Precursor to metabolite: Amitriptyline to Nortriptyline
Amitriptyline is converted to Nortriptyline by CYP2C19.
Visual mnemonic: Amitriptyline mascot
Visual mnemonic: Nortriptyline mascot
The pair
- Amitriptyline — Sedating TCA for pain, migraine and sleep; anticholinergic and lethal in overdose.
- Nortriptyline — Amitriptyline metabolite; best-tolerated TCA, with therapeutic level monitoring.
Anything that inhibits or induces CYP2C19 shifts the balance between Amitriptyline and Nortriptyline.
Amitriptyline · Nortriptyline · Open Amitriptyline in the interactive console ↗