Taking nortriptyline with other medicines and herbal supplements

Cautions with other medicines

Some medicines affect the way nortriptyline works and can increase the chance of you having side effects. These include:

• opioid-based medicines, like codeine, morphine, oxycodone , or tramadol – taking these with nortriptyline can increase your risk of becoming very drowsy and having breathing problems
• medicines for depression – some antidepressants can affect the way nortriptyline works and cause very high blood pressure. This can happen even after you have stopped taking them, so tell your doctor if you are taking, or have ever taken, other antidepressants
• sodium valproate and valproic acid (epilepsy medicines), and cimetidine (for stomach ulcers) – these can increase the levels of nortriptyline in your body and increase the risk of side effect.

Always check with your doctor or a pharmacist before taking nortriptyline with any other medicines.

Mixing nortriptyline with herbal remedies and supplements

Do not take St John's wort, the herbal remedy for depression, while you're being treated with nortriptyline. It will increase your risk of side effects.

There's not enough information to say that other complementary medicines, herbal remedies and supplements are safe to take with nortriptyline. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.