Does Nortriptyline cause acid reflux? 

Does Nortriptyline cause acid reflux? 

Yes, Nortriptyline can cause acid reflux. Nortriptyline is an antidepressant and the majority of these medications can cause acid reflux and heartburn (1,2). 

It is more common in people who are new to Nortriptyline or antidepressants in general. In most cases, acid reflux on antidepressants begins to subside as your body adjusts to the medication and can be managed as long as it stays (1). 

However, every individual is different and is differently affected. If your symptoms are severe, reach out to your healthcare provider. Nortriptyline is a Tricyclic antidepressant (TCA), a class of antidepressants that doesn’t suit everyone (1,2). 

Incidence of acid reflux on Nortriptyline

Research suggests that acid reflux, or gastroesophageal reflux disease (GERD), can be a potential side effect of taking Nortriptyline (3). The exact incidence of this side effect may vary among individuals.

The mechanism behind this side effect is not fully understood, but it is believed to be related to the effects of Nortriptyline on the digestive system.

Nortriptyline can affect the muscles that control the opening between the oesophagus and the stomach, leading to the backward flow of stomach acid into the oesophagus, causing symptoms of acid reflux (1,3). 

Persistent acid reflux on Nortriptyline may reduce appetite and overall calorie intake, which can lead to weight loss over time. 

It is important to note that not everyone who takes Nortriptyline will experience this side effect, and its occurrence may depend on individual factors. If you are taking Nortriptyline and experience symptoms of acid reflux, such as heartburn or regurgitation, it is recommended to inform your healthcare provider.

What to do if Nortriptyline causes acid reflux? 

You can manage acid reflux caused by Nortriptyline or any other antidepressant by taking OTC acid reducers, including (4):

  • Proton pump inhibitors (PPIs) – Omeprazole, Esomeprazole, Pantoprazole, etc. 
  • Antacids – Milk of Magnesia, Tums, Pepto-Bismol, Gaviscon, etc. 
  • H2 receptor antagonists – Famotidine, Cimetidine, etc. 

These meds either prevent the secretion of gastric acid or dilute it. Most of the acid reducers are safe to use with Nortriptyline, but it’s best to ask your doctor which one would be best for you, specifically. 

You should also limit the use of caffeine and carbonated beverages and should stick to a healthy diet. If your acid reflux stays for longer than 3 weeks and starts affecting the quality of your life, reach out to your healthcare provider. 

Tips to relieve Nortriptyline-induced acid reflux

Some helpful tips to relieve acid reflux include:

  • fruits, caffeine, alcohol, and carbonated drinks.
  • Chew food slowly and thoroughly to aid digestion and reduce the risk of reflux.
  • Maintain a healthy weight as excess weight can put pressure on the stomach and increase the likelihood of acid reflux.
  • Wear loose-fitting clothing to avoid putting pressure on the abdomen.
  • Avoid smoking and secondhand smoke, as smoking can weaken the lower oesophagal sphincter and contribute to acid reflux.
  • Manage stress levels through relaxation techniques like deep breathing, meditation, or yoga, as stress can worsen acid reflux symptoms.

Final words

To sum up, Nortriptyline may cause acid reflux or increase the symptoms of pre-existing GERD. However, meds affect people differently and not everyone experiences this side effect. If you are struggling with acid reflux while taking Nortriptyline, please reach out to your doctor. 

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References

1.-

Merwar G, Gibbons JR, Hosseini SA, Saadabadi A. Nortriptyline. 2023 Feb 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 29489270. https://www.ncbi.nlm.nih.gov/books/NBK482214

2.-

PubChem [Internet]. Bethesda (MD): National Library of Medicine (US), National Center for Biotechnology Information; 2004-. PubChem Compound Summary for CID 4543, Nortriptyline; [cited 2023 July 14]. Available from: https://pubchem.ncbi.nlm.nih.gov/compound/Nortriptyline

3.-

Brahm NC, Kelly-Rehm MC. Antidepressant-mediated gastroesophageal reflux disease. Consult Pharm. 2011 Apr;26(4):274-8. doi: 10.4140/TCP.n.2011.274. PMID: 21486738. https://pubmed.ncbi.nlm.nih.gov/21486738/

4.-

Kroch DA, Madanick RD. Medical Treatment of Gastroesophageal Reflux Disease. World J Surg. 2017 Jul;41(7):1678-1684. doi: 10.1007/s00268-017-3954-2. PMID: 28321555. https://pubmed.ncbi.nlm.nih.gov/28321555/

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