Nortriptyline

Drug uses

 It may also be prescribed for the treatment of other conditions like childhood nocturnal enuresis (bedwetting), chronic fatigue syndrome, chronic pain and migraines.

How it is taken

Nortriptyline can be taken by mouth with to avoid an upset stomach.

The best way to use the drug is as recommended by your doctor.

Missed Dosage

If you miss a dose of Nortriptyline then you may take it as soon as you remember and adjust the remaining doses accordingly. However, if it is nearly time for the next dose then you may skip this dose and continue with the regular dosage. Do not take a double dose to make up for the missed dose.

Overdose

A Nortriptyline overdose may lead to symptoms like agitation, bluish skin or mucous membranes, breathing problems, chest pain, coma, confusion, dry mouth, enlarged pupils, excess sweating, fainting, fast or irregular heartbeat, flushing, incoordination, involuntary movements, loss of consciousness, restlessness, rigid muscles, seizures, severe drowsiness, shock, stupor, trouble breathing, vomiting. Seek medical attention immediately if you suspect an overdose.
 

Warnings/Precautions
Discuss with your doctor about any prior medical condition that you may have including allergies to medicines, food or other substances, f you have a history of suicidal thoughts or behavior, bipolar disorder, or any other mental disorders, you are undergoing electroshock therapy, or you are scheduled to have any surgery, if you drink alcohol–containing beverages daily or you have a history of alcohol abuse, if you take thyroid medicine or you have a history of overactive thyroid, glaucoma, heart problems, kidney or liver problems, diabetes, seizures, the blood disease porphyria, or difficulty urinating.

You must not take if you are allergic to any ingredient in it or if you have taken furazolidone or a monoamine oxidase (MAO) inhibitor (e.g. phenelzine) within the last 14 days, or you are taking astemizole, dofetilide, droperidol, terfenadine, or cisapride or if you are recovering from a recent heart attack.

If you are pregnant or suspect that you are, then stop using Nortriptyine and contact your doctor immediately to discuss the risk to the fetus.

Do not become overheated in hot weather or during exercise or other activities, heatstroke may occur. Alcohol, hot weather, exercise, and fever can increase dizziness. To prevent dizziness or fainting, sit up or stand slowly, especially in the morning. Also, sit or lie down at the first sign of dizziness, lightheadedness, or weakness.

It is unknown whether Nortriptyine is secreted in breast milk. Avoid breast feeding while using the drug.

Certain drugs can interact with and hence, mention clearly to your doctor or pharmacist all medicines, dietary supplements and herbal prescriptions that you are taking.

Nortriptyline should not be used in children as it can increase suicidal thoughts and behaviors in some children and teenagers. This risk may be higher in individuals with bipolar illness (also called manic–depressive illness), a family history of bipolar illness, or a history of attempting suicide. Contact your doctor immediately if you notice depression, anxiety, restlessness or irritability, panic attacks, thoughts or attempts of suicide, or other unusual changes in behavior or mood.

Ensure that you inform your doctor and your dentist about depression, anxiety, restlessness or irritability, panic attacks, thoughts or attempts of suicide, or other unusual changes in behavior or mood before receiving any form of medical treatment or dental treatment or emergency surgery.

Nortriptyline may make you more sensitive to the sun so please avoid the sun, sunlamps or a tanning booth until you know how your body reacts to the drug. If you cannot avoid going out in the sun for a long while, then wear protective clothing or use a proper sunscreen.

It has been noted that elder patients are more sensitive to the side effects of the drug. They might need a dosage adjustment or special monitoring throughout the treatment.
 

Possible Side Effects

Some of the common side effects are of Dizziness, drowsiness, dry mouth, excitement, headache, impotence, nausea, nightmares, pupil dilation, and sensitivity to sunlight, sweating, tiredness, upset stomach, vomiting, weakness, weight loss or gain. Please contact your doctor if the symptoms persist or become bothersome.

Other severe side effects include allergic reactions (rash, hives, itching, difficulty breathing, tightness in the chest, swelling of the mouth, face, lips, or tongue), blurred vision or other vision changes, changes in sex drive, chest pain, confusion, constipation, fainting, fever, frequent or difficult urination, hallucinations, impulsive behaviour or other unusual changes in behaviour, fast, slow, or irregular heartbeat, jaw, neck, or muscle spasms, mental or mood changes (e.g. increased anxiety, mood swings, agitation, irritability, nervousness, restlessness), panic attacks, ringing in the ears, seizures, severe dizziness or drowsiness, sore throat, stomach pain, suicidal thinking or behaviour, swelling of the testicles, tremor, trouble sleeping, trouble walking or keeping your balance, twitching of the face or tongue, uncontrolled movements of arms and legs or stiffness, unusual bleeding or bruising, worsening of depression, yellowing of the skin or eyes.

You must seek medical attention immediately if any of these side effects occur.