Drug Interaction Report

Talk to your doctor before using nortriptyline and PARoxetine. This combination may cause sedation, dry mouth, blurred vision, constipation, or urinary retention. You might also have altered consciousness, confusion, poor muscle coordination, abdominal cramping, shivering, pupil dilation, sweating, high blood pressure, and high heart rate. If you take both medications together, tell your doctor if you have any of these symptoms. You may need a dose adjustment or special test if you take both medications. 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.

Topiramate can cause increased body temperature and decreased sweating, and these effects may be worsened when combined with medications like nortriptyline. Heat stroke and hospitalization may occur in some people, especially in warm weather and during vigorous exercise. Children are particularly susceptible. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should drink plenty of fluids during warm weather and when exercising, and seek medical attention if you have decreased sweating or a fever. You may also experience drowsiness, dizziness, or lightheadedness when taking these medications together. Therefore, avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. 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.

Before taking verapamil, tell your doctor if you also use nortriptyline. You may need dose adjustments or special tests in order to safely take both medications together. This combination may increase the effects of nortriptyline. You should notify your doctor if you have symptoms of dry mouth, blurry vision, irregular or fast heartbeat, constipation, urine retention, dizziness, or a drop in blood pressure that is brought on by changes in body position. It is important that you tell your healthcare provider about all other medications that you are using including vitamins and herbs. Do not stop using your medications without first talking to your doctor.

Treatment with PARoxetine may occasionally cause blood sodium levels to get too low, a condition known as hyponatremia, and using it with some anticonvulsants can increase that risk. In addition, PARoxetine can cause seizures in susceptible patients, which may reduce the effectiveness of medications that are used to control seizures such as topiramate. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. You should seek medical attention if you experience nausea, vomiting, headache, lethargy, irritability, difficulty concentrating, memory impairment, confusion, muscle spasm, weakness or unsteadiness, as these may be symptoms of hyponatremia. More severe cases may lead to hallucination, fainting, seizure, coma, and even death. Also let your doctor know if you develop seizures or experience an increase in seizures during treatment with PARoxetine. Additionally, because these medications may cause dizziness, drowsiness, and impairment in judgment, reaction speed and motor coordination, you should avoid driving or operating hazardous machinery until you know how they affect you. 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.

You may take verapamil with or without food, but take it the same way every time. You should avoid consuming grapefruit or grapefruit juice as much as possible during treatment with verapamil. If you have been regularly consuming grapefruit or grapefruit juice with verapamil, do not increase or decrease the amounts of these products in your diet without first talking to your doctor. Grapefruit juice can increase the blood levels and effects of verapamil. Contact your doctor if you experience sudden, unexplained weight gain; swelling of the hands, ankles, or feet; chest pain; or difficulty breathing. Avoid driving or operating hazardous machinery until you know how the medication affects you, and use caution when getting up from a sitting or lying position. 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.

Alcohol can increase the nervous system side effects of PARoxetine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with PARoxetine. Do not use more than the recommended dose of PARoxetine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Ask your doctor before using verapamil together with ethanol (alcohol). Verapamil may increase the blood levels and intoxicating effects of ethanol (alcohol). This can cause symptoms of extreme drowsiness, confusion, and nausea. If you experience any of these side effect you should avoid activities requiring mental alertness. 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.

Ask your doctor before using nortriptyline together with ethanol (alcohol), this can alter the effects of nortriptyline and cause increased side effects. Call the doctor if you experience uneven heartbeats, extreme drowsiness, confusion, agitation, vomiting, blurred vision, sweating, muscle stiffness, feeling light-headed, and seizures. You should be warned not to exceed recommended dosages, to avoid alcohol, and to avoid activities requiring mental alertness. If your doctor prescribes these medications together, you may need a dose adjustment to safely take this combination. 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 verapamil together with multivitamin with minerals can decrease the effects of verapamil. Talk with your doctor before using verapamil and multivitamin with minerals together. You may need a dose adjustment or need your blood pressure checked more often if you take both medications. 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.