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Nortriptyline is used to treat depression. Nortriptyline is in a group of medications called tricyclic antidepressants. It works by increasing the amounts of certain natural substances in the brain that are needed to maintain mental balance.

Usage directions

Nortriptyline comes as a capsule and an oral liquid to take by mouth. It is usually taken one to four times a day and may be taken with or without food. Take nortriptyline at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take nortriptyline exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor will probably start you on a low dose of nortriptyline and gradually increase your dose.

Continue to take nortriptyline even if you feel well. Do not stop taking nortriptyline without talking to your doctor. If you suddenly stop taking nortriptyline, you may experience withdrawal symptoms such as headache, nausea, and weakness. Your doctor will probably want to decrease your dose gradually.

Other uses

Nortriptyline is also sometimes used to treat panic disorders and post-herpetic neuralgia (the burning, stabbing pains, or aches that may last for months or years after a shingles infection). Nortriptyline is also sometimes used to help people stop smoking. Talk to your doctor about the possible risks of using this medication for your condition.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information

Special precautions

Before taking nortriptyline,

• tell your doctor and pharmacist if you are allergic to nortriptyline and other tricyclic antidepressants such as desipramine (Norpramin), clomipramine (Anafranil), imipramine (Tofranil), trimipramine (Surmontil),any other medications, or any of the ingredients in nortriptyline capsules or liquid. Ask your doctor or pharmacist for a list of the ingredients.
• tell your doctor if you are taking a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan), linezolid (Zyvox), methylene blue, phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate), or if you have stopped taking an MAO inhibitor within the past 14 days. Your doctor will probably tell you not to take nortriptyline. If you stop taking nortriptyline, you should wait at least 14 days before you start to take an MAO inhibitor.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants (blood thinners) such as warfarin (Coumadin, Jantoven); antihistamines; chlorpropamide (Diabinese); cimetidine (Tagamet); flecainide (Tambocor); guanethidine (Ismelin); lithium (Eskalith, Lithobid); medication for high blood pressure, seizures, Parkinson's disease, diabetes, asthma, nausea, mental illness, colds, or allergies; methylphenidate (Ritalin); muscle relaxants; propafenone (Rhythmol); quinidine; sedatives; selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft);sleeping pills; thyroid medication; and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have recently had a heart attack. Your doctor may tell you not to take nortriptyline.
• tell your doctor if you have or have ever had glaucoma (an eye condition), an enlarged prostate (a male reproductive gland), difficulty urinating, diabetes, seizures, schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions), an overactive thyroid gland, or liver, kidney, or heart disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking nortriptyline, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking nortriptyline.
• you should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
• talk to your doctor about the safe use of alcohol while you are taking this medication.
• plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Nortriptyline may make your skin sensitive to sunlight.

Food limitations and special diet when taking Nortriptyline

Unless your doctor tells you otherwise, continue your normal diet.

Missed dose

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Possible side effects

Nortriptyline may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea
• drowsiness
• weakness or tiredness
• excitement or anxiety
• nightmares
• dry mouth
• changes in appetite or weight
• constipation
• difficulty urinating
• frequent urination
• blurred vision
• changes in sex drive or ability
• excessive sweating

Some side effects may be serious. If you experience any of the following symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately or get emergency medical treatment:

• jaw, neck, and back muscle spasms
• slow or difficult speech
• shuffling walk
• uncontrollable shaking of a part of the body
• fever
• difficulty breathing or swallowing
• rash
• yellowing of the skin or eyes
• irregular heartbeat

Nortriptyline may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.

Storage and disposal of Nortriptyline

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

Emergency/overdose

In case of overdose, call your local poison control center. If the victim has collapsed or is not breathing, call local emergency services.

Symptoms of overdose may include

• irregular heartbeat
• seizures
• coma (loss of consciousness for a period of time)
• confusion
• hallucination (seeing things that do not exist)
• widened pupils (dark circles in the middle of the eyes)
• drowsiness
• agitation
• fever
• low body temperature
• stiff muscles
• vomiting

Other important information

Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your response to nortriptyline.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Disclaimer

We provide only general information about Pamelor which does not cover all possible drug integrations, directions or precautions. Information at our website cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with his health care adviser or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.

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