Nortriptyline (nor-TRIP-ti-leen)Brand Name:
Examples include Aventyl and Pamelor
Antidepressants may increase the risk of suicidal thoughts or actions in children, teenagers, and young adults. However, depression and certain other mental problems may also increase the risk of suicide. Talk with the patient's doctor to be sure that the benefits of using Nortriptyline outweigh the risks.
Family and caregivers must closely watch patients who take Nortriptyline . It is important to keep in close contact with the patient's doctor. Tell the doctor right away if the patient has symptoms like worsened depression, suicidal thoughts, or changes in behavior. Discuss any questions with the patient's doctor.
Nortriptyline is used for:
Treating depression. It may also be used for other conditions as determined by your doctor.
Nortriptyline is a tricyclic antidepressant. It works by increasing the activity of certain chemicals in the brain that help elevate mood.
Do NOT use Nortriptyline if:
- you are allergic to any ingredient in Nortriptyline or to similar medicines
- you have taken furazolidone or a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) within the last 14 days, or you are taking astemizole, droperidol, or terfenadine
- you are recovering from a recent heart attack
Contact your doctor or health care provider right away if any of these apply to you.
Before using Nortriptyline :
Some medical conditions may interact with Nortriptyline . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you drink alcohol-containing beverages daily or you have a history of alcohol abuse
- if you take thyroid medicine or you have a history of overactive thyroid, glaucoma, heart problems, kidney or liver problems, diabetes, seizures, the blood disease porphyria, or difficulty urinating
- if you have a history of suicidal thoughts or behavior, bipolar disorder, or any other mental disorders; you are undergoing electroshock therapy; or you are scheduled to have any surgery
Some MEDICINES MAY INTERACT with Nortriptyline . Tell your health care provider if you are taking any other medicines, especially any of the following:
- Azole antifungals (eg, fluconazole), cimetidine, duloxetine, flecainide, methylphenidate, mibefradil, phenothiazines (eg, chlorpromazine), propafenone, quinidine, selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine), or terbinafine because they may increase the risk of Nortriptyline 's side effects
- Arsenic, astemizole, droperidol, furazolidone, MAOIs (eg, phenelzine), pimozide, quinolone antibiotics (eg, ciprofloxacin), streptogramins (eg, dalfopristin), terfenadine, or tramadol because the risk of high blood pressure, serious heart problems (eg, irregular heartbeat), or seizures may be increased
- Barbiturates (eg, phenobarbital) or phenytoin because they may decrease Nortriptyline 's effectiveness
- Anticholinergics (eg, benztropine), carbamazepine, chlorpropamide, or sympathomimetics (eg, phenylephrine) because the risk of their side effects may be increased by Nortriptyline
- Clonidine, guanethidine, or guanfacine because their effectiveness may be decreased by Nortriptyline
This may not be a complete list of all interactions that may occur. Ask your health care provider if Nortriptyline may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use Nortriptyline :
Use Nortriptyline as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Nortriptyline comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Nortriptyline refilled.
- Take Nortriptyline by mouth with or without food.
- If you miss a dose of Nortriptyline , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. If you take 1 dose daily at bedtime, do not take the missed dose the next morning.
Ask your health care provider any questions you may have about how to use Nortriptyline .
Important safety information:
- Nortriptyline may cause drowsiness, dizziness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Nortriptyline with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Nortriptyline ; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
- Nortriptyline may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
- Do not become overheated in hot weather or while you are being active; heatstroke may occur.
- Children, teenagers, and young adults who take Nortriptyline may be at increased risk for suicidal thoughts or actions. Watch all patients who take Nortriptyline closely. Contact the doctor at once if new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.
- Nortriptyline may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Nortriptyline . Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
- Tell your doctor or dentist that you take Nortriptyline before you receive any medical or dental care, emergency care, or surgery.
- Lab tests, including blood cell counts, may be performed while you use Nortriptyline . These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Use Nortriptyline with caution in the ELDERLY; they may be more sensitive to its effects, especially confusion, blood pressure changes, and irregular heartbeat.
- Nortriptyline should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
- PREGNANCY and BREAST-FEEDING: It is not known if Nortriptyline can cause harm to the fetus. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Nortriptyline while you are pregnant. It is not known if Nortriptyline is found in breast milk. Do not breast-feed while taking Nortriptyline .
If you stop taking Nortriptyline suddenly, you may have WITHDRAWAL symptoms. These may include headache, nausea, and tiredness.
Possible side effects of Nortriptyline :
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Dizziness; drowsiness; dry mouth; excitement; headache; impotence; nausea; nightmares; pupil dilation; sensitivity to sunlight; sweating; tiredness; upset stomach; vomiting; weakness; weight loss or gain.
Seek medical attention right away if any of these SEVERE side effects occur:
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision or other vision changes; changes in sex drive; chest pain; confusion; constipation; fainting; fast, slow, or irregular heartbeat; fever; frequent or difficult urination; hallucinations; impulsive behavior or other unusual changes in behavior; jaw, neck, or muscle spasms; mental or mood changes (eg, increased anxiety, mood swings, agitation, irritability, nervousness, restlessness); panic attacks; ringing in the ears; seizures; severe dizziness or drowsiness; sore throat; stomach pain; suicidal thinking or behavior; swelling of the testicles; tremor; trouble sleeping; trouble walking or keeping your balance; twitching of the face or tongue; uncontrolled movements of arms and legs or stiffness; unusual bleeding or bruising; worsening of depression; yellowing of the skin or eyes.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch .
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org), or emergency room immediately. Symptoms may include agitation; bluish skin or mucous membranes; breathing problems; chest pain; coma; confusion; dry mouth; enlarged pupils; excess sweating; fainting; fast or irregular heartbeat; flushing; incoordination; involuntary movements; loss of consciousness; restlessness; rigid muscles; seizures; severe drowsiness; shock; stupor; trouble breathing; vomiting.Proper storage of Nortriptyline :
Store Nortriptyline at room temperature, between 68 and 77 degrees F (20 and 25 degrees C), in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Nortriptyline out of the reach of children and away from pets.
- If you have any questions about Nortriptyline , please talk with your doctor, pharmacist, or other health care provider.
- Nortriptyline is to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
This information is a summary only. It does not contain all information about Nortriptyline . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.
- Nortriptyline Prescribing Information (FDA)
- nortriptyline Advanced Consumer (Micromedex) - Includes Dosage Information
- nortriptyline Concise Consumer Information (Cerner Multum)
- Pamelor Prescribing Information (FDA)
- Pamelor Detailed Consumer Information (PDR)