Drug & supplement interaction

Scopolia + Nortriptyline

Nortriptyline brand names: Pamelor, Nortriptyline, Aventyl, Allegron.

Major Interaction
The bottom line Major

Nortriptyline falls into 2 drug categories that Scopolia can interact with; the most serious is rated major. The alkaloid constituents of scopolia, including hyoscyamine, scopolamine, and atropine, could potentiate the effects and adverse effects of anticholinergic drugs.

Read the full interaction report
SeverityMajor
LikelihoodProbable
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Scopolia and Nortriptyline

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Scopolia interacts with whole categories of medication. Nortriptyline falls into 2 of those categories, so it can interact with Scopolia in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Major).

Major

ANTICHOLINERGIC DRUGS

1 of 2

Why this applies to Nortriptyline

Nortriptyline falls under ANTICHOLINERGIC DRUGS — the group Scopolia interacts with.

The alkaloid constituents of scopolia, including hyoscyamine, scopolamine, and atropine, could potentiate the effects and adverse effects of anticholinergic drugs.
Severity Major Likelihood Probable Evidence D

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing about nortriptyline (Pamelor): on top of treating depression, it already has noticeable anticholinergic activity. That's why people on it often notice dry mouth, constipation, blurry vision, trouble urinating, or a faster heartbeat. Scopolia is loaded with the same kind of acetylcholine-blocking compounds (atropine, hyoscyamine, scopolamine), so pairing them is basically stacking two anticholinergics on top of each other.

That overlap can amplify those side effects, and in older adults it can also bring on confusion or dizziness. This warning is based on how these drugs work rather than hard human studies, but the concern makes sense pharmacologically, and scopolia itself is a risky plant. Please loop in your doctor or pharmacist before combining them.

References
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
Major

TRICYCLIC ANTIDEPRESSANTS (TCAs)

2 of 2

Nortriptyline also falls under TRICYCLIC ANTIDEPRESSANTS (TCAs).

Concomitant use of TCAs with scopolia can increase the risk for anticholinergic effects and adverse effects.
Severity Major Likelihood Probable Evidence D

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing about combining these two: nortriptyline already has its own anticholinergic side. Like other tricyclics, it tends to dry you out and slow some body functions. Scopolia is loaded with strong anticholinergic alkaloids (atropine, hyoscyamine, scopolamine), so stacking the two means you're piling the same type of effect on top of itself.

What could that look like? Worse dry mouth, blurry vision, constipation, trouble urinating, a racing heartbeat, confusion, or feeling overheated. This concern is based on how these compounds work rather than hard human studies, but the risk is real enough that I'd take it seriously. Please don't pair them without talking to your pharmacist or doctor first.

References
  1. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Scopolia Also Interacts With Other Medications

Scopolia has 199 major, known drug interactions in our database — the Nortriptyline one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Scopolia

Covers the 2,830 medications we’ve checked against Scopolia. Pick one to open its full report.

From our Q&A

Questions About Scopolia or Nortriptyline

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Scopolia or Nortriptyline, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Nortriptyline

This page covers Scopolia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nortriptyline page lists 198 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Henbane (major), Lithium (major), 1,3-dmaa (moderate) and 5-htp (moderate).

By severity: 4 major · 150 moderate · 44 minor.

Open the Nortriptyline interaction page

How much people look this up

Where Scopolia and Nortriptyline Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Scopolia
Top half

#552 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Nortriptyline
Top 25%

#344 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Scopolia

What is Scopolia?

Scopolia
  • Stomach and intestinal cramps
  • Motion sickness
  • Spasms and colic
  • Excess saliva or secretions
  • Pain relief (traditional)

Scopolia is a poisonous plant in the nightshade family that contains powerful anticholinergic alkaloids like atropine, hyoscyamine, and scopolamine. While these compounds are used in carefully measured prescription medicines, the raw plant is dangerous for self-treatment and should never be used without a doctor's supervision.

Read the full Scopolia monograph & all interactions
Medication

About Nortriptyline

What Is Nortriptyline Used For?

Brand names: Pamelor, Nortriptyline, Aventyl, Allegron

Nortriptyline is approved to relieve symptoms of depression. This applies to nortriptyline hydrochloride capsules, nortriptyline hydrochloride oral solution, and Pamelor capsules — all used for the same core indication.

The label notes that depression arising from within the body (endogenous depression) may respond better than other types of depression, though all of these products are indicated for the broader relief of depressive symptoms.

See full Nortriptyline drug information
Keep checking

Other Drugs & Scopolia

Browse every other medication we’ve checked against Scopolia — both the ones with a known interaction and the ones without. Select any drug for the full detail.

199Major
0Moderate
0Minor
2,630No known interaction
Major

199 interactions

Showing 60 of 199 major interactions — see all 199 on the Scopolia page.

No interaction 2,630 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Scopolia and Nortriptyline Together: Common Questions

Can you take Scopolia with Nortriptyline?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Scopolia and Nortriptyline?
Nortriptyline belongs to more than one drug category, and Scopolia interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Scopolia and Nortriptyline interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Nortriptyline and Scopolia?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.