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How does this medication work? What will it do for me?
Nortriptyline belongs to the group of medications known as tricylic antidepressants. It is used to treat depression. It works in the central nervous system to elevate the mood of people with depression. It is believed to work by affecting the balance of natural chemicals (called neurotransmitters) in the brain.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
What form(s) does this medication come in?
See your pharmacist or doctor for further details.
How should I use this medication?
The recommended adult dose ranges from 30 mg to 150 mg daily in divided doses. The usual adult starting dose is 25 mg 3 or 4 times daily. The dosage can be increased until the desired effect is achieved.
Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
It is important that this medication be taken exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Who should NOT take this medication?
Nortriptyline should not be taken by anyone who:
- is allergic to nortriptyline, other antidepressants in the same family (e.g., amitriptyline, desipramine), or to any of the ingredients of the medication
- has recently had a heart attack
- takes MAO inhibitors (e.g., phenelzine, tranylcypromine) - MAO inhibitors should be stopped at least 2 weeks before nortriptyline treatment is started
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- blurred vision
- dryness of mouth
- increased appetite (may include a craving for sweets)
- tiredness or weakness (mild)
- unpleasant taste
- weight gain
Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
Stop taking the medication and seek immediate medical attention if any of the following occur:
- skin rash and itching
- sore throat and fever
- swelling of face and tongue
- yellow eyes or skin
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Behaviour changes and suicidal thoughts: This medication may worsen symptoms of depression, including thoughts of suicide or wanting to harm others. It may also cause agitated or aggressive behaviour. If you experience these symptoms or any other behaviour change while taking this medication, contact your doctor immediately. Family members or caregivers of people who are taking this medication should contact the person's doctor immediately if they notice unusual behaviour changes.
Drowsiness/reduced alertness: People who take nortriptyline should avoid driving and operating hazardous machinery until they determine that the medication does not adversely affect their ability to do such activities.
Medical conditions: This medication should be used with caution by anyone with:
- diabetes (both increases and decreases in blood sugar levels have been noted for people with diabetes who take nortriptyline)
- difficulties with urination
- epilepsy or a history of seizures
- heart disease
- hyperactive thyroid disease (or those receiving thyroid medication)
Sun exposure: Nortriptyline can make your skin more sensitive to sunlight. Sun exposure can lead to a rash, itching, redness, or a severe sunburn. Use a sunscreen and avoid sun exposure especially between the hours between 10 am and 3 pm.
Withdrawal: Stopping treatment suddenly after prolonged therapy may produce nausea, headache, and malaise. These symptoms do not mean that you are addicted to the medication.
Pregnancy: The safe use of nortriptyline during pregnancy has not been established. If you are or may be pregnant, talk to your doctor about the risks and benefits of taking this medication.
Breast-feeding: The safe use of nortriptyline while breast-feeding has not been established. If you are breast-feeding, talk to your doctor about the risks and benefits of taking this medication.
Children: Nortriptyline is not recommended for use by children under 12 years of age.
What other drugs could interact with this medication?
There may be an interaction between nortriptyline and any of the following:
- anticholinergic medications (e.g., atropine, benztropine, pinaverium)
- certain antiarrhythmic medications (e.g., propafenone, flecainide, encainide)
- other antidepressants especially MAO inhibitors (e.g., phenelzine, tranylcypromine)
- phenothiazines (e.g., perphenazine, chlorpromazine)
- sympathomimetic medications (e.g., epinephrine)
Nortriptyline may alter the effect of alcohol.
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
All material © 1996-2013 MediResource Inc. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
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