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Nortriptyline

Nortriptyline affects chemicals in the brain that may become unbalanced. Nortriptyline is the active ingredient in the popular medication Pamelor, manufactured by Mylan Pharmaceuticals Inc. Nortriptyline is one of the most prescribed medications for depression, and now you can order it for a fraction of its regular price!

Nortriptyline is also marketed as: Pamelor and Aventyl HCl.

Uses

Generic Nortriptyline is used to treat symptoms of depression. Nortriptyline is in a group of drugs called tricyclic antidepressants. It affects chemicals in the brain that may become unbalanced.

How to take

Take nortriptyline 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.

Side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

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.

Call your doctor at once if you have any of these serious side effects:

  • 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 include:

  • 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.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

Precautions

Do not use this medication if you are allergic to nortriptyline, or if you have recently had a heart attack. Do not use nortriptyline if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take nortriptyline before the MAO inhibitor has cleared from your body.

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 need a dose adjustment or special tests to safely take nortriptyline.

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.

This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether nortriptyline passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Do not give this medication to anyone under 18 years old without the advice of a doctor.

Drug interactions

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).

This list is not complete and there are many other medicines that can interact with nortriptyline. Tell your doctor about all the prescription and over-the-counter medications you use.

Missed 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.

Storage

Store nortriptyline at room temperature away from moisture and heat.