Nortriptyline for depression Adult dose for depression is normally nortriptyline 25mg, taken orally three to four times daily. The dosage may be reduced if patients develop minor side effects even below nortriptyline 75mg daily. Patients may start with a nortriptyline 10mg capsule to increase dosage later on. But, the maximum nortriptyline dosage to be taken for depression is mg.
Nortriptyline for pain Nortriptyline is not approved by fda for neuropathic pain, but clinical trials have proven that it can be used on both depressed and non-depressed patients to treat neuropathic pain. Therefore, before using nortriptyline, report all medications you are currently using to your doctor or pharmacist.
Tell your doctor or pharmacist if you are taking other products that cause drowsiness, including alcohol, marijuana , antihistamines such as cetirizine , diphenhydramine , drugs for sleep or anxiety such as alprazolam , diazepam , zolpidem , muscle relaxants, and narcotic pain relievers such as codeine. Check the labels on all your medicines such as allergy or cough -and-cold products because they may contain decongestants or ingredients that cause drowsiness.
Ask your pharmacist about using those products safely. Nortriptyline is very similar to amitriptyline. Do not use medications containing amitriptyline while using nortriptyline. Does Nortriptyline HCL interact with other medications? Overdose If someone has overdosed and has serious symptoms such as passing out or trouble breathing , call Otherwise, call a poison control center right away.
US residents can call their local poison control center at Canada residents can call a provincial poison control center. Symptoms of overdose may include: Notes Do not share this medication with others. Keep all medical appointments. Consult your doctor for more details. Missed Dose If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip themissed dose and resume your usual dosing schedule.
Do not double the dose to catch up. Storage Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Excessive consumption of alcohol in combination with Nortriptyline therapy may have a potentiating effect, which may lead to the danger of increased suicidal attempts or overdosage, especially in patients with histories of emotional disturbances or suicidal ideation.
The concomitant administration of quinidine and Nortriptyline may result in a significantly longer plasma half-life, higher AUC, and lower clearance of Nortriptyline. Serotonin Syndrome The development of a potentially life-threatening serotonin syndrome has been reported with SNRIs and SSRIs, including Nortriptyline hydrochloride, alone but particularly with concomitant use of other serotonergic drugs including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, and St.
John's Wort and with drugs that impair metabolism of serotonin in particular, MAOIs, both those intended to treat psychiatric disorders and also others, such as linezolid and intravenous methylene blue.
Serotonin syndrome symptoms may include mental status changes e. Patients should be monitored for the emergence of serotonin syndrome. The concomitant use of Nortriptyline hydrochloride with MAOIs intended to treat psychiatric disorders is contraindicated.
Nortriptyline hydrochloride should also not be started in a patient who is being treated with MAOIs such as linezolid or intravenous methylene blue. No reports involved the administration of methylene blue by other routes such as oral tablets or local tissue injection or at lower doses.
There may be circumstances when it is necessary to initiate treatment with an MAOI such as linezolid or intravenous methylene blue in a patient taking Nortriptyline hydrochloride. If concomitant use of Nortriptyline hydrochloride with other serotonergic drugs, including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, buspirone, tryptophan, and St.
John's Wort is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases. Treatment with Nortriptyline hydrochloride and any concomitant serotonergic agents should be discontinued immediately if the above events occur and supportive symptomatic treatment should be initiated. Angle-Closure Glaucoma The pupillary dilation that occurs following use of many antidepressant drugs including Nortriptyline hydrochloride may trigger an angle-closure attack in a patient with anatomically narrow angles who does not have a patent iridectomy.
If you are thinking of stopping the medication, check with your doctor first. Your doctor may want you to decrease the dose of the medication gradually when it is time to stop taking nortriptyline. Nortriptyline can make your skin more sensitive to sunlight.
Sun exposure can lead to a rash, itching, redness, or severe sunburn. Some people with an overactive thyroid gland have reported an irregular heartbeat when they have taken nortriptyline. If you are taking medication for thyroid or have an overactive thyroid gland, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
This medication can cause difficulty with urination. If you have difficulties with urination or conditions that make urinating difficult, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
This medication should not be used during pregnancy unless the benefits outweigh the risks. Report any new or worsening symptoms right away. This medication may not work right away. You may see some benefit within a week. However, it may take up to 4 weeks before you feel the full effect. Tell your doctor if your condition persists or worsens such as your feelings of sadness get worse, or you have thoughts of suicide.
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