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Nortriptyline + Tropicamide + Phenylephrine Hydrochloride

Major 11 published sources

This interaction is documented in this data source.

Nortriptyline
Checked as Nortriptyline
Tropicamide + Phenylephrine Hydrochloride
Checked as Tropicamide + Phenylephrine

What is documented

  1. Synergy

    Major

    via Nortriptyline and Phenylephrine

    What happens

    Tricyclic antidepressants (TCAs) may markedly enhance the pressor response to parenteral direct-acting sympathomimetic agents and vasoconstrictor-containing local anesthetics.

    What to do

    Parenteral administration of direct-acting sympathomimetic agents should preferably be avoided during therapy with tricyclic antidepressants except in cases of emergency (e.g., treatment of anaphylaxis). If concomitant use is necessary, initial dose and rate of administration of the sympathomimetic should be reduced, and cardiovascular status including blood pressure should be monitored closely. Although clinical data are lacking, it may be prudent to follow the same precaution with mixed-acting sympathomimetic agents.

    11 sources

    1. Borg KO, Johnsson G, Jordo L, Lundborg P, Ronn O, Welin-Fogelberg I "Interaction studies between three antidepressant drugs (zimelidine, imipramine and chlorimipramine) and noradrenaline in healthy volunteers and some pharmacokinetics of the drugs studied." Acta Pharmacol Toxicol (Copenh) 45 (1979): 198-205
    2. Ghose K "Sympathomimetic amines and tricyclic antidepressant drugs." Neuropharmacology 19 (1980): 1251-4
    3. Fritz H, Hagstam KE, Lindqvist B "Local skin necrosis after intravenous infusion of norepinephrine, and the concept of endotoxinaemia. A clinical study on 10 cases." Acta Med Scand 178 (1965): 403-16
    4. Boakes AJ, Laurence DR, Teoh PC, Barar FS, Benedikter LT, Pritchard BN "Interactions between sympathomimetic amines and antidepressant agents in man." Br Med J 1 (1973): 311-5
    5. Goulet JP, Perusse R, Turcotte JY "Contraindications to vasoconstrictors in dentistry: Part III. Pharmacologic interactions." Oral Surg Oral Med Oral Pathol 74 (1992): 692-7
    6. Boakes AJ. Vasoconstrictors in local anaesthetics and tricyclic antidepressants. In: Grahame-Smith, DG, ed. "Drug Interactions. QV 38 D7932 1975." Baltimore, MD: University Park Press (1977): 275-83
    7. Svedmyr N "The influence of a tricyclic antidepressive agent (protriptyline) on some of the circulatory effects of noradrenaline and adrenaline in man." Life Sci 7 (1968): 77-84
    8. Linnoila M, Karoum F, Calil HM, Kopin IJ, Potter WZ "Alteration of norepinephrine metabolism with desipramine and zimelidine in depressed patients." Arch Gen Psychiatry 39 (1982): 1025-8
    Show all 11 sources
    1. Niemegeers CJ, Lenaerts FM, Artois KS, Janssen PA "Interaction of drugs with apomorphine, tryptamine and norepinephrine. A new 'in vivo' approach: the ATN-test in rats." Arch Int Pharmacodyn Ther 227 (1977): 238-53
    2. Mitchell JR, Cavanaugh JH, Arias L, Oates JA "Guanethidine and related agents. III: antagonism by drugs which inhibit the norepinephrine pump in man." J Clin Invest 49 (1970): 1596-604
    3. Teba L, Schiebel F, Dedhia HV, Lazzell VA "Beneficial effect of norepinephrine in the treatment of circulatory shock caused by tricyclic antidepressant overdose." Am J Emerg Med 6 (1988): 566-8

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