What is the most important information I should know about nortriptyline?
You should not use nortriptyline if you recently had a heart attack.
Do not use this medicine if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.
Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.
What is nortriptyline?
Nortriptyline is a tricyclic antidepressant that is used to treat symptoms of depression.
Nortriptyline may also be used for purposes not listed in this medication guide.
What should I discuss with my healthcare provider before taking nortriptyline?
You should not use this medicine if:
- you are allergic to nortriptyline or similar medicines (amitriptyline, amoxapine, clomipramine, desipramine, doxepin, imipramine, protriptyline, trimipramine);
- you are allergic to certain seizure medications (carbamazepine, eslicarbazepine, oxcarbazepine, rufinamide); or
- you recently had a heart attack.
Do not use nortriptyline if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.
Tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone.
Tell your doctor if you have ever had:
- unexplained fainting spells;
- a genetic heart condition called Brugada syndrome;
- a family history of unexplained death at younger than 45 years old;
- heart disease;
- a heart attack or stroke;
- a seizure;
- bipolar disorder (manic-depression);
- schizophrenia or other mental illness;
- a thyroid disorder;
- problems with urination;
- narrow-angle glaucoma; or
- if you are receiving electroshock treatment.
Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. These medicines may interact with nortriptyline and cause a serious condition called serotonin syndrome.
Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.
Tell your doctor if you are pregnant or breastfeeding.
Nortriptyline is not approved for use by anyone younger than 18 years old.
How should I take nortriptyline?
Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.
Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).
If you need surgery, tell your surgeon you currently use this medicine. You may need to stop 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 this medicine.
It may take a few weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.
Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.
What happens if I miss a dose?
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of nortriptyline can be fatal.
Overdose symptoms may include irregular heartbeats, severe drowsiness, vision problems, confusion, hallucinations, agitation, stiff muscles, overactive reflexes, vomiting, feeling hot or cold, feeling like you might pass out, seizures, or coma.
What should I avoid while taking nortriptyline?
Do not drink alcohol. Dangerous side effects or death could occur.
Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.
Nortriptyline could make you sunburn more easily. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.
What are the possible side effects of nortriptyline?
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, 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:
- blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
- 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, easy bruising, unusual bleeding;
- painful or difficult urination; or
- jaundice (yellowing of the skin or eyes).
Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.
Common side effects may include:
- increased blood pressure;
- numbness or tingling in your hands or feet;
- dry mouth, nausea, vomiting, loss of appetite;
- blurred vision;
- rash, itching; or
- breast swelling (in men or women).
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect nortriptyline?
Using nortriptyline with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.
Tell your doctor about all your other medicines, especially:
- medicine to treat depression, anxiety, mood disorders, or mental illness;
- cold or allergy medicine (Benadryl, Sudafed, and others);
- a stimulant medicine, such as diet pills or ADHD medicine;
- medicine to treat Parkinson's disease;
- medicine to treat stomach problems, motion sickness, or irritable bowel syndrome;
- medicine to treat overactive bladder; or
- bronchodilator asthma medication.
This list is not complete. Other drugs may affect nortriptyline, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.
Where can I get more information?
Your pharmacist can provide more information about nortriptyline.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Every 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 outside 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 should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid 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.
Copyright 1996-2020 Cerner Multum, Inc. Version: 12.01. Revision date: 6/22/2020.
