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What the FDA labels say about taking them together

Carbamazepine and nortriptyline

Carbamazepine's FDA label of August 20, 2026 names nortriptyline in its contraindications section; the nortriptyline label PlainMeds reads does not name carbamazepine. The carbamazepine label: “… compounds, such as amitriptyline, desipramine, imipramine, protriptyline, nortriptyline, etc. Likewise, on theoretical grounds its use with monoamine oxidase (MAO) inhibitors is not recommended.”

Check it at the source: the carbamazepine FDA label on DailyMed (effective August 20, 2026, Novartis Pharmaceuticals Corporation); the nortriptyline FDA label on DailyMed (effective December 4, 2024).

What does the carbamazepine label say about nortriptyline?

Carbamazepine label, contraindications

CONTRAINDICATIONS Tegretol should not be used in patients with a history of previous bone marrow depression, hypersensitivity to the drug, or known sensitivity to any of the tricyclic compounds, such as amitriptyline, desipramine, imipramine, protriptyline, nortriptyline, etc. Likewise, on theoretical grounds its use with monoamine oxidase (MAO) inhibitors is not recommended.

Carbamazepine label, drug interactions

… paliperidone, phensuximide, phenytoin, praziquantel, protease inhibitors, risperidone, sertraline, sirolimus, tadalafil, theophylline, tiagabine, topiramate, tramadol, trazodone, tricyclic antidepressants (e.g., imipramine, amitriptyline, nortriptyline), valproate, warfarin, ziprasidone, zonisamide.

Carbatrol label (Takeda Pharmaceuticals America, Inc., August 17, 2026), contraindications

CONTRAINDICATIONS Carbamazepine should not be used in patients with a history of previous bone marrow depression, hypersensitivity to the drug, or known sensitivity to any of the tricyclic compounds, such as amitriptyline, desipramine, imipramine, protriptyline and nortriptyline.

Carbatrol label (Takeda Pharmaceuticals America, Inc., August 17, 2026), drug interactions

Acetaminophen, albendazole, alprazolam, aprepitant, buprenorphine, apixaban (6), bupropion, buspirone, citalopram, clobazam, clonazepam, clozapine, corticosteroids (e.g. prednisolone, dexamethasone), cyclosporin, dabigatran (6), delavirdine, desipramine, diazepam, dicumarol, dihydropyridine calcium channel blockers (e.g., felodipine), doxycycline, edoxaban (6), eslicarbazepine, ethosuximide, everolimus, felbamate, haloperidol, imatinib, itraconazole, lamotrigine, levothyroxine, lorazepam, methadone, methsuximide, midazolam, mirtazapine, nefazodone, nortriptyline, olanzapine, oral and other hormonal contraceptives (2), oxcarbazepine, paliperidone, phenytoin (3), praziquantel, protease …

Equetro label (Validus Pharmaceuticals LLC, August 19, 2025), contraindications

Known hypersensitivity to any of the tricyclic compounds (e.g., amitriptyline, desipramine, imipramine, protriptyline, and nortriptyline.) Hypersensitivity reactions include anaphylaxis and serious rash.

Equetro label (Validus Pharmaceuticals LLC, August 19, 2025), drug interactions

… contraceptives, oxcarbazepine, paliperidone, phenytoin, praziquantel, quetiapine, risperidone, sertraline, sirolimus, tadalafil, theophylline, topiramate, tiagabine, tramadol, triazolam, tricyclic antidepressants (e.g., imipramine, amitriptyline, nortriptyline), trazodone, valproate, warfarin, ziprasidone, and zonisamide.

Source: FDA drug label (Carbatrol, NDA020712), Takeda Pharmaceuticals America, Inc., effective August 17, 2026 (SPL set bc03e499-5bac-4293-bff4-6864153a624d), via openFDA

Source: FDA drug label (Tegretol), Novartis Pharmaceuticals Corporation, effective August 20, 2026 (SPL set 8d409411-aa9f-4f3a-a52c-fbcb0c3ec053), via openFDA; the full label on DailyMed

What does the nortriptyline label say about carbamazepine?

Nortriptyline's label (effective December 4, 2024) does not name carbamazepine in these sections. A label lists what its studies and reports found; it is not a complete list.

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

42Carbamazepine generic labelers
25Nortriptyline generic labelers
CarbamazepineNortriptyline
Labeled forBipolar disorder, Seizures and epilepsyDepression
Boxed warningYesYes
Pharmacy cost (NADAC)$0.119 per tablet 200 mg tablet$0.113 per capsule 10 mg capsule
Shortage nowA presentation being discontinuedNo current entry

Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)

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