300 633 424) to get information about your prescription, over-the-counter and complementary medicines (herbal, ‘natural’, vitamins and minerals) from a pharmacist. Your call will be answered by healthdirect Australia.
Find out more about
If you are starting nortriptyline, see 10 things you should know about antidepressants.
For more information
The consumer medicine information (CMI) for your brand of nortriptyline is available from our website or a pharmacist. If you have any concerns about interactions, talk to your health professional. The CMI includes:
- how to take this medicine
- what to do if you forget to take it
- if you take too much (overdose)
- things you must and must not do while taking this medicine
- signs of severe reactions and what to do.
- Rossi S, ed. eAMH [online]. Adelaide: Australian Medicines Handbook, 2012. www.amh.net.au. (Accessed 9 February 2012).
- Psychotropic Expert Group. Therapeutic Guidelines: Psychotropic, Version 6. In: eTG complete [CD-ROM]. Melbourne: Therapeutic Guidelines Limited; 2008.
- Aspen Pharmacare Australia Pty Ltd. Allegron consumer medicine information. January 2005. (Accessed 22 March 2012).