Nortriptyline Consumer Information

nortriptyline

Generic Name: nortriptyline (nor TRIP ti leen)
Brand Names: Aventyl HCl, Pamelor

What is nortriptyline?

Nortriptyline is in a group of drugs called tricyclic antidepressants. Nortriptyline affects chemicals in the brain that may become unbalanced.

Nortriptyline is used to treat symptoms of depression.

Nortriptyline may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about nortriptyline?

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

What should I discuss with my healthcare provider before taking nortriptyline?

Before taking nortriptyline, tell your doctor if you are allergic to any drugs, or if you have:

• heart disease;

• a history of heart attack, stroke, or seizures;

• bipolar disorder (manic-depression);

• schizophrenia or other mental illness;

• diabetes (nortriptyline may raise or lower blood sugar);

• overactive thyroid;

• glaucoma; or

• problems with urination.

If you have any of these conditions, you may not be able to use nortriptyline, or you may need a dosage adjustment or special tests during treatment.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Older adults may be more likely to have side effects from this medication.

How should I take nortriptyline?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from this medication. Follow the directions on your prescription label.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking nortriptyline. You may need to stop using the medicine for a short time.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Symptoms of a nortriptyline overdose may include extreme drowsiness, confusion, agitation, hallucinations, blurred vision, vomiting, muscle stiffness, feeling hot or cold, fainting, seizure (convulsions), or coma.

What should I avoid while taking nortriptyline?

Avoid using other medicines that make you sleepy (such as cold medicine, pain medication, muscle relaxers, medicine for seizures, or other antidepressants). They can add to sleepiness caused by nortriptyline.

Grapefruit and grapefruit juice may interact with nortriptyline. Discuss the use of grapefruit products with your doctor before increasing or decreasing the amount of grapefruit products in your diet.

Nortriptyline side effects

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

• fast, pounding, or uneven heart rate;

• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;

• sudden numbness or weakness, especially on one side of the body;

• sudden headache, confusion, problems with vision, speech, or balance;

• confusion, hallucinations, or seizure (convulsions);

• easy bruising or bleeding, unusual weakness;

• restless muscle movements in your eyes, tongue, jaw, or neck;

• tremors;

• extreme thirst with headache, nausea, vomiting, and weakness;

• feeling light-headed or fainting; or

• urinating less than usual or not at all.

Less serious side effects may be more likely to occur, such as:

• nausea, vomiting, stomach pain, loss of appetite;

• constipation or diarrhea;

• weight changes;

• dry mouth, unpleasant taste;

• weakness, lack of coordination;

• numbness or tingly feeling;

• blurred vision, headache, ringing in your ears;

• mild skin rash;

• breast swelling (in men or women); or

• increased sweating.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect nortriptyline?

Before taking nortriptyline, tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft).

Before taking nortriptyline, tell your doctor if you are currently using any of the following drugs:

• cimetidine (Tagamet);

• guanethidine (Ismelin);

• reserpine; or

• heart rhythm medications such as flecainide (Tambocor), propafenone (Rhythmol), or quinidine (Cardioquin, Quinidex, Quinaglute).

If you are using any of these drugs, you may not be able to use nortriptyline, or you may need dosage adjustments or special tests during treatment.

There are many other medicines that can interact with nortriptyline. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.