Cipralex (escitalopram) (Cipralex 10 mg) and Nortriptyline: interaction and safety
This source-based reference is not a personal treatment recommendation. The relevance and management of an interaction depend on the exact products, route, dose and clinical situation.
Interaction mechanism
Citalopram or escitalopram combined with a tricyclic antidepressant can increase QT-related cardiac risk. Other serotonergic medicines may increase serotonin-syndrome risk.
Clinical significance and safety
Cipralex (escitalopram) and Nortriptyline: Citalopram or escitalopram combined with a tricyclic antidepressant can increase QT-related cardiac risk. Other serotonergic medicines may increase serotonin-syndrome risk. The cited UK MHRA safety advice contraindicates citalopram or escitalopram with QT-prolonging medicines; it specifically includes the relevant antiarrhythmic or tricyclic class. Heart disease, a slow pulse and low potassium or magnesium can increase concern. A clinician determines whether ECG or electrolyte checks are needed. Fainting or new irregular palpitations require urgent assessment. Urgent assessment is needed for a new combination of agitation or confusion, fever, marked sweating, tremor or abnormal muscle movements. The warning does not provide a pair-specific incidence or establish that toxicity is inevitable.
Using this information
This is a source-based reference record, not a recommendation to combine, stop or change medicines. A missing interaction record does not establish safe use. A qualified healthcare professional should consider the exact products, doses, other medicines and individual health circumstances.