Does Nortriptyline Interact With Rifampin?

Decrease exposure Selective 5-HT3 Receptor Antagonists Ondansetron Decrease exposure Statins Metabolized by CYP3A4 Simvastatin Decrease exposure Thiazolidinediones Rosiglitazone Decrease AUC by 66% Tricyclic Antidepressants Nortriptyline A tuberculosis treatment regimen including rifampin (600 mg/day), isoniazid (300 mg/day), pyrazinamide (500 mg 3× per day), and pyridoxine (25 mg) was associated with higher than expected doses of nortriptyline were required to obtain a therapeutic drug level.

Severity: Minor

Severity basis: drug interactions section. Combining Nortriptyline (Tricyclic antidepressant) and Rifampin (Rifamycin antibiotic (strong CYP3A4 inducer)) is classified as a minor interaction.

What to Do

This is generally a minor interaction, but review it with your pharmacist to be sure it is safe for you.

From the FDA Label

Decrease exposure Selective 5-HT3 Receptor Antagonists Ondansetron Decrease exposure Statins Metabolized by CYP3A4 Simvastatin Decrease exposure Thiazolidinediones Rosiglitazone Decrease AUC by 66% Tricyclic Antidepressants Nortriptyline A tuberculosis treatment regimen including rifampin (600 mg/day), isoniazid (300 mg/day), pyrazinamide (500 mg 3× per day), and pyridoxine (25 mg) was associated with higher than expected doses of nortriptyline were required to obtain a therapeutic drug level.

Source: FDA structured product labeling (set_id 036ab68e-5085-4edc-bd83-784b43d64eab).

Nortriptyline

Tricyclic antidepressant

Brands: Pamelor

View Nortriptyline safety profile

Rifampin

Rifamycin antibiotic (strong CYP3A4 inducer)

Brands: Rifadin

View Rifampin safety profile

Check these against your full medication list in our free Interaction Checker

This information is educational — not medical advice.

This page is provided for general educational purposes and summarizes publicly available data from sources such as the U.S. Food & Drug Administration. It is not a substitute for the judgment of a licensed clinician and should not be used to start, stop, or change any medication. It may be incomplete or out of date, and individual circumstances vary. Always talk with your prescriber or pharmacist about your specific medications and health conditions. If you think you may have a medical emergency, call 911.

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