NORTRIPTYLINE

(nor TRIP ti leen) Brand: Pamelor

What is the most significant information I must know about nortriptyline?

• You must not take nortriptyline if you have recently had a heart onslaught or if you are being treated with methylene blue injection.

• Do not use nortriptyline if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

• Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using nortriptyline. Your family or another caregivers must also be alert to changes in your mood or symptoms.

• Report any new or worsening symptoms to your doctor, 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.

What is nortriptyline?

• Nortriptyline is a tricyclic antidepressant. 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 not listed in this medicine guide.

What must I discuss with my healthcare provider till taking nortriptyline?

• You must not take nortriptyline if you have recently had a heart onslaught or if you are being treated with methylene blue injection. You must not take nortriptyline if you are allergic to it or to similar antidepressants (amitriptyline, amoxapine, clomipramine, desipramine, doxepin, imipramine, protriptyline, trimipramine).

• Do not use nortriptyline if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include furazolidone, isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

• To create certain nortriptyline is safety for you, speak your doctor if you have:

· heart malady, or a history of heart onslaught, stroke, or seizures;

· a family history of sudden death related to a heart rhythm disorder;

· bipolar mess (manic-depression);

· schizophrenia or another mental illness;

· liver disease;

· a thyroid disorder;

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

· glaucoma; or

· problems with urination.

• It is not known whether nortriptyline will harm an unborn child. Speak your doctor if you are pregnant or plan to become pregnant while using this medication.

• It is not known whether nortriptyline passes into breast milk or if it could harm a nursing child. Speak your doctor if you are breast-feeding a baby.

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

• Do not give this medication to a baby without medical advice.

How must I take nortriptyline?

• Follow all directions on your prescription label. Your doctor may occasionally change your doze to create certain you get the excellent results. Do not take this medication in larger or less amounts or for longer than recommended.

• If you need surgery, speak the surgeon onward of time that you are using nortriptyline. You may need to stop using the medication for a short time.

• Do not stop using nortriptyline suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using nortriptyline.

• It may take up to a little weeks till your symptoms improve. Hold using the medicine as directed and speak your doctor if your symptoms do not improve during treatment.

• Store at room temperature away from moisture and heat.

What happens if I miss a dose?

• Take the missed doze as soon as you remember. Skip the missed doze if it is nearly time for your following scheduled doze. Do not take extra medication to create up the missed dose.

What happens if I overdose?

• Search abnormal medical attention or call the Poison Help line at 1-800-222-1222. An overdose of nortriptyline can be fatal.

What must I avoid while taking nortriptyline?

• Do not drink alcohol. Nortriptyline can magnify the effects of alcohol, which could be dangerous.

• Grapefruit and grapefruit juice may interact with nortriptyline and lead to unwanted side effects. Discuss the use of grapefruit commodity with your doctor.

• This medicine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

• Avoid exposure to sunlight or tanning beds. Nortriptyline can create you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

What are the possible side effects of nortriptyline?

• Get abnormal medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your person, lips, tongue, or throat.

• Report any new or worsening symptoms to your doctor, 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:

· agitation, hallucinations, overactive reflexes, confusion, unusual thoughts or behavior;

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

· a light-headed feeling, like you might pass out;

· seizure (convulsions);

· new or worsening chest pain, pounding heartbeats or fluttering in your chest;

· sudden numbness or weakness, problems with vision, speech, or balance;

· fever, sore throat, light bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

· painful or difficult urination; or

· upper stomach pain, loss of appetite, jaundice (yellowing of the skin or eyes).

• General side effects may include:

· tingly feeling, weakness, lack of coordination;

· dry mouth, unpleasant taste, nausea, constipation;

· blurred vision, ringing in your ears;

· breast swelling (in men or women); or

· decreased sex drive, impotence, or difficulty having an orgasm.

• This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may message side effects to FDA at 1-800-FDA-1088.

What another drugs will affect nortriptyline?

• Taking nortriptyline with another drugs that create you sleepy or slow your breathing can magnify these effects. Ask your doctor till taking nortriptyline with a sleeping pill, narcotic pain medication, muscle relaxer, or medication for anxiety or seizures.

• Till taking nortriptyline, tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, or sertraline. You should wait at least 5 weeks after stopping fluoxetine (Prozac) till you can take nortriptyline.

• Much drugs can interact with nortriptyline. Not all possible interactions are listed here. Speak your doctor about all your medications and any you start or stop using during treatment with nortriptyline, especially:

· bupropion;

· reserpine;

· St. John's wort;

· terbinafine;

· any another antidepressant, or medicine to treat mental illness;

· bladder or urinary medicines--darifenacin, fesoterodine, oxybutynin, tolterodine, solifenacin;

· bronchodilators--ipratropium, tiotropium;

· cool or allergy medication that contains an antihistamine;

· medicine for Parkinson's disease;

· medicine to treat excess stomach acid, stomach ulcer, motion sickness, or irritable bowel syndrome;

· a decongestant (pseudoephedrine, phenylephrine), diet pills, stimulant medicine; or

· heart rhythm medications--flecainide, propafenone, or quinidine.

• This list is not complete and much another drugs can interact with nortriptyline. This includes prescription and over-the-counter medicines, vitamins, and herbal commodity. Give a list of all your medicines to any healthcare provider who treats you.

Where can I get more information?

• Your pharmacist can provide more information about nortriptyline.

Remember, hold this and all another medicines out of the reach of children, never share your medicines with others, and use this medicine only for the indication prescribed.

Disclaim: Each effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses external of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way must be construed to indicate that the drug or drug combination is safety, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the help of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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