Hyperpyrexia has been reported with tricyclic antidepressants when administered with anticholinergic or with neuroleptic medications, especially in hot weather. Nortriptyline is a medicine available in a number of countries worldwide. Clinical monitoring is therefore recommended.There is a moderate amount of data from the use of nortriptyline in pregnant women.
The recommended dose is:Dosage should begin at a low level (50mg once daily or 25mg 2-3 times daily). By continuing to browse the site you are agreeing to our policy on the use of cookies. Phenytoin may treat seizures and cardiac rhythm disturbances. What you need to know before you take NortriptylineYou should not take Nortriptyline if any of the above applies to you.
It allows continued monitoring of the benefit/risk balance of the medicinal product.
Cimetidine, methylphenidate and calcium-channel blockers (e.g. AU TGA pregnancy category B1: Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed.
This medicinal product can be given in usual doses to patients with renal failure.In case of reduced liver function careful dosing and, if possible, a serum level determination is advisable.Nortriptyline should not be used in children and adolescents aged less than 18 years, as safety and efficacy have not been established (see section 4.4).The antidepressant effect usually sets in after two to four weeks. as contained in local and general anaesthetics and nasal decongestants).Nortriptyline may decrease the antihypertensive effect of guanethidine, debrisoquine, bethanidine, methyldopa and possibly clonidine.
Nortriptyline was approved for medical use in the United States in 1964. Do not take a double dose to make up for a missed dose.Do not stop taking the tablets or reduce the dose without telling your doctor first.If you stop taking the tablets suddenly you may have difficulty sleeping (insomnia), become irritable, and sweat excessively.If you have further questions on the use of this medicine, ask your doctor or pharmacist.Like all medicines, Nortriptyline can cause side effects, although not everybody gets them.Stop taking Nortriptyline and tell your doctor straight away if you notice any of the following serious side effects:Tell your doctor if you notice any of the following side effects or notice any other effects not listed;If you get any side effects, talk to your doctor. Both elevation and lowering of blood sugar levels have been reported. L3.
Patients (and caregivers of patients) should be alerted about the need to monitor for any clinical worsening, suicidal behaviour or thoughts and unusual changes in behaviour and to seek medical advice immediately if these symptoms present.
The use of nortriptyline should be avoided, if possible, in patients with a history of epilepsy. Clinically relevant interactions may be expected with concomitant use of nortriptyline and strong CYP3A4 inhibitors such as ketoconazole, itraconazole and ritonavir.Nortriptyline plasma concentration can be increased by valproic acid. See references.
Symptomatic and supportive therapy is recommended. Dosage should begin at a low level e.g. Hypotension may be caused by vasodilatation, central and peripheral alpha adrenergic blockade and cardiac depression. FDA pregnancy category* AAP rating Lactation risk category † Anxiolytics and hypnotics. Three to ten per cent of the population have reduced isoenzyme activity ('poor metabolisers') and may have higher than expected plasma concentrations at usual doses. Refractory arrhythmias may respond to propranolol, bretylium or lignocaine. Studies in depression of this age group did not show a beneficial effect for class of tricyclic antidepressants. Treatment with MAOIs may be introduced 14 days after discontinuation of nortriptyline. Select one or more newsletters to continue.
Nortriptyline should be used with caution in patients with urinary retention, pylorus stenosis or paralytic ileus.
Treatment with nortriptyline may be instituted 14 days after discontinuation of irreversible non-selective MAOIs and minimum one day after discontinuation of the reversible moclobemide. The following medicines can affect or be affected by treatment with Nortriptyline:Excessive consumption of alcohol may lead to increased suicide attempts or overdosage, especially if you have a history of emotional disturbances or thoughts of harming or killing yourself.If you are pregnant or breast-feeding, think you might be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.Nortriptyline should not be taken by pregnant women, unless your doctor decides otherwise.Breast-feeding is not recommended whilst taking Nortriptyline.Nortriptyline may affect alertness.
If possible, discontinue this medicinal product several days before surgery; if emergency surgery is unavoidable, the anaesthetist should be informed that the patient is being so treated (see section 4.5).
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