Brand name: Nortriptyline HCl
Pronounced: PAM-eh-lore
Generic name: Nortriptyline hydrochloride
Other brand name: Aventyl
Why is Nortriptyline HCl prescribed?

Nortriptyline HCl is prescribed for the relief of symptoms of depression. It is one of the drugs known as tricyclic antidepressants.

Some doctors also prescribe Nortriptyline HCl to treat chronic hives, premenstrual depression, attention deficit hyperactivity disorder in children, and bedwetting.
Most important fact about Nortriptyline HCl without prescriptions

Nortriptyline HCl must be taken regularly to be effective and it may be several weeks before you begin to feel better. Do not skip doses, even if they seem to make no difference.
How should you take Nortriptyline HCl ?

Take Nortriptyline HCl exactly as prescribed. Nortriptyline HCl may make your mouth dry. Sucking on hard candy, chewing gum, or melting ice chips in your mouth can provide relief.

If you miss a dose...

Take it as soon as you remember. If it is almost time for the next dose, skip the one you missed and go back to your regular schedule. If you take Nortriptyline HCl once a day at bedtime and you miss a dose, do not take it in the morning, since disturbing side effects could occur. Never take 2 doses at once.

Storage instructions Nortriptyline HCl 25mg

Keep Nortriptyline HCl in the container it came in, tightly closed and away from light. Be sure to keep Nortriptyline HCl out of reach of children; an overdose is particularly dangerous in the young. Store at room temperature.
Nortriptyline HCl side effects

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Nortriptyline HCl .

* Side effects may include: Anxiety, blurred vision, confusion, dry mouth, hallucinations, heart attack or vascular heart blockage, heartbeat irregularities, high blood pressure, insomnia, loss of muscle coordination, low blood pressure, rapid heartbeat, sensitivity to sunlight, skin rash, stroke, tremors, weight loss

* Side effects due to rapid decrease in dose or abrupt withdrawal from Nortriptyline HCl after prolonged treatment include:
Headache, nausea, vague feeling of bodily discomfort

These side effects do not indicate addiction to Nortriptyline HCl .
Why should Nortriptyline HCl not be prescribed?

If you are sensitive to or have ever had an allergic reaction to Nortriptyline HCl or similar drugs, you should not take Nortriptyline HCl . Make sure your doctor is aware of any drug reactions you have experienced.

Do not take Nortriptyline HCl if you are taking--or have taken within the past 14 days--a drug classified as an MAO inhibitor. Drugs in this category include the antidepressants Nardil and Parnate. Combining these drugs with Nortriptyline HCl can cause fever and convulsions, and could even be fatal.

Unless you are directed to do so by your doctor, do not take this medication if you are recovering from a heart attack or are taking any other antidepressant drugs.

If you have been taking Prozac, you may have to wait at least 5 weeks before beginning therapy with Nortriptyline HCl . A drug interaction could result.
Special warnings about Nortriptyline HCl

In clinical studies, antidepressants increased the risk of suicidal thinking and behavior in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of Nortriptyline HCl or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Nortriptyline HCl is not approved for use in children.

Additionally, the progression of major depression is associated with a worsening of symptoms and/or the emergence of suicidal thinking or behavior in both adults and children, whether or not they are taking antidepressants. Individuals being treated with Nortriptyline HCl and their caregivers should watch for any change in symptoms or any new symptoms that appear suddenly--especially agitation, anxiety, hostility, panic, restlessness, extreme hyperactivity, and suicidal thinking or behavior--and report them to the doctor immediately. Be especially observant at the beginning of treatment or whenever there is a change in dose.

Nortriptyline HCl may cause you to become drowsy or less alert; therefore, you should not drive or operate dangerous machinery or participate in any hazardous activity that requires full mental alertness until you know how Nortriptyline HCl affects you.

Use Nortriptyline HCl with caution if you have a history of seizures, difficulty urinating, diabetes, or chronic eye conditions such as glaucoma. Be careful, also, if you have heart disease, high blood pressure, or an overactive thyroid, or are receiving thyroid medication. You should discuss all of your medical problems with your doctor before taking Nortriptyline HCl .

If you are being treated for a severe mental disorder (schizophrenia or manic depression), tell your doctor before taking Nortriptyline HCl .

Nortriptyline HCl may make your skin more sensitive to sunlight. Try to stay out of the sun, wear protective clothing, and apply a sun block.

Before having surgery, dental treatment, or any diagnostic procedure, tell your doctor that you are taking Nortriptyline HCl . Certain drugs used during these procedures, such as anesthetics and muscle relaxants, may interact with Nortriptyline HCl .
Possible food and drug interactions when taking Nortriptyline HCl

Combining Nortriptyline HCl and MAO inhibitors can be fatal.

Nortriptyline HCl may intensify the effects of alcohol. Do not drink alcohol while taking Nortriptyline HCl .

If Nortriptyline HCl is taken with certain other drugs, the effects of either can be increased, decreased, or altered. It is especially important to check with your doctor before combining Nortriptyline HCl with the following:

Airway-opening drugs such as Ventolin and Proventil
Antidepressants such as Wellbutrin and Desyrel
Antidepressants that act on serotonin, such as Prozac, Paxil, and Zoloft
Blood pressure medications such as Catapres and Esimil
Cimetidine (Tagamet)
Chlorpropamide (Diabinese)
Drugs for heart irregularities, such as Tambocor and Rythmol
Drugs that control spasms, such as Donnatal and Bentyl
Levodopa (Larodopa)
Major tranquilizers such as Thorazine and Mellaril
Quinidine (Quinidex)
Reserpine (Diupres)
Stimulants such as Dexedrine
Thyroid medication such as Synthroid
Warfarin (Coumadin)
Special information if you are pregnant or breastfeeding

The effects of Nortriptyline HCl during pregnancy have not been adequately studied. If you are pregnant or planning to become pregnant, inform your doctor immediately. Also consult your doctor before breastfeeding.
Recommended dosage for Nortriptyline HCl

This medication is available in tablet and liquid form. Only tablet dosages are listed. Consult your doctor if you cannot take the tablet form of Nortriptyline HCl .

ADULTS
Overdosage

An overdose of this type of antidepressant can be fatal. If you suspect an overdose, seek medical help immediately.

* Symptoms of Nortriptyline HCl overdose may include:
Agitation, coma, confusion, congestive heart failure, convulsions, dilated pupils, disturbed concentration, drowsiness, excessive reflexes, extremely high fever, fluid in the lungs, hallucinations, irregular heartbeat, low body temperature, restlessness, rigid muscles, severely low blood pressure, shock, stupor, vomiting