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    HomeMedication GuideDrug InteractionsNortriptyline + Valproic Acid
    Moderate interaction

    Does Nortriptyline Interact With Valproic Acid?

    diazepam, ethosuximide, lamotrigine, phenytoin) by inhibiting their metabolism or protein binding displacement ( 7.2 ) Patients stabilized on rufinamide should begin valproate therapy at a low dose, and titrate to clinically effective dose ( 7.2 ) Dosage adjustment of amitriptyline/nortriptyline, propofol, warfarin, and zidovudine may be necessary if used concomitantly with valproic acid ( 7.2 ) Topiramate: Hyperammonemia and encephalopathy ( 5.10 , 7.3 ) 7.1 Effects of Co-Administered Drugs …

    Reviewed by the OmniRx Health clinical team•Last reviewed Jul 4, 2026

    Severity: Moderate

    Severity basis: drug interactions section (keywords: dosage adjustment, may increase). Combining Nortriptyline (Tricyclic antidepressant) and Valproic Acid (Anticonvulsant / mood stabilizer) is classified as a moderate interaction.

    What to Do

    Use this combination with caution. Your prescriber may monitor you more closely or adjust doses.

    How This Interaction Works

    Interactions like this one can happen when two medicines have overlapping effects, or when one changes how the other is absorbed, broken down, or cleared from the body. Nortriptyline is a tricyclic antidepressant and Valproic Acid is a anticonvulsant / mood stabilizer; together they are documented as a moderate interaction. How much this matters depends on your dose, your other medications, and your overall health.

    If You Take Both Medications

    If you have been prescribed both Nortriptyline and Valproic Acid, do not start, stop, or change either medication on your own — some medicines are unsafe to stop suddenly. Tell your prescriber and pharmacist that you take both so they can decide whether the combination is right for you, adjust the dose, monitor you more closely, or suggest an alternative.

    From the FDA Label

    diazepam, ethosuximide, lamotrigine, phenytoin) by inhibiting their metabolism or protein binding displacement ( 7.2 ) Patients stabilized on rufinamide should begin valproate therapy at a low dose, and titrate to clinically effective dose ( 7.2 ) Dosage adjustment of amitriptyline/nortriptyline, propofol, warfarin, and zidovudine may be necessary if used concomitantly with valproic acid ( 7.2 ) Topiramate: Hyperammonemia and encephalopathy ( 5.10 , 7.3 ) 7.1 Effects of Co-Administered Drugs …

    Source: FDA structured product labeling (set_id 1286ab49-fa34-488e-e063-6394a90ad582).

    Nortriptyline

    Tricyclic antidepressant

    Brands: Pamelor

    View Nortriptyline safety profile

    Valproic Acid

    Anticonvulsant / mood stabilizer

    Brands: Depakote, Depakene

    View Valproic Acid safety profile

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

    Frequently Asked Questions

    Can you take Nortriptyline and Valproic Acid together?

    Nortriptyline and Valproic Acid have a documented moderate interaction. Use this combination with caution. Your prescriber may monitor you more closely or adjust doses.

    How serious is the Nortriptyline and Valproic Acid interaction?

    It is classified as a moderate interaction, based on the FDA label's drug interactions section (keywords: dosage adjustment, may increase). A moderate interaction can be clinically meaningful and usually calls for monitoring or a dose adjustment.

    What should I do if I'm taking both Nortriptyline and Valproic Acid?

    If you have been prescribed both Nortriptyline and Valproic Acid, do not start, stop, or change either medication on your own — some medicines are unsafe to stop suddenly. Tell your prescriber and pharmacist that you take both so they can decide whether the combination is right for you, adjust the dose, monitor you more closely, or suggest an alternative.

    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.

    Questions About Your Medications?

    A licensed OmniRx provider can review your full medication list and help you understand what's safe for you — no office visit required.

    Sources & References

    Learn more about where our data comes from and how we write and review medical content.