Nortriptyline

For an informed discussion with your doctor or pharmacist. This information collection is not a clinically validated interaction checker. Missing data do not establish safety. Do not change or stop prescribed medicines on the basis of this information. The findings apply to the specific conditions studied; laboratory and animal studies cannot be directly extrapolated to humans.

Active substance: Nortriptyline

Examples of brand names: Pamelor [USA]

ATC code: N06AA10

Main use (for orientation): Depression

Documented research summary

A historical case describes sinus tachycardia with nortriptyline after marijuana smoking. Composition and mechanism unknown; no established isolated THC/CBD effect.

Uncertainties and limitations

Historical single case, unknown cannabis composition; no inference of population risk or dose threshold possible.

Research is limited to the specified date and protocol; it is not globally exhaustive. Brand names and authorisations do not constitute a complete current market overview.

Structured assessment

Category: Direct pair finding

Cannabinoid scope: 28 register names in the documented search family; neither 28 individual clinical trials nor a blanket assessment of all cannabinoids.

Evidence status: Pair-specific evidence, distinguished in the individual findings

Mechanism / drug context: Mechanism uncertain in the individual case; possible additive autonomic/cardiac effects.

Type of supporting material: See the separate original findings

Clinical interpretation: Requires individual assessment by a doctor or pharmacist. Lack of evidence does not establish safety; no dosage or discontinuation advice is provided.

Context: Oral nortriptyline hydrochloride; active substance and active amitriptyline metabolite, not a prodrug.

Drug context and gaps in search results are not measured interactions. The source role below describes which statement the source actually supports.

Source role [CA_L_D0097]: Drug context

Statement supported: Supports dosage form, metabolism and/or known risks; alone, it does not substantiate a cannabinoid–drug pair finding.

Source: Nortriptyline 50mg Film-coated Tablets – SmPC [CA_L_D0097]

Source role [CA_P_6303138]: Pair finding

Statement supported: Sinus tachycardia following marijuana smoking while taking nortriptyline.

Source: Marked sinus tachycardia resulting from the synergistic effects of marijuana and nortriptyline. [CA_P_6303138]

Scope of review: Individual research with documented title/abstract screening and targeted review of original sections. This is not exhaustive evidence that interactions are absent.

Unresolved source question: The complete stored individual review, label review, literature screening, conclusion and uncertainties were read. Targeted sections of original information were rechecked; no claim is made that all product information or full texts were completely revalidated.

Separately recorded findings

1 separately recorded finding. Each statement applies to its documented study context.

Cannabis smoke – composition undetermined – clinical signals

Finding ID: V6_D0097_1

Type of result: Finding within the documented study context

Observation: Sinus tachycardia following marijuana smoking while taking nortriptyline.

Mechanism: Mechanism uncertain

Study type: Single case report

Context studied: Hillard and Vieweg 1983.

Clinical interpretation: Cardiac signal, not incidence.

Limitations and uncertainties: No defined isolated cannabinoid exposure or proven CYP causality.

Original sources for this finding: Marked sinus tachycardia resulting from the synergistic effects of marijuana and nortriptyline. [CA_P_6303138]

References and access status

[CA_L_D0097] Nortriptyline 50mg Film-coated Tablets – SmPC

Original source / bibliographic reference

Authors: Glenmark Pharmaceuticals Europe Ltd

Year: 2024

Source type: Official manufacturer's SmPC (eMC)

Source access – 23 October 2026: Source destination was accessible when checked.

Bibliographic attribution or source identity cross-checked.

[CA_P_6303138] Marked sinus tachycardia resulting from the synergistic effects of marijuana and nortriptyline.

Original source / bibliographic reference

Authors: Hillard JR, Vieweg WV.

Year: 1983

Source type: Journal Article; Case Reports

DOI: 10.1176/ajp.140.5.626

PMID: 6303138

Source access – 23 October 2026: Source destination was accessible when checked.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

Research as of 23 October 2026. Not all original full texts could be reviewed in full. Source accessibility and the strength of scientific evidence must be assessed separately. An accessible link does not establish medical approval; a bibliographic record with an abstract does not replace the original full text.

Drug search and explanation of the evidence · Guide: cannabinoids and medicines · Author and responsibility