Nortriptyline and Terbinafine: Drug Interaction Guide
Quick answer: This combination requires caution. Nortriptyline and Terbinafine can be used together with adjustments and monitoring.
How Nortriptyline interacts with Terbinafine
Terbinafine is a strong CYP2D6 inhibitor with a long elimination half-life. Co-administration raises nortriptyline exposure substantially, increasing anticholinergic and cardiac toxicity.
What you should do
Reduce nortriptyline dose by 50% and monitor for sedation, dry mouth and ECG changes. Effect persists for weeks after stopping terbinafine.
Key facts
Severity
Moderate — caution required
Mechanism
Terbinafine is a strong CYP2D6 inhibitor with a long elimination half-life. Co-administration raises nortriptyline expos...
Action
Reduce nortriptyline dose by 50% and monitor for sedation, dry mouth and ECG changes. Effect persists for weeks after st...
Frequently asked questions
Can I take Nortriptyline and Terbinafine together?
With caution. Reduce nortriptyline dose by 50% and monitor for sedation, dry mouth and ECG changes. Effect persists for weeks after stopping terbinafine.
What is the severity of this interaction?
The interaction between Nortriptyline and Terbinafine is classified as Moderate — caution required. Terbinafine is a strong CYP2D6 inhibitor with a long elimination half-life. Co-administration raises nortriptyline exposure substantially, increasing anticholinergic and cardiac toxicity.
What should I do if I'm prescribed both?
Reduce nortriptyline dose by 50% and monitor for sedation, dry mouth and ECG changes. Effect persists for weeks after stopping terbinafine. Always consult your prescribing clinician — do not stop or change medications without medical guidance.
Last reviewed: by iMedic Medical Editorial Team. Our editorial process.