Author: James Anderson

Nortriptyline and Alcohol Food Interactions

The mixture of carisoprodol with beer is popular among street abusers for creating a quick state of euphoria. In contrast to ADH, the alcohol-metabolizing enzyme cytochrome P450—also called microsomal ethanol oxidizing system (MEOS) (Lieber 1994)—plays a central role in alcohol-medication interactions. Accordingly, CYP2E1 plays an important role in many alcohol-medication interactions. Alcohol is broken down to acetaldehyde either by alcohol dehydrogenase (ADH) or cytochrome P450 (CYP). The acetaldehyde then is broken down to acetic acid and water by two variants of the enzyme aldehyde dehydrogenase (ALDH).

Note – Included in the following list are a few adverse reactions that have not been reported with this specific drug. However, the pharmacologic similarities among the tricyclic antidepressant drugs require that each of the reactions be considered when nortriptyline is administered. Concurrent administration of cimetidine and tricyclic antidepressants can produce clinically significant increases in the plasma concentrations of the tricyclic antidepressant. The patient should be informed that the response to alcohol may be exaggerated.

Close supervision and careful adjustment of the dosage are required when Pamelor is used with other anticholinergic drugs and sympathomimetic drugs. Patients should be advised that taking Pamelor can cause mild pupillary dilation, which in susceptible individuals, can lead to an episode of angle-closure glaucoma. Pre-existing glaucoma is almost always open-angle glaucoma because angle-closure glaucoma, when diagnosed, can be treated definitively with iridectomy. Patients may wish to be examined to determine whether they are susceptible to angle closure, and have a prophylactic procedure (e.g., iridectomy), if they are susceptible. Pamelor may impair the mental and/or physical abilities required for the performance of hazardous tasks, such as operating machinery or driving a car; therefore, the patient should be warned accordingly. If you’re concerned about your alcohol use, you may benefit from substance abuse counseling and treatment programs that can help you overcome your misuse of alcohol.

Vitamin C and Adderall interactions

When doses above 100 mg daily are administered, plasma levels of nortriptyline should be monitored and maintained in the optimum range of 50 to 150 ng/mL. The use of Pamelor in schizophrenic patients may result in an exacerbation of the psychosis or may activate latent schizophrenic symptoms. If the drug is given to overactive or agitated patients, increased anxiety and agitation may occur. In manic-depressive patients, Pamelor may cause symptoms of the manic phase to emerge.

1. Caution is advised if you have diabetes, alcohol dependence, liver disease, or any other condition that requires you to limit/avoid alcohol in your diet.
2. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely.
3. It is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.
4. Aside from these effects, however, moderate alcohol consumption probably does not interfere with antibiotic effectiveness.
5. The dosage is based on your medical condition and response to treatment.

As alcohol ingestion increases, the amount of alcohol eliminated by first-pass metabolism becomes an even smaller fraction of the total amount of alcohol consumed. Some researchers have suggested, however, that some medications can block first-pass metabolism, resulting in blood alcohol levels (BALs) that are higher than normal for a given alcohol dose. Similarly, medications that accelerate gastric emptying (e.g., the stomach medications metoclopramide [Reglan® ] and cisapride [Propulsid® ] and the antibiotic erythromycin) may reduce first-pass metabolism in the stomach. Infection with the hepatitis C virus, which can result in serious and even fatal liver damage, is common in the United States and around the world. The only effective treatment to date involves a substance called interferon-α, often in combination with an agent called ribavirin, and has a cure rate of approximately 40 percent. Heavy alcohol use in patients infected with hepatitis C accelerates the rate of liver damage and increases the risk of cirrhosis.

Interactions

Speak with your doctor or pharmacist before mixing an antihistamine with your favorite cocktail. Lab and/or medical tests (such as EKG, liver function, nortriptyline blood level) may be done while you are taking this medication. Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Older adults may be more sensitive to the side effects of this drug, especially dry mouth, dizziness, confusion, difficulty urinating, and QT prolongation (see above).

Potential alcohol-medication interactions involving cytochrome P450 enzymes (CYP) in the liver. Alcohol that has not been eliminated by first-pass metabolism enters the systemic circulation and is distributed throughout the body water (i.e., the blood and the watery fluid surrounding and inside the cells). The proportion of body water and body fat differs between men and women and between young and old people; women and older people generally have more body fat and less body water than do men and younger people.

The Effects of Mixing Pamelor With Alcohol

Conversely, people taking MAO inhibitors or atypical antidepressants can experience adverse consequences when simultaneously consuming alcohol. Thus, MAO inhibitors (e.g., phenelzine and tranylcypromine) can induce severe high blood pressure if they are consumed together with a substance called tyramine, which is present in red wine. Accordingly, people taking MAO inhibitors should be warned against drinking red wine. The atypical antidepressants (i.e., nefazodone and trazodone) may cause enhanced sedation when used with alcohol.

This medicine may increase your risk of having a heart attack or stroke. Check with your doctor right away if you are having chest pain or discomfort, nausea or vomiting, pain or discomfort in the arms, jaw, back, or neck, trouble breathing, slurred speech, or weakness. It is intended for general informational purposes and is not meant to be a substitute for professional medical advice, diagnosis, or treatment.

To prevent constipation, eat dietary fiber, drink enough water, and exercise. To relieve dry mouth, suck on (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water, or use a saliva substitute. Tell your doctor if your condition lasts or gets worse (such as your feelings of sadness get worse, or you have thoughts of suicide).

Because CYP2E1 also metabolizes several medications, alcoholics, in whom CYP2E1 activity is enhanced, exhibit increased metabolic rates for those medications when they are sober. When those alcoholics are intoxicated, however, the alcohol in their system competes with the medication for metabolism by CYP2E1. With many medications, increased or decreased metabolic rates can have adverse or even fatal consequences. With increased metabolic rates, the medication’s concentration in the body may be too low or may decline too fast for it to be effective. Conversely, decreased metabolic rates may result in the accumulation of higher drug concentrations over longer periods of times, which may result in harmful overdoses. Such monitoring should include daily observation by families and caregivers.