Drug Interactions between nortriptyline and Symbyax

Talk to your doctor before using nortriptyline and FLUoxetine. This combination may cause sedation, dry mouth, blurred vision, constipation, and urinary retention. In addition, combining these medications can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. In general, you should wait at least 14 days after stopping nortriptyline before you start treatment with FLUoxetine. Conversely, if you have recently been on FLUoxetine and are now starting treatment with nortriptyline, you should check with your doctor or pharmacist to see how long you should wait before it is safe for you to use nortriptyline, as some antidepressants can take a while to clear from your body. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using your medications without first talking to your doctor.

Using nortriptyline together with OLANZapine may increase side effects such as drowsiness, blurred vision, dry mouth, heat intolerance, flushing, decreased sweating, difficulty urinating, abdominal cramping, constipation, irregular heartbeat, confusion, and memory problems. Side effects may be more likely to occur in the elderly or those with a debilitating condition. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Using OLANZapine together with FLUoxetine can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.