Nortriptyline – what is it for, how to take it and contraindications!

Nortriptyline  is a tricyclic antidepressant that inhibits the action of the neurotransmitters Histamine, Serotonin and Acetylcholine . It affects chemicals in the brain that may be out of balance in people with depression .

Its main function is to be used to treat symptoms of depression . You should not use Nortriptyline  if you have recently had a heart attack or if you are allergic to certain medications. Some young people have thoughts of suicide when taking an antidepressant.

Your doctor will need to check your progress at regular visits while you are using Nortriptyline . Your family or other caregivers should also be aware of changes in your mood or symptoms.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety , panic attacks, difficulty sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically) , more depressed, or having thoughts about suicide or harming yourself.

How should I take?

Take Nortriptyline  exactly as it has been prescribed for you. Follow all instructions on your prescription label. Your doctor may occasionally change your dose to ensure you get the best results. Do not take this medication in larger or smaller amounts or for longer than recommended.

If you need surgery, let the surgeon know in advance that you are using Nortriptyline . You may need to stop using the drug for a short time. Do not stop using Nortriptyline  suddenly, or you may experience unpleasant withdrawal symptoms.

Ask your doctor how to safely stop using this medication. It may take a few weeks for symptoms to improve. Continue using medication as directed and tell your doctor if symptoms do not improve. Store at room temperature away from moisture and heat.


Check the recommended dosage of Nortriptyline below :

Usual Adult Dose for Depression:

Initial dose:

  • 25 mg orally three or four times a day.

Maximum dose:

  • 150 mg orally per day.

The total daily dose can be administered once a day.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up for the missed dose.

What should I avoid while taking nortriptyline?

Do not drink alcohol. Nortriptyline  can increase the effects of alcohol, which can be dangerous. 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. This medication can cause burns more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when outdoors.

Precautions when taking nortriptyline:

You should not use Nortriptyline  if:

  • You are allergic to Nortriptyline ;
  • If you have recently had a heart attack ;
  • You are allergic to similar antidepressants (amitriptyline, amoxapine, clomipramine, desipramine, doxepin, imipramine, protriptyline, trimipramine);
  • You are allergic to certain seizure medications (carbamazepine, eslicarbazepine, oxcarbazepine, rufinamide).

Do not use Nortriptyline  if you have used an inhibitor within the last 14 days. A dangerous drug interaction may occur. Inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine and others. To make sure Nortriptyline  is safe for you, tell your doctor if you have:

  • Heart disease or a history of heart attack , stroke, or seizures ;
  • Bipolar disorder (manic-depressive);
  • Schizophrenia or other mental illnesses;
  • Liver disease;
  • A thyroid disorder;
  • Diabetes;
  • Narrow-angle glaucoma;
  • Problems with urination.

It is not known whether nortriptyline  will harm an unborn baby. Tell your doctor if you are pregnant or planning to become pregnant while using this medicine. It is not known whether nortriptyline  passes into breast milk or whether it could harm a nursing baby.

Tell your doctor if you are breast-feeding a baby. Do not give this medicine to a child without medical advice. Nortriptyline is  not approved for use in children.

Nortriptyline side effects:

Get emergency medical help if you have signs of an allergic reaction to Nortriptyline :

  • Urticaria ;
  • Breathing difficulty;
  • Swelling of the face, lips, tongue or throat.

Report any new or worsening symptoms to your doctor, such as:

  • Changes in mood or behavior;
  • Anxiety ;
  • Panic attacks;
  • Difficulty sleeping or if you feel impulsive
  • Irritable, agitated, hostile, aggressive;
  • Restless, hyperactive (mentally or physically);
  • More depressed, or having thoughts about suicide or hurting yourself.

Call your doctor right away if you have:

  • Blurred vision, tunnel vision;
  • Pain or swelling in the eyes;
  • or seeing halos around lights;
  • Restless muscle movements in your eyes, tongue, jaw or neck
  • A dizzy feeling, as if you were going to pass out;
  • Convulsion ( seizures );
  • New or worsening chest pain, rapid heartbeat or chest tremors;
  • Sudden numbness or weakness, problems with vision, speech or balance;
  • Fever , sore throat, easy bruising, unusual bleeding;
  • Jaundice (yellowing of the skin or eyes);
  • Painful or difficult urination;
  • High levels of serotonin in the body – restlessness, hallucinations, fever , fast heart rate, overactive reflexes, nausea , vomiting , diarrhea , loss of coordination, fainting.

What other medicines will affect nortriptyline?

Taking this medicine with other medicines that make you sleepy can make this effect worse. Ask your doctor before taking Nortriptyline  with a sleeping pill, narcotic pain reliever, muscle relaxant, or medication for anxiety , depression , or seizures .

Before taking Nortriptyline , tell your doctor if you have used an “SSRI” antidepressant in the last 5 weeks, such as citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, or sertraline. You must wait at least 5 weeks after stopping fluoxetine (Prozac) before you can take this medicine.

Many medications can interact with medications, which can cause unwanted or dangerous effects. This includes prescription and over-the-counter drugs, vitamins and herbal products.

Useful links: 

Not all possible interactions are listed in this medication guide. Tell your doctor about all the medicines you use and those you start or stop using during treatment with these medicines. Give a list of all your medications to any healthcare provider who treats you.

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