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Nortriptyline 10mg capsule


Nortriptyline: a medicine used to treat nerve pain and depression

1. About nortriptyline

Nortriptyline is a medicine used for treating nerve pain.

Occasionally, it's also used to treat depression and bedwetting in children (nocturnal enuresis) .

Nortriptyline is available on prescription. It comes as tablets.

2. Key facts

  • If you take nortriptyline to treat nerve pain, it usually takes a week or so for pain to begin to wear off.
  • If you take it for depression, it can take 4 to 6 weeks until it reaches full effect.
  • Common side effects include a dry mouth and constipation. They're usually mild and go away after a couple of weeks.
  • Nortriptyline can make you feel sleepy so it's best to take it in the evening or before you go to bed.
  • If your doctor decides to take you off nortriptyline, they will reduce your dose gradually to help prevent withdrawal side effects such as muscle pain or feeling sick or tired.

3. Who can and cannot take nortriptyline

Most adults can take nortriptyline. Teenagers aged 12 to 17 years can take it for depression.

Children aged 6 to 17 years old can also take it for bedwetting but other medicines are used first which have less side effects.

Nortriptyline is not suitable for some people. Check with your doctor before starting to take nortriptyline if you:

  • have ever had an allergic reaction to nortriptyline or any other medicine
  • have a heart problem – nortriptyline can make some heart problems worse
  • have liver or kidney problems
  • have epilepsy or are having electroconvulsive treatment (ECT) – nortriptyline can increase your risk of seizures or fits
  • have ever taken any medicines for depression – some antidepressants can affect the way nortriptyline works, even after you've stopped taking them
  • are pregnant, trying to get pregnant or breastfeeding
  • have glaucoma – nortriptyline can increase the pressure in your eye
  • have thoughts about harming yourself or ending your life
  • have type 1 or type 2 diabetes – if you have diabetes, nortriptyline may affect your blood sugar levels. If you usually test your blood sugar level, you may have to do this more often for the first few weeks of treatment. Talk to your diabetes nurse or doctor if the reading is high or low

4. How and when to take nortriptyline

You'll usually take nortriptyline once a day. If you take it once a day, it's best to take it before you go to bed as it can make you feel sleepy. If you find that it's affecting your sleep, you could try taking it earlier in the evening.

This medicine does not usually upset your stomach. You can take it with or without food.

Swallow the tablets whole, with a drink of water. If you chew them, they taste bitter.

Dosage and strength

Nortriptyline tablets come in 3 different strengths, 10mg, 25mg or 50mg.

The usual dose to treat nerve pain in adults is 10mg a day. This can be increased if necessary. The maximum dose of nortriptyline for treating pain is 75mg a day, but this is only under the supervision of a pain specialist.

For depression in adults, the dose is increased gradually to between 75mg and 100mg a day. It can be increased to a maximum dose of 150mg a day if a specialist prescribes it.

For depression in teenagers (12 to 17 years), the dose is usually increased gradually to 30mg to 50mg a day, but higher doses may be needed.

What if I forget to take it?

If you forget a dose, take it as soon as you remember, unless it's nearly time for your next dose. In this case, just leave out the missed dose and take your next dose at the usual time.

Never take 2 doses at the same time to make up for a forgotten dose.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

What if I take too much?

Urgent advice: Contact 111 for advice now if:

  • you take more than your usual dose of nortriptyline

Go to 111.nhs.uk or call 111

Taking too much nortriptyline can cause serious side effects such as a change in your heartbeat, or you may have a seizure or fit.

5. Side effects

Like all medicines, nortriptyline can cause side effects in some people, but many people have no side effects or only minor ones.

Some of the common side effects of nortriptyline will gradually improve as your body gets used to the medicine.

Common side effects

Doses of nortriptyline for pain are lower than the doses for depression. This means the common side effects tend to be milder and go away within a few days.

Keep taking the medicine but talk to your doctor or pharmacist if these side effects bother you or do not go away:

  • constipation
  • feeling dizzy
  • dry mouth
  • feeling sleepy
  • difficulty peeing
  • headaches

Serious side effects

It happens rarely, but some people have a serious side effect after taking nortriptyline.

Contact a doctor if:

  • your heartbeat becomes fast and irregular
  • the whites of your eyes turn yellow, or your skin turns yellow, although this may be less obvious on brown or black skin – these can be signs of a liver problem
  • you have a headache that does not get better, feel confused or weak and have muscle cramps – together these can be signs of low sodium levels in your blood
  • you have thoughts about harming yourself or ending your life
  • you have eye pain, a change in your eyesight, or swelling or redness in or around the eye
  • you have constipation that lasts a long time or problems peeing which are causing stomach ache

Immediate action required: Call 999 or go to A&E if:

  • you have weakness on one side of your face or body, trouble speaking or thinking, loss of balance or blurred eyesight – these can be signs of a stroke
  • you have a seizure or fit
  • you get severe chest pain – this can be a sign of a heart attack
Serious allergic reaction

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to nortriptyline.

Immediate action required: Call 999 or go to A&E now if:

  • you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
  • you're wheezing
  • you get tightness in the chest or throat
  • you have trouble breathing or talking
  • your mouth, face, lips, tongue or throat start swelling

You could be having a serious allergic reaction and may need immediate treatment in hospital.

These are not all the side effects of nortriptyline. For a full list see the leaflet inside your medicines packet.

Information:

You can report any suspected side effect using the Yellow Card safety scheme.

Visit Yellow Card for further information.

6. How to cope with side effects of nortriptyline

What to do about:

  • constipation – get more fibre into your diet such as fresh fruit, vegetables and cereals. Try to drink several glasses of water or squash every day. If you can, it may also help to increase your level of exercise.
  • feeling dizzy – this is probably due to low blood pressure. Drink plenty of water or squash. Do not stand up too quickly after you've been sitting or lying down. Do not drive, cycle or use tools or machinery until this feeling passes. It's best not to drink alcohol until you see how the medicine affects you.
  • dry mouth – chew sugar-free gum or have some sugar-free sweets.
  • feeling sleepy – take nortriptyline in the evening. It's best not to drink alcohol until you see how the medicine affects you. Do not drive, cycle or use tools or machinery while you're feeling sleepy.
  • difficulty peeing – try to relax when you pee. Do not try to force the flow of urine. If it does not happen, try again later. Talk to your doctor urgently if you cannot pee at all.
  • headaches – make sure you rest and drink plenty of fluids. It's best not to drink alcohol until you see how the medicine affects you. Try taking paracetamol or ibuprofen if you need pain relief. Talk to your doctor if the headaches last longer than a few days or are severe.

7. Pregnancy and breastfeeding

Nortriptyline and pregnancy

You may be advised to continue taking nortriptyline during pregnancy, especially if you take it to treat depression.

Speak to your doctor if you become pregnant while taking nortriptyline. Do not stop taking your medicine unless your doctor tells you to.

Your doctor can explain the risks and benefits of taking nortriptyline and will help you choose the best treatment for you and your baby.

Nortriptyline and breastfeeding

If your doctor or health visitor says your baby is healthy, you can use nortriptyline while breastfeeding.

Notriptyline passes into breast milk in very small amounts so it's unlikely to cause any harm to your baby.

If you are being treated for depression it's important to continue taking nortriptyline to keep you well. Breastfeeding will also benefit both you and your baby.

If you notice that your baby is not feeding as well as usual, or seems unusually sleepy, or if you have any other concerns about your baby, then talk to your health visitor or doctor as soon as possible.

Non-urgent advice: Tell your doctor if you're:

  • trying to get pregnant
  • pregnant
  • breastfeeding

For more information about how nortriptyline can affect you and your baby during pregnancy, read this leaflet on the Best Use of Medicines in Pregnancy (BUMPs) website.

8. Cautions with other medicines

Many medicines taken with nortriptyline can affect each other and increase the chance of side effects.

Always check with your doctor or a pharmacist before starting any new medicine while you are taking nortriptyline.

Taking opioid-based medicines, like codeine, morphine or oxycodone, together with nortriptyline can increase your risk of becoming very drowsy and having breathing problems.

Tell your doctor if you have ever taken any medicines for depression. Some antidepressants can affect the way nortriptyline works and cause very high blood pressure. This can happen even after you have stopped taking them.

Mixing nortriptyline with herbal remedies and supplements

Do not take St John's wort, the herbal remedy for depression, while you are being treated with nortriptyline. It will increase your risk of side effects.

There's very little information about taking nortriptyline with other herbal remedies and supplements. They are not tested in the same way as medicines.

Important: Medicine safety

Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements.

9. Common questions about nortriptyline

How does nortriptyline work?

Nortriptyline is from a group of antidepressants called tricyclic antidepressants.

If you're taking it for pain relief, it will change the way that your nerves receive pain signals so your pain goes away.

If you're taking nortriptyline for depression, it's thought to work by increasing a chemical called serotonin in the brain. This helps to improve your mood.

How long does it take to work?

If you take nortriptyline to treat nerve pain, it usually takes a week or so for pain to begin to wear off. You may start to sleep better at night.

If you take nortriptyline for depression, you may start to feel better after a couple of weeks. It can take 4 to 6 weeks until you feel the full benefits.

Do not stop taking nortriptyline after 1 to 2 weeks just because you feel it's not helping your symptoms. Give it at least 6 weeks to work.

How will nortriptyline make me feel?

Although nortriptyline is an antidepressant, the doses are lower if you take it to help pain. Taking nortriptyline as a painkiller will not change your personality or make you feel any different.

If you're taking nortriptyline for depression, it helps to lift your mood gradually so you feel better. You may get on with people more easily because you are less anxious.

Nortriptyline will not change your personality or give you a high of feeling happy. It will simply help you feel like yourself again.

Do not expect to feel better overnight though. Some people feel worse during the first few weeks of treatment before they begin to feel better.

What if I do not feel better?

When nortriptyline is taken for nerve pain, most people are able to sleep better within a few days and the pain starts to wear off after a week or so.

If your pain does not get better or you have side effects, talk to your doctor as there may be other treatments which work for you.

Talk to your doctor if you take nortriptyline for depression and you do not feel better after taking it for 6 weeks, or the side effects bother you.

How long will I take nortriptyline for?

If you take nortriptyline for pain, once your pain is under control, you'll probably continue to take it for as long as it's working for you. Some people take it for many months and even for years.

If you take nortriptyline for depression, it's likely you'll take it for several more months once you're feeling better.

Most doctors recommend that you take antidepressants for 6 months to a year after you've stopped feeling depressed.

Stopping before then can make depression come back. Talk to your doctor about the risks and benefits of continuing to take nortriptyline for more than a few months.

Can I take nortriptyline long term?

For most people, nortriptyline is safe to take for a long time.

There do not seem to be any lasting harmful effects from taking nortriptyline for many months or years.

Is nortriptyline addictive?

Nortriptyline is not addictive but you can get withdrawal side effects if you stop taking it suddenly. You may have flu-like symptoms like feeling sick, muscle pain and feeling tired or restless.

To help prevent this happening, your doctor will probably recommend reducing your dose gradually over several weeks, or longer if you have been taking nortriptyline for a long time.

What will happen when I stop taking it?

You may get withdrawal side effects when you stop taking nortriptyline, especially if you stop taking it suddenly.

These side effects are a physical reaction as the medicine leaves your body. They can include sweating, being sick, feeling anxious, and difficulty falling asleep.

To help prevent them, your doctor will probably recommend reducing your dose gradually over several weeks, or longer if you have been taking nortriptyline for a long time.

Important

Do not stop taking nortriptyline suddenly, or without talking to your doctor.

Can I take nortriptyline with other painkillers?

Paracetamol and ibuprofen are safe to take with nortriptyline for a short time. Talk to your doctor if you need to take them for more than a few days.

Will it affect my sex life?

A few people have sex-related problems while they take nortriptyline. Both men and women may have changes in their sex drive.

Sexual side effects are not very common and should pass after the first couple of weeks. If they do not, and this is a problem for you, go back to your doctor to see if there's another medicine you can try.

How is nortriptyline different to other medicines for nerve pain?

Nortriptyline is usually prescribed by your doctor if other painkillers, such as paracetamol and ibuprofen, have not worked.

Nortriptyline does not work any better or worse than other medicines for nerve pain.

How is it different to other antidepressants?

Nortriptyline does not work any better or worse than other antidepressants. However, sometimes people respond better to one antidepressant than another.

The best antidepressant for you depends on your symptoms and what medicines have worked for you in the past.

Talk to your doctor if you are not feeling any better after taking nortriptyline for 6 weeks or if the side effects still bother you.

Will I gain or lose weight?

Nortriptyline can change how hungry you feel. Some people feel more hungry when they're taking it, and others feel less hungry. So your weight may change when you first start taking it.

If you start to have problems with your weight while taking nortriptyline, talk to your doctor or pharmacist.

Can I drink alcohol with it?

You can drink alcohol while taking nortriptyline but it may make you feel sleepy. It might be best to stop drinking alcohol until you see how the medicine makes you feel.

Are there foods and drinks I should avoid?

Apart from being extra careful with alcohol, you can eat and drink normally while taking nortriptyline.

Will it affect my contraception?

Nortriptyline does not affect any type of contraception including the combined pill and emergency contraception.

Will it affect my fertility?

There's no clear evidence to suggest that nortriptyline affects fertility in either men or women.

However, speak to your doctor or a pharmacist before taking nortriptyline if you're trying to get pregnant.

Can I drive or ride a bike?

Some people feel sleepy while they're taking nortriptyline. It's best to stop driving, cycling or operating machinery for the first few days and after each dose increase, until you know how this medicine makes you feel.

Will recreational drugs affect nortriptyline?

Cannabis with nortriptyline can make you feel very sleepy, especially if you've just started taking it. Cannabis can also give you a fast heartbeat.

It may be dangerous to take nortriptyline with:

  • methadone
  • stimulants like MDMA (ecstasy) or cocaine
  • hallucinogens like LSD
  • novel psychoactive substances (these used to be called "legal highs") like mephedrone

Nortriptyline has not been properly tested with recreational drugs. Talk to your doctor if you think you might use recreational drugs while taking nortriptyline.

Side Effects, Dosage, Uses, and More

Highlights for nortriptyline

  1. Nortriptyline oral capsule is available as both a generic and brand-name drug. Brand name: Pamelor.
  2. Nortriptyline comes as an oral capsule and an oral solution.
  3. Nortriptyline oral capsule is used to treat depression.

FDA warning: Suicide risk


  • This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.
  • Nortriptyline may increase the risk of suicidal thoughts and behavior for people younger than 24 years. Having depression and psychiatric problems puts you at higher risk of suicide. Your doctor will monitor you for any changes in your depression symptoms and any unusual behavior or thoughts about suicide.

Other warnings

  • Cardiovascular problems warning: Taking nortriptyline could put you at risk of a fast heart rate, heart attack, stroke, and other circulatory problems. Tell your doctor if you have any heart problems before taking nortriptyline. Do not take nortriptyline if you recently had a heart attack.
  • Increased eye pressure warning: Nortriptyline may increase pressure in your eyes. This may cause glaucoma in people who are already at risk of glaucoma.
  • Serotonin syndrome warning: This drug may cause a condition called serotonin syndrome. The symptoms of serotonin syndrome include hallucinations and delusions, agitation, coma, fast heart rate, changes in blood pressure, dizziness, loss of consciousness, seizures, shakiness, muscle tremors or stiff muscles, sweating, nausea, and vomiting.
  • Dementia warning: Research has indicated that this type of medication can cause effects similar to those caused by drugs called anticholinergics. This can raise your risk of dementia.

Nortriptyline is a prescription drug. It comes as an oral capsule and an oral solution.

Nortriptyline oral capsule is available as the brand-name drug Pamelor. It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in all strengths or forms as the brand-name drug.

Why it’s used

Nortriptyline is used to treat depression.

Nortriptyline may be used as part of a combination therapy. This means you may need to take it with other medications.

How it works

Nortriptyline belongs to a class of drugs called tricyclic antidepressants. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Nortriptyline works on your central nervous system to increase the level of certain chemicals in your brain. This helps relieve your depression.

Nortriptyline oral capsule may cause drowsiness. It may also cause other side effects.

More common side effects

Some of the more common side effects that can occur with use of nortriptyline include:

  • low blood pressure
  • high blood pressure
  • confusion (mainly in seniors)
  • sleep problems
  • shakiness
  • dry mouth
  • blurry vision
  • constipation
  • skin rash
  • hives
  • itching
  • skin sensitivity to light
  • nausea
  • vomiting
  • diarrhea
  • stomach cramps
  • decreased sexual desire
  • unexpected weight loss or gain
  • sweating
  • headache

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Psychiatric problems. Symptoms can include:
    • suicidal thoughts and behavior
    • depression
    • anxiety
    • restlessness
    • panic attacks
    • sleep disturbances such as nightmares or insomnia (trouble sleeping)
    • disorientation
    • changes in behavior
    • rapid speech and increased activity (signs of mania)
  • Fast heart rate
  • Heart attack. Symptoms can include:
    • chest pain
    • shortness of breath
    • pain or pressure in your upper body
  • Stroke. Symptoms can include:
    • weakness in one part or side of your body
    • slurred speech or trouble speaking
  • Inability to urinate
  • Seizures
  • Drowsiness
  • Serotonin syndrome. Symptoms can include:
    • hallucinations
    • agitation
    • delusions
    • changes in blood pressure level
    • fast heart rate
    • loss of consciousness
    • sweating
    • muscle tremors or stiff muscles
    • shakiness
    • nausea and vomiting
  • Increased eye pressure. Symptoms can include:
    • eye pain
    • swelling and redness near your eyes
    • changes in vision

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Nortriptyline oral capsule can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with nortriptyline are listed below.

Drugs you should not use with nortriptyline

Do not take these drugs with nortriptyline. Doing so can cause dangerous side effects in your body. Examples of these drugs include:

  • Monoamine oxidase inhibitors (MAOIs) and drugs with MAOI effects such as phenelzine, tranylcypromine, selegiline, linezolid, and methylene blue
    • Taking these drugs with nortriptyline can cause serotonin syndrome. Wait at least 14 days after stopping nortriptyline before taking an MAOI, and vice versa.
  • Increased side effects from nortriptyline: Taking nortriptyline with certain medications raises your risk of side effects from nortriptyline. This is because the amount of nortriptyline in your body may be increased. Examples of these drugs include:
    • Cimetidine
      • Increased side effects of nortriptyline can include headache, fast heart rate, and drowsiness.
    • Cytochrome P450 2D6 inhibitors such as quinidine, sertraline, paroxetine, and fluoxetine (Note: You might need to wait about 5 weeks after stopping fluoxetine before starting nortriptyline.)
      • Increased side effects of nortriptyline can include headache, fast heart rate, and drowsiness. Your doctor may start you at a lower dosage of nortriptyline if you’re taking it with one of these medications.
  • Increased side effects from other drugs: Taking nortriptyline with certain medications raises your risk of side effects from these drugs. Examples of these drugs include:
    • Reserpine
      • Increased side effects of this drug can include higher blood pressure and heart rate, and trouble sleeping.
    • Drugs with anticholinergic effects such as diphenhydramine, loratadine, oxybutynin, solifenacin, and olanzapine
      • Increased side effects of these drugs can include changes in your blood pressure, urinary retention, and increased heart rate. Your doctor may have to adjust your dosages if you take one of these drugs with nortriptyline.
    • Sympathomimetic drugs such as epinephrine, ephedrine, and norepinephrine
      • Increased side effects of these drugs can include changes in your blood pressure, headache, and increased heart rate. Your doctor may have to adjust your dosages if you take one of these drugs with nortriptyline.
    • Chlorpropamide
      • Increased side effects of this drug can include low blood sugar levels in people with diabetes.
  • Increased side effects from both drugs: Taking nortriptyline with certain medications raises your risk of side effects. This is because nortriptyline and these other medications can cause the same side effects. As a result, these side effects can be increased. Examples of these drugs include:
    • Serotonin reuptake inhibitors (SSRIs) such as sertraline, fluoxetine, paroxetine, and venlafaxine
      • Taking these medications with nortriptyline increases your risk of serotonin syndrome. If you need to take any of these drugs with nortriptyline, your doctor may adjust your dosage of both drugs.
    • Norepinephrine reuptake inhibitors (SNRIs) such as duloxetine and desvenlafaxine
      • Taking these medications with nortriptyline increases your risk of serotonin syndrome. If you need to take any of these drugs with nortriptyline, your doctor may adjust your dosage of both drugs.
    • Triptans, such as sumatriptan and naratriptan
      • Taking these medications with nortriptyline increases your risk of serotonin syndrome. If you need to take any of these drugs with nortriptyline, your doctor may adjust your dosage of both drugs.
    • Other drugs, such as fentanyl, lithium, tramadol, tryptophan, buspirone, and St. John’s wort
      • Taking these medications with nortriptyline increases your risk of serotonin syndrome. If you need to take any of these drugs with nortriptyline, your doctor may adjust your dosage of both drugs.

Interactions that increase your risk of side effects

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

Call your doctor if you notice your depression getting worse while you take this drug. Also call your doctor if you have suicidal thoughts.

Nortriptyline oral capsule comes with several warnings.

Allergy warning

Nortriptyline can cause a severe allergic reaction. Symptoms can include:

  • skin rash, hives, itching, and sun sensitivity
  • swelling of your body or face and tongue
  • fever

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 911 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Alcohol interaction warning

The use of drinks that contain alcohol together with nortriptyline can lead to suicidal thoughts and attempts. This risk is higher if you have a history of suicidal thoughts and trouble controlling your emotions. If you drink alcohol, talk to your doctor.

Warnings for people with certain health conditions

For people with heart and other cardiovascular disorders: Taking this drug may increase your risk of stroke and heart problems, such as irregular heart rhythm or heart attack. Do not take this drug if you’re recovering from a recent heart attack.

For people with bipolar disorder: Before starting therapy with antidepressants, it’s important for your doctor to check your risk of bipolar disorder. If you have bipolar disorder that’s not being treated, taking nortriptyline can make your condition worse.

For people with a history of seizures: Taking this drug may increase your risk of seizures. If you have a history of seizures, your doctor will monitor you more closely. If you have a seizure while taking nortriptyline, stop taking it and call your doctor.

For people with glaucoma or increased eye pressure: Taking this drug could increase the pressure in your eyes. If you have a history of glaucoma or increased eye pressure, your doctor will monitor you more closely while you take nortriptyline.

For people with urinary retention: Taking this drug could make symptoms of urinary retention worse. If you have a history of urinary retention, your doctor will monitor you more closely while you take nortriptyline.

For people with hyperthyroidism or who take thyroid medication: Taking this drug could increase heart rhythm irregularity for you. Your doctor will need to monitor you very closely.

Warnings for other groups

For pregnant women: It’s unclear if nortriptyline is safe in pregnancy. Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should be used only if the potential benefit justifies the potential risk to the fetus.

For women who are breastfeeding: It’s unclear if nortriptyline is safe when breastfeeding. Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

For seniors: Seniors might experience more side effects from nortriptyline. Confusion, irregular heartbeat, and changes in blood pressure have been noticed more commonly in seniors. Your doctor might start you on a lower dose.

For children: This drug hasn’t been studied in children. It may cause suicidal thoughts and behavior in people younger than 24 years during the first months of use.

This dosage information is for nortriptyline oral capsule. All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

Forms and strengths

Generic: Nortriptyline

  • Form: oral capsule
  • Strengths: 10 mg, 25 mg, 50 mg, 75 mg

Brand: Pamelor

  • Form: oral capsule
  • Strengths: 10 mg, 25 mg, 50 mg, 75 mg

Dosage for depression

Adult dosage (ages 18–64 years)

  • Recommended dosage: 25 mg, three to four times per day or once daily; start at the low level and increase as required.
  • Maximum dosage: 150 mg per day.

Child dosage (ages 0–17 years)

This drug is not recommended for use in children.

Senior dosage (ages 65 years and older)

  • Recommended dosage: 30–50 mg, once per day or in divided doses; start at the low level and increase as required.
  • Maximum dosage: 150 mg per day.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.

Nortriptyline oral capsule is used for long-term treatment. It comes with risks if you don’t take it as prescribed.

If you stop taking the drug or don’t take it at all: Your depression won’t improve or might even worsen.

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

  • irregular heart rhythm
  • very low blood pressure
  • seizures

If you think you’ve taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 800-222-1222 or through their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: Your symptoms of depression should get better or be more controlled. It may take a month of treatment before you notice that your depression is getting better.

Keep these considerations in mind if your doctor prescribes nortriptyline oral capsules for you.

General

  • You can take nortriptyline with or without food.
  • Don’t cut or crush the capsule.

Storage

  • Store nortriptyline at room temperature between 68°F and 77°F (20°C and 25°C).
  • Don’t store the capsules in moist or damp areas, such as bathrooms.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Your doctor will monitor you for side effects while you take nortriptyline. Your doctor may also monitor:

  • your blood levels of nortriptyline, if you’re taking more than 100 mg per day
  • your symptoms of depression

Sun sensitivity

This drug may make your skin more sensitive to the sun. Be sure to use sunscreen or wear protective clothing to prevent sunburn.

Refills

A prescription for this drug is refillable. You shouldn’t need a new prescription for this drug to be refilled. Your doctor will write the number of refills authorized on your prescription.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

side effects, dosage, usage and more

contents

  • Nortriptyline oral capsules are available in both generic and branded form. Brand: Pamelor.
  • Nortriptyline is available as oral capsules and oral solution.
  • Nortriptyline oral capsules are used to treat depression.

    • FDA Warning: risk of suicide

    • This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to exposure to drugs that may be dangerous. nine0005
    • Nortriptyline may increase the risk of suicidal thoughts and behavior in people under 24 years of age. The presence of depression and mental problems increases the risk of suicide. Your doctor will monitor for any changes in your symptoms of depression, unusual behavior, or suicidal thoughts.

    Other Warnings

    • Cardiovascular Warning: Taking nortriptyline may put you at risk for heart palpitations, heart attack, stroke, and other circulatory problems. Tell your doctor if you have heart problems before taking nortriptyline. Do not take nortriptyline if you have recently had a heart attack. nine0005
    • Increased intraocular pressure warning: Nortriptyline may increase intraocular pressure. It can cause glaucoma in people who are already at risk for glaucoma.
    • Serotonin syndrome warning: This drug may cause a condition called serotonin syndrome. Symptoms of serotonin syndrome include hallucinations and delusions, agitation, coma, palpitations, changes in blood pressure, dizziness, loss of consciousness, convulsions, tremors, muscle tremors or rigidity, sweating, nausea, and vomiting. nine0005
    • Dementia Warning: Istrazhivane has suggested that this type of drug may cause effects similar to those produced by drugs called anticholinergics. This may increase the risk of dementia.

    Nortriptyline is a prescription drug. It comes in the form of oral capsules and oral solution.

    Nortriptyline oral capsules are available as the brand name Pamelor. It is also available as a generic medicine. Generic drugs usually cost less than their brand-name versions. In some cases, they may not be available in all strengths or forms as a brand name drug. nine0003

    Why it is used

    Nortriptyline is used to treat depression.

    Nortriptyline can be used in combination therapy. This means that you may need to take it with other medicines.

    How it works

    Nortriptyline belongs to a class of drugs called tricyclic antidepressants. A drug class is a group of drugs that work in a similar way. These drugs are often used to treat these conditions. nine0003

    Nortriptyline affects your central nervous system by increasing the levels of certain chemicals in your brain. It helps get rid of depression.

    Nortriptyline oral capsules may cause drowsiness. This may cause other side effects.

    More common side effects

    Some of the more common side effects that may occur with nortriptyline include:

    • low blood pressure
    • increased blood pressure
    • confusion (mainly in the elderly)
    • Problems with a dream of
    • Unpressiveness
    • Dry VISION
    • Bolt
    • Supply
      • 9000
    • 9000 to light
    • nausea
    • vomiting
    • diarrhea
    • abdominal cramps
    • decreased sex drive
    • sudden weight loss or weight gain
    • sweating
    • headache

    If these effects are mild, they may disappear within a few days or a couple of weeks. If they are more severe or do not go away, talk to your doctor or pharmacist.

    Serious side effects

    Call your doctor if you have serious side effects. Call 911 if your symptoms seem life-threatening or if you think you need emergency medical attention. Serious side effects and their symptoms may include the following:

    • Psychiatric problems. Symptoms may include:
      • Suicidal thoughts and behavior
      • Depression
      • Anxiosity
      • Anxiety
      • Panic attacks
      • Disorders of sleep, such as nightmares or insomnia (dream problems)
      • Deerientation
        • 9000 and increased activity (signs of mania)
    • Rapid heartbeat
    • Heart attack. Symptoms may include:
      • chest pain
      • shortness of breath
      • pain or pressure in the upper body
    • Stroke. Symptoms may include:
      • weakness in one part or side of your body
      • blurred or speech problems
    • Inability to urinate
    • Seizures
    • Hangover
    • Serotonin syndrome. Symptoms may include:
      • hallucinations
      • excitement
      • delusions
      • changes in blood pressure
      • rapid heartbeat
      • loss of consciousness
      • sweating
      • muscle tremor or muscle stiffness
      • hesitation
      • nausea and vomiting
      increased eye pressure Symptoms may include:
      • eye pain
      • swelling and redness around the eyes
      • changes in vision

    Disclaimer: Our goal is to provide you with the most current and up-to-date information. But because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information does not replace medical advice. Always discuss possible side effects with a doctor who knows your medical history. nine0003

    Nortriptyline Oral Capsule may interact with other medicines, vitamins, or herbs you are taking. An interaction is when a substance changes how a drug works. It can be harmful or prevent the medicine from working well.

    To avoid interactions, your doctor must carefully administer all of your medicines. Tell your doctor about any medications, vitamins, or herbs you are taking. To find out how this medicine may interact with other medicines you are taking, talk to your doctor or pharmacist. nine0003

    Examples of drugs that may interact with nortriptyline are listed below.

    Medicines you should not use with nortriptyline

    Do not take these medicines with nortriptyline. This can cause dangerous side effects in the body. Examples of such drugs include:

    • Monoamine oxidase inhibitors (MAOIs) and drugs with MAOI effects such as phenelzine, tranylcypromine, selegiline, linezolid and methylene blue
      • Taking these drugs with nortiptyline can cause serotonin syndrome. Wait at least 14 days after stopping nortiptilin before taking an MAOI, and vice versa. nine0005
    • Increased side effects of nortriptyline: Taking nortriptyline with certain medications increases the risk of side effects of nortriptyline. This is because the amount of nortiptyline in the body may increase. Examples of such drugs include:
      • Cimetidine
        • Increased side effects of nortriptyline may include headache, palpitations and drowsiness.
      • Cytochrome P450 2D6 inhibitors such as quinidine, sertraline, paroxetine, and fluoxetine (Note: you may need to wait about 5 weeks after stopping fluoxetine before starting nortiptyline). nine0012
      • Increased side effects of nortriptyline may include headache, palpitations and drowsiness. Your doctor may prescribe you a lower dose of nortiptyline if you are taking it with one of these medicines.
  • Increased side effects of other drugs: Taking nortriptyline with certain drugs increases the risk of side effects from these drugs. Examples of such drugs include:
    • reserpine
      • Increased side effects of this drug may include increased blood pressure and heart rate, and trouble sleeping. nine0005
    • Medicines with anticholinergic effects such as diphenhydramine, loratadine, oxybutynin, solifenacin and olanzapine.
      • Increased side effects of these drugs may include changes in blood pressure, urinary retention, and increased heart rate. Your doctor may need to adjust your doses if you are taking one of these medicines with nortriptyline.
    • Sympathomimetic drugs such as epinephrine, ephedrine and norepinephrine
      • Increased side effects of these medicines may include changes in blood pressure, headache, and increased heart rate. Your doctor may need to adjust your doses if you are taking one of these medicines with nortriptyline.
    • Chlorpropamide
      • Increased side effects of this drug may include low blood sugar in people with diabetes.
  • Increased side effects of both drugs: Taking nortriptyline with some drugs increases the risk of side effects. This is because nortriptyline and other drugs can cause the same side effects. As a result, these side effects may be exacerbated. Examples of such drugs include:
    • Serotonin reuptake inhibitors (SSRIs) such as sertraline, fluoxetine, paroxetine and venlafaxine
      • Taking these drugs with nortriptyline increases the risk of serotonin syndrome. If you need to take any of these drugs with nortriptyline, your doctor may adjust the dosage of both drugs.
    • Norepinephrine reuptake inhibitors (SNRIs) such as duloxetine and desvenlafaxine
      • Taking these drugs with nortriptyline increases the risk of serotonin syndrome. If you need to take any of these drugs with nortriptyline, your doctor may adjust the dosage of both drugs. nine0005
    • Triptans such as sumatriptan and naratriptan
      • Taking these drugs with nortriptyline increases the risk of serotonin syndrome. If you need to take any of these drugs with nortriptyline, your doctor may adjust the dosage of both drugs.
    • Other drugs such as fentanyl, lithium, tramadol, tryptophan, buspirone and St. John's wort.
      • Taking these drugs with nortriptyline increases the risk of serotonin syndrome. If you need to take any of these drugs with nortriptyline, your doctor may adjust the dosage of both drugs. nine0005

    • Interactions that increase the risk of side effects

    Disclaimer: Our goal is to provide you with the most current and up-to-date information. However, because drugs affect each person differently, we cannot guarantee that these data include all possible interactions. This information does not replace medical advice. Always talk to your doctor about potential interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter medications you are taking. nine0003

    Nortriptyline oral capsule comes with several warnings.

    Allergy Warning

    Nortriptyline may cause a severe allergic reaction. Symptoms may include:

    • skin rash, rash, itching, and sensitivity to the sun
    • swelling of the body or face and tongue
    • fever

    If you have an allergic reaction, call your doctor or local poison control center right away. If you have severe symptoms, call 911 or go to the nearest emergency room.

    Do not take this medicine again if you have ever had an allergic reaction to it. Repeated use may be lethal (lead to death).

    Alcohol Interaction Warning

    Consumption of alcoholic beverages with nortriptyline may lead to suicidal thoughts and attempts. This risk is higher if you have a history of suicidal thoughts and problems controlling your emotions. If you drink alcohol, talk to your doctor. nine0003

    Warnings for people with certain medical conditions

    For people with heart and other cardiovascular diseases: Taking this medicine may increase your risk of stroke and heart problems such as an irregular heartbeat or heart attack. Do not take this medicine if you are recovering from a recent heart attack.

    For people with bipolar disorder: Before starting antidepressant treatment, it is important that your doctor checks your risk for bipolar disorder. If you have untreated bipolar disorder, taking nortriptyline may make your condition worse. nine0003

    For people with a history of seizures: Taking this medicine may increase the risk of seizures. If you have a history of seizures, your doctor will monitor you more closely. If you have a seizure while taking nortriptyline, stop taking it and call your doctor.

    For people with glaucoma or high eye pressure: Taking this medicine may increase the pressure in your eyes. If you have a history of glaucoma or high eye pressure, your doctor will monitor you more closely while you are taking nortriptyline. nine0003

    For people with urinary retention: taking this medicine may make symptoms of urinary retention worse. If you have a history of urinary retention, your doctor will monitor you more closely while you are taking nortriptyline.

    For people with hyperthyroidism or taking thyroid medications: Taking this medication may increase irregular heart rhythms. Your doctor will need to monitor you closely.

    Warnings for other groups

    Pregnant women: It is unclear if nortriptyline is safe during pregnancy. Talk to your doctor if you are pregnant or planning to become pregnant. This medicine should only be used if the potential benefit justifies the potential risk to the fetus. nine0003

    For women who are breastfeeding: it is unclear whether nortriptyline is safe while breastfeeding. Talk to your doctor if you are breastfeeding. You may need to decide if you want to stop breastfeeding or stop taking this medicine.

    For the elderly: Older people may experience more side effects from nortriptyline. Confusion, irregular heartbeat, and changes in blood pressure are more common in older people. Your doctor may prescribe a lower dose for you. nine0003

    For children: This medicine has not been studied in children. May cause suicidal thoughts and behavior in persons under 24 years of age during the first months of use.

    This dosage information is for nortriptyline oral capsule. Not all possible doses and forms of drugs are included here. Your dosage, form of medication, and how often you take your medication will depend on:

    • your age
    • the condition being treated
    • how serious your condition is
    • other health conditions you have
    • how you respond to the first dose

    Forms and strengths

    Generic: Nortriptyline

    • Form: oral capsule
    • Strengths: 20 mg, 5.5 mg 75mg

    Brand: Pamelor

    • Form: oral capsule
    • Strengths: 10mg, 25mg, 50mg, 75mg

    Depression Dose 4 yr

    0003

    • Recommended dose: 25 mg XNUMX-XNUMX times a day or once a day; start small and increase as needed.
    • Maximum dose: 150 mg per day.

    Pediatric dose (age 0-17 years)

    This medicine is not recommended for use in children.

    Higher dose (age 65 and older)

    • Recommended dose: 30-50 mg once a day or in divided doses; start small and increase as needed. nine0005
    • Maximum dose: 150 mg per day.

    Disclaimer: Our goal is to provide you with the most current and up-to-date information. But because drugs affect each person differently, we cannot guarantee that this list includes all possible doses. This information does not replace medical advice. Always talk to your doctor or pharmacist about the doses that are right for you.

    Nortriptyline oral capsules are used for long-term treatment. There are also risks if you don't take it as prescribed. nine0003

    If you stop taking your medicine or don't take it at all: Your depression will not get better or may even get worse.

    If you miss a dose or don't take your medicine as scheduled: The medicines may not work properly or may stop working completely. For this medicine to work well, a certain amount must be in your system at all times.

    If you take too much: You may have dangerous levels of the drug in your body. Overdose symptoms with this medicine may include:

    • irregular heartbeat
    • very low blood pressure
    • seizures

    their online tool, but if you have severe symptoms, call 911 or go straight to your nearest emergency room.

    What to do if you miss a dose: Take the dose as soon as you remember. But if you only remember a few hours before your next scheduled dose, take only one dose. Never try to compensate for taking two doses at the same time. This can lead to dangerous side effects. nine0003

    How to tell if a drug is working: Your symptoms of depression should improve or become more manageable. It may take a month of treatment before you notice an improvement in depression.

    Important Considerations When Taking Nortriptyline

    Keep this in mind if your doctor prescribes nortriptyline oral capsules.

    Basic Information

    • Nortriptyline can be taken with or without food.
    • Do not cut or crush the capsule. nine0005

    Warehouse

    • Store nortriptyline at room temperature between 68°F and 77°F (20°C to 25°C).
    • Do not store capsules in damp or damp places such as bathrooms.

    Travel

    When traveling with medication:

    • Always carry your medication with you. Never put it in your checked bag while flying. Keep it in your bag.
    • Don't worry about air devices at the airport. I can't hurt drugs. nine0005
    • You may need to show airport staff the pharmacy sticker for your medications. Always carry the original prescription container with you.
    • Do not put this medicine in the glove compartment of your car or leave it in your car. Be sure to avoid this when the weather is very hot or very cold.

    Clinical observation

    Doctor, you are taking nortriptyline, the doctor will monitor for side effects. Your doctor may also monitor:

    • blood levels of nortiptyline if you take more than 100 mg per day
    • your symptoms of depression

    Sun sensitivity

    This medicine may make your skin more sensitive to the sun. Be sure to use sunscreen or wear protective clothing to prevent sunburn.

    tapping

    The prescription for this medicine can be refilled. You do not need a new prescription to refill this medicine. Your doctor will write the number of refills on your prescription. nine0003

    There are other medicines available to treat your condition. Some may suit you better than others. Talk to your doctor about other treatment options that may help you.

    Disclaimer: Healthline has made every effort to ensure that all information is correct, complete, and up-to-date. However, this article should not be used as a substitute for the knowledge and experience of a licensed healthcare professional. Always check with your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, instructions, precautions, warnings, drug interactions, allergic reactions, or side effects. The absence of warnings or other information for a particular drug does not mean that the drug or combination of drugs is safe, effective, or suitable for all patients or for all special uses. nine0003

    Memorial Sloan Kettering Cancer Center

    Adult Medication

    Share

    This document, provided by Lexicomp ® , contains all the information you need to know about this medicine, including indications, directions for use, side effects, and when your healthcare provider should be contacted.

    Trade names: USA

    Pamelor

    Brand names: Canada

    APO-Northriptyline; Aventyl; TEVA-Northriptyline [DSC]

    Warning

    • Drugs like this have increased the likelihood of suicidal thoughts or actions in children and young people. This risk may be higher in people who have tried or had suicidal thoughts in the past. All people taking this drug must be closely monitored. If you develop or worsen disorders such as depression, nervousness, anxiety, grouchiness, panic attacks, and changes in mood or behavior, contact your doctor immediately. Contact your doctor immediately if you have suicidal thoughts or suicide attempts. nine0005
    • This drug is not approved for use in children. Consult your doctor.

    What is this drug used for?

    • Used to treat depression.
    • This drug may also be used for other indications. Consult your doctor.

    What should I tell my doctor BEFORE taking this drug?

    • If you have an allergy to this drug, any of its ingredients, other drugs, foods or substances. Tell your doctor about your allergies and how they have manifested. nine0005
    • If you have recently had a myocardial infarction.
    • If you have a certain heart disorder called Brugada syndrome or have ever fainted for no reason.
    • If you are taking any of the following drugs: linezolid or methylene blue.
    • If you have taken medications for depression or Parkinson's disease in the past 14 days. These include isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline. An episode of very high blood pressure may occur. nine0005

    This list of drugs and conditions that may interfere with this drug is not all inclusive.

    Tell your doctor and pharmacist about all medicines you take (prescription and over-the-counter, natural products and vitamins) and any health problems you have. You need to make sure that this drug is safe for your conditions and in combination with other drugs you are already taking. Do not start or stop taking any drug or change the dosage without your doctor's advice. nine0003

    What do I need to know or do while taking this drug?

    • Tell all your health care workers that you are taking this drug. These are doctors, nurses, pharmacists and dentists. You may need to stop taking this drug before certain types of surgery, as told by your doctor. If you stop taking this drug, your doctor will tell you when you can start taking this drug again after your surgery or procedure. nine0005
    • Avoid driving and other activities that require increased attention until you see how this drug affects you.
    • To reduce the risk of dizziness or loss of consciousness, get up slowly from a lying or sitting position. Walking up and down stairs should be done with care.
    • If you have high blood sugar (diabetes), you should check your blood sugar regularly.
    • Talk to your doctor if you have signs of high or low blood sugar such as fruity breath, dizziness, rapid breathing, tachycardia, confusion, drowsiness, feeling weak, flushing, headache, unusual thirst or hunger, frequent urination, tremors or sweating. nine0005
    • Check with your doctor before using alcohol, marijuana or other forms of cannabis, or prescription or over-the-counter drugs that can slow you down.
    • If you have or have ever had seizures, talk to your doctor.
    • You can get burned quickly. Avoid direct sunlight, sun lamps and tanning beds. Use sun umbrellas, wear long clothes and sunglasses. nine0005
    • Caution should be exercised in hot weather and during vigorous activity. Drink plenty of fluids to prevent dehydration.
    • Some patients may be at increased risk of eye problems when using this drug. Your doctor may order an eye examination to see if you are at increased risk for these eye problems. Call your doctor right away if you have eye pain, vision changes, swelling or redness around the eye. nine0005
    • Some people who take this drug have a certain heart disorder (Brugada syndrome). These people had the disorder before but were unaware of it. People with Brugada syndrome have abnormal heart rhythms and are at risk of sudden death. Consult your doctor.
    • A severe and sometimes deadly complication called serotonin syndrome can occur. This risk may be increased if certain other drugs are taken at the same time. Call your doctor right away if you experience agitation, balance problems, confusion, hallucinations, high fever, tachycardia or abnormal heart rhythms, flushing, muscle twitching or stiffness, seizures, tremors or tremors, excessive sweating, severe diarrhea, nausea or vomiting , a very severe headache. nine0005
    • If you are 65 years of age or older, use this drug with caution. You may experience more side effects.
    • Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding. The benefits and risks for you and your child will need to be discussed.

    What side effects should I report to my doctor immediately?

    WARNING. In rare cases, this drug can cause serious and sometimes deadly side effects in some patients. Call your doctor right away or get medical help if you have any of the following signs or symptoms that could be associated with serious side effects:

    • Signs of an allergic reaction, such as rash, hives, itching, red and swollen skin with blisters or peeling, possibly accompanied by fever, wheezing or wheezing, tightness in the chest or throat, difficulty breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue or throat.
    • Signs of high or low blood pressure, such as a very severe headache or dizziness, fainting, or changes in vision. nine0005
    • Pain or pressure in the chest.
    • Increased or abnormal heart rhythm.
    • Weakness on 1 side of the body, difficulty speaking or thinking, problems with balance, sagging on one side of the face, or blurred vision.
    • Confusion of consciousness.
    • Hallucinations (a person sees or hears something that is not in reality).
    • Nightmares.
    • Unusual sensations of burning, numbness, or tingling.
    • Shiver. nine0005
    • With problems in controlling body movements.
    • Tinnitus.
    • Severe constipation or abdominal pain. These may be signs of a severe bowel disorder.
    • Obstruction of the urinary tract.
    • Seizures.
    • fever, chills, sore throat; the appearance of bruising and bleeding for unexplained reasons; pronounced feeling of tiredness or weakness.
    • Yellowness of the skin or eyes.
    • Irritation or pain in the mouth. nine0005
    • Changing the color of the tongue.
    • Change in the frequency of urination.
    • Hair loss.
    • Enlarged chest.
    • Discharge from the nipple.
    • Change in sex drive.
    • Inability to achieve or maintain an erection.
    • Swelling of testicles.

    What are some other side effects of this drug?

    Any medicine can have side effects. However, for many people, side effects are either minor or non-existent. Talk to your doctor or get medical help if these or any other side effects bother you or don't go away:

    • Dry mouth.
    • Feeling dizzy, drowsy, tired or weak.
    • Constipation, diarrhea, abdominal pain, nausea, vomiting, or decreased appetite.
    • Headache.
    • Change in the ability to perceive taste.
    • Gastric colic.
    • Sleep disorders.
    • Weight gain or loss.
    • Excessive sweating.
    • Hyperemia (blush).

    This list of possible side effects is not exhaustive. If you have any questions about side effects, please contact your doctor. Talk to your doctor about side effects. nine0003

    You can report side effects to the National Health Board.

    You can report side effects to the FDA at 1-800-332-1088. You can also report side effects at https://www.fda.gov/medwatch.

    What is the best way to take this drug?

    Use this drug as directed by your doctor. Read all the information provided to you. Strictly follow all instructions.

    All forms:
    • When taken once a day, take this medication 30 minutes before bedtime.
    • Keep taking this drug as instructed by your doctor or other health care professional, even if you feel well.
    • Do not stop taking this drug abruptly without consulting your doctor. This can increase the risk of side effects. If necessary, taking this drug should be stopped gradually, in accordance with the recommendations of the doctor. nine0005
    Fluid:
    • Liquid doses should be measured with caution. Use the dispenser that comes with the medicine. If the dispenser is not provided in the package, ask the pharmacist for a dosing agent for this drug.

    What if I miss a dose of a drug?

    • Take the missed dose as soon as you can.
    • If it's time for your next dose, don't take the missed dose and then go back to your regular dosing schedule. nine0005
    • Do not take 2 doses or an additional dose at the same time.
    • If you are taking the 1 daily dose at bedtime, do not take the missed dose the next morning.

    How do I store and/or discard this drug?

    • Store at room temperature.
    • Store in a dry place. Do not store in the bathroom.
    • Keep all medicines in a safe place. Keep all medicines out of the reach of children and pets. nine0005
    • Dispose of unused or expired drugs. Do not empty into a toilet or sewer unless instructed to do so. If you have any questions about disposing of medicines, ask your pharmacist. Drug disposal programs may be in place in your area.

    General information about medicines

    • If your health does not improve or even worsens, see your doctor. nine0005
    • Do not give your medicine to anyone and do not take other people's medicines.
    • Some medicines may come with other patient information leaflets. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other health care professional.
    • A separate instruction for patients is attached to the drug. Please read this information carefully. Reread it each time you refill your supply. If you have any questions about this drug, ask your doctor, pharmacist, or other health care professional. nine0005
    • If you think you have overdosed, call a poison control center or get medical help right away. Be prepared to tell or show what drug you took, how much, and when it happened.

    Consumer Use of Information and Limitation of Liability

    This summary information includes a summary of the diagnosis, treatment, and/or drug product. It is not intended to be a comprehensive source of data and should be used as a tool to help the user understand and/or evaluate potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a particular patient. It should not be considered medical advice or a substitute for medical advice, diagnosis or treatment provided by a physician based on a medical examination and assessment of the patient's specific and unique circumstances. Patients should consult with their physician for full information about their health, medical issues, and treatment options, including any risks or benefits regarding the use of medications. This information is not a guarantee that a treatment or drug is safe, effective, or approved for a particular patient.

    Learn more