What the FDA labels say about taking them together
Fluoxetine and nortriptyline
Nortriptyline's FDA label of December 4, 2024 names fluoxetine in its drug interactions section; fluoxetine's label does not name nortriptyline itself but warns about its class (Tricyclic antidepressants). The nortriptyline label: “While all the selective serotonin reuptake inhibitors (SSRIs), e.g., fluoxetine, sertraline, and paroxetine, inhibit P450 2D6, they may vary in the extent of inhibition.”
Check it at the source: the fluoxetine FDA label on DailyMed (effective January 8, 2026, Dista Products Company); the nortriptyline FDA label on DailyMed (effective December 4, 2024).
What does the fluoxetine label say about nortriptyline?
Fluoxetine's label does not name nortriptyline itself; it warns about its class (Tricyclic antidepressants):
Fluoxetine label, drug interactionsThe concomitant use of serotonergic drugs (including other SSRIs, SNRIs, triptans, tricyclic antidepressants, opioids, lithium, buspirone, amphetamines, tryptophan, and St. John's Wort) with PROZAC increases the risk of serotonin syndrome.
Fluoxetine label, warnings and precautionsThe risk is increased with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, meperidine, methadone, buspirone, amphetamines, and St. John's Wort) and with drugs that impair metabolism of serotonin, i.e., MAOIs [see Contraindications ( 4 ), Drug Interactions ( 7.1 )].
Source: FDA drug label (Prozac), NDA018936 (Eli Lilly And Co), as published by Dista Products Company, effective January 8, 2026 (SPL set c88f33ed-6dfb-4c5e-bc01-d8e36dd97299), via openFDA; the full label on DailyMed
What does the nortriptyline label say about fluoxetine?
Nortriptyline label, drug interactionsWhile all the selective serotonin reuptake inhibitors (SSRIs), e.g., fluoxetine, sertraline, and paroxetine, inhibit P450 2D6, they may vary in the extent of inhibition.
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
| Fluoxetine | Nortriptyline | |
|---|---|---|
| Labeled for | Depression, Anxiety, Bipolar disorder | Depression |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | $0.0519 per capsule 40 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