Nortriptyline hydrochloride
Trade Names:
Aventyl, Pamelor
Type of Drug:
Nortriptyline hydrochloride belongs to a general class of tricyclic antidepressant drugs.
How Drug Works:
Nortriptyline hydrochloride stops the uptake of serotonin in the nerve endings, thus increasing the amount of serotonin and norepinephrine available in the brain. This decreases the feeling of depression. Nortriptyline hydrochloride also may increase pain relief when given with opioid analgesics.
How Drug Is Given:
Nortriptyline hydrochloride is a pill given by mouth once a day at bedtime, so you will sleep better. Once you start taking the pills, it may take up to 2 weeks to feel the full effect. Other benefits like sleeping better and decreased pain will happen right away. The dose depends on your age, how well the medicine helps you, and how well your liver is working. Your doctor may need to gradually increase the dose. In addition, the doctor will monitor the drug level in the blood. Keep the medicine in a tightly closed container away from heat and moisture and out of the reach of children and pets.
Read the following information. If you do not understand it or if any of it causes you special concern, check with your doctor.
Before taking this drug, tell your doctor if you are taking any other prescription or over-the-counter drugs, including vitamins and herbals.
Should I avoid any other medicines, foods, alcohol, and/or activities?
Your prescription and nonprescription medicines may interact with other drugs, causing harm. Certain foods or alcohol can also interact with drug products. Never begin taking a new medicine"prescription or nonprescription"without asking your doctor or nurse if it will interact with alcohol, food, or other medicines. Some drug products can cause drowsiness and affect activities such as driving.
Precautions:
Tell your doctor if you are taking any of the following drugs as they may have serious interactions with nortriptyline hydrochloride: other antidepressant drugs (monoamine oxidase inhibitors), sedatives, cimetidine, barbiturates, or warfarin (Coumadin).
Since nortriptyline hydrochloride affects the central nervous system (CNS), it is important not to take other drugs or substances that are known CNS depressants such as alcohol, sedatives, and hypnotics.
Tell your doctor if you have had a heart attack (myocardial infarction), have a seizure disorder, or have benign prostatic hypertrophy. You should not take this drug.
Tell your doctor if you have urinary retention, narrow-angle glaucoma, hyperthyroidism, liver problems, or have thoughts of suicide. This drug should be used very cautiously if you have any of these conditions.
Abruptly stopping the drug can cause anxiety, dizziness, nausea and vomiting, and tiredness. The drug should be gradually stopped.
Side effects in the elderly may be more severe. These include dry mouth, constipation, confusion, disorientation, and hallucinations.
When you start taking the drug, you may feel drowsy, dizzy, confused, or weak. This should go away after 1 to 2 weeks of taking the drug. If it does not, talk to your doctor. Your dose may need to be reduced.
Tell all the doctors, dentists, and pharmacists you visit that you are taking this drug.
  • Most of the following side effects probably will not occur.
  • Your doctor or nurse will want to discuss specific care instructions with you.
  • They can help you understand these side effects and help you deal with them.
Side Effects:
More Common Side Effects
  • Drowsiness
  • Tiredness (fatigue)
  • Dizziness
  • Dry mouth
  • Vomiting
  • Diarrhea
  • Abdominal cramping
Less Common Side Effects
  • Confusion
  • Disorientation
  • Nausea
  • Changes in appetite
  • Urinary retention
Rare Side Effects
  • Hallucinations
  • Fine tremors
  • Rigidity
  • Difficulty speaking
  • Difficulty swallowing
  • Numbness and tingling in hands and/or feet
  • Blurred vision
  • Decrease in blood pressure when changing position
  • Change in the electrical activity of the heart by EKG (electrocardiogram)
  • Increased blood pressure
  • Increased heart rate
  • Rash
  • Hives
  • Increased sensitivity to sunlight
Side Effects / Symptoms of the Drug

Be careful walking around or changing position if you are drowsy. Do not drive a car or operate heavy machinery if you are drowsy or dizzy. Stop the drug and call your doctor or nurse if the drowsiness does not go away, or if you have trouble walking or moving because of it.

Tell your doctor or nurse if you get fine tremors, feel like your body is rigid, or have difficulty speaking or swallowing. You can be given another medicine to lessen these problems.
Other side effects not listed above can also occur in some patients. Tell your doctor or nurse if you develop any problems.
FDA Approval: Yes