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Nortriptyline is an active metabolite of Amitriptyline. Therapeutic drug levels are monitored to assist the physician assessing therapeutic response and to avoid toxicity.ortriptyline is an active metabolite of Amitriptyline. Therapeutic drug levels are monitored to assist the physician assessing therapeutic response and to avoid toxicity.
CHI has identified warfarin, disulfiram, metronidazole and MAOI inhibitors as having a high potential for food/ drug interactions. Initial passage through the liver produces active metabolites from the tricyclic and atypical drugs, and inactive metabolites from the MAOI drugs (first-pass metabolism). She was prescribed a combination of two drugs, a tricyclic and an MAOI which worked very well for her and she returned to work.