What the FDA labels say about taking them together
Duloxetine and nortriptyline
Duloxetine's FDA label of May 14, 2024 names nortriptyline in its drug interactions section; nortriptyline's label does not name duloxetine itself but warns about its class (SNRIs (serotonin and norepinephrine reuptake inhibitors)).
Check it at the source: the duloxetine FDA label on DailyMed (effective May 14, 2024, SUN PHARMACEUTICAL INDUSTRIES, INC.); the nortriptyline FDA label on DailyMed (effective December 4, 2024).
What does the duloxetine label say about nortriptyline?
Duloxetine label, drug interactionsExamples; TCAs (nortriptyline, amitriptyline, imipramine, desipramine); phenothiazines (thioridazine); Type 1C antiarrhythmics (propafenone, flecainide)
Duloxetine label, warnings and precautionsPotential for DRIZALMA SPRINKLE to Affect Other Drugs Drugs Metabolized by CYP2D6 - Co-administration of DRIZALMA SPRINKLE with drugs that are extensively metabolized by CYP2D6 and that have a narrow therapeutic index, including certain antidepressants (tricyclic antidepressants [TCAs], such as nortriptyline, amitriptyline, and imipramine), phenothiazines and Type 1C antiarrhythmics (e.g., propafenone, flecainide), should be approached with caution.
Source: FDA drug label (DRIZALMA SPRINKLE), SUN PHARMACEUTICAL INDUSTRIES, INC., effective May 14, 2024 (SPL set b41423b8-dfec-4d79-ba3c-e43a87803d85), via openFDA; the full label on DailyMed
What does the nortriptyline label say about duloxetine?
Nortriptyline's label does not name duloxetine itself; it warns about its class (SNRIs (serotonin and norepinephrine reuptake inhibitors)):
Nortriptyline label, warningsSerotonin Syndrome The development of a potentially life-threatening serotonin syndrome has been reported with SNRIs and SSRIs, including Pamelor, alone but particularly with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, and St. …
Source: FDA drug label (PAMELOR), SpecGx LLC, effective December 4, 2024 (SPL set e17dc299-f52d-414d-ab6e-e809bd6f8acb), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Duloxetine | Nortriptyline | |
|---|---|---|
| Labeled for | Depression, Anxiety, Nerve pain and fibromyalgia, Pain | Depression |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | $0.102 per capsule 30 mg capsule | $0.113 per capsule 10 mg capsule |
| Shortage now | No current entry | No current entry |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once