Nortriptyline (nor-TRIP-ti-leen)

Treats depression. This medicine is a TCA.

Brand Name(s):

Pamelor

When This Medicine Should Not Be Used:

How to Use This Medicine:

Capsule, Liquid

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• Oral liquid: Measure the oral liquid medicine with a marked measuring spoon, oral syringe, or medicine cup.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine and an MAO inhibitor (MAOI) within 14 days of each other.
• Tell your doctor if you are using the following:
  • Buspirone, chlorpropamide, cimetidine, fentanyl, guanethidine, lithium, reserpine, St John's wort, tramadol, tryptophan
  • Medicine for heart rhythm problems (including flecainide, propafenone)
  • Phenothiazine medicine (including chlorpromazine, perphenazine, prochlorperazine, promethazine, thioridazine)
  • Thyroid medicine
  • Triptan medicine to treat migraine headaches
• Alcohol, narcotic pain relievers, or sleeping pills may cause you to feel more lightheaded, dizzy, or faint when used with this medicine. Tell your doctor if you drink alcohol or use pain relievers or sleeping pills.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have heart disease (including Brugada syndrome), heart rhythm problems, glaucoma, depression, thyroid problems, trouble urinating, or a history of seizures or other mental problems.
• This medicine may cause the following problems:
  • Increased risk of heart attack, hearth rhythm problems, or stroke
  • Serotonin syndrome (especially when used with certain medicines)
  • Eye or vision problems
• For some children, teenagers, and young adults, this medicine may increase mental or emotional problems. This may lead to thoughts of suicide and violence. Talk with your doctor right away if you have any thoughts or behavior changes that concern you. Tell your doctor if you or anyone in your family has a history of bipolar disorder or suicide attempts.
• This medicine may make you dizzy or drowsy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• Tell any doctor or dentist who treats you that you are using this medicine. You may need to stop using this medicine several days before you have surgery or medical tests.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Anxiety, restlessness, fever, sweating, muscle spasms, twitching, nausea, vomiting, diarrhea, seeing or hearing things that are not there
• Change in how much or how often you urinate, problems urinating
• Chest pain that may spread to your arms, jaw, back, or neck, trouble breathing, nausea, unusual sweating, dizziness, lightheadedness
• Eye pain, vision changes, seeing halos around lights
• Fast, pounding, or uneven heartbeat
• Numbness or weakness in your arm or leg, or on one side of your body
• Seizures or tremors
• Sudden or severe headache, problems with speech or walking
• Thoughts of hurting yourself or others, unusual behavior
• Unexplained fainting

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088