Generic Name: nortriptyline

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 other purposes not listed in this medication guide.

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What is the price of this medication and similar alternatives?

Pricing information provided by drugstore.com.

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What are the possible side effects of nortriptyline?

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.

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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. Do not stop using nortriptyline without first talking to your doctor. You may need to use less and less before you stop the medication completely. Stopping this medication suddenly could cause you to have unpleasant side effects.

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What is the most important information I should know about nortriptyline?
Do not use nortriptyline if you have recently had a heart attack, or 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. 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. 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.

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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.

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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).

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Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Nortriptyline has not been formally assigned to a pregnancy category by the FDA. Limb reduction anomalies have been reported in humans exposed to nortriptyline, however, no firm association has been made. There are no controlled data in human pregnancy. Nortriptyline should only be given during pregnancy when there are no alternatives and benefit outweighs risk.

Nortriptyline is excreted into human milk in small amounts. Infant serum analysis failed to find detectable concentrations of nortriptyline. However, one of the metabolites, 10-hydroxynortriptyline was detected in two of the twelve infants that were analyzed. The American Academy of Pediatrics has no position on nortriptyline but classifies amitriptyline, the metabolic precursor of nortriptyline, as a drug "whose effect on nursing infants is unknown but may be of concern."

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Who should NOT use this medication?

• Concurrent or recent (i.e., within 2 weeks) therapy with an MAO inhibitor. (See Specific Drugs under Interactions.)
• During the acute recovery phase following MI.
• Known hypersensitivity to nortriptyline, other dibenzazepine-derivative TCAs, or any ingredient in the formulation.

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What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine. An overdose of nortriptyline can be fatal. Overdose symptoms may include extreme drowsiness, confusion, agitation, hallucinations, blurred vision, vomiting, muscle stiffness, feeling hot or cold, fainting, seizure (convulsions), or coma.

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

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Can I stop taking the medication if I feel better?
As a general rule, you should always take your medications exactly as prescribed and do not change the dosage or stop taking the medication without first discussing it with your healthcare provider.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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Where can I get more information?
More Information

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