In this session, we will be discussing the consumer medication information for nortriptyline, trade name PamelorTM.

What it’s for & How to take

Nortriptyline is used to treat depression. This medication may sometimes be used to treat nerve pain, migraine headaches or fibromyalgia. If you are using this medication for any reason not listed here, please talk about it with your doctor.

Nortriptyline is an antidepressant medication that works by increasing the amount of natural substances in your brain that are needed to help maintain mental balance. This medication may improve your mood, decrease anxiety, help you sleep better, increase your energy levels and may increase your interest in daily living.

Nortriptyline is usually taken 1-4 times daily, with or without food. Your doctor may have you start this medication at a lower dose and gradually increase the dose based on your tolerance to the side effects and response to treatment. If you forget to take a dose, take it as soon as you remember. If it is near the time of your next dose, skip it and continue with your normal dose time. Do not take a double dose to make up the missed dose.

During the first week of treatment, you may feel anxious or agitated. Your body is getting used to the effects of the medication. After 7-10 days, your body should be adjusted to the medication. It may take 4-5 weeks before you feel the full benefit of this medication. If your condition is not improving or worsens, contact your doctor.

If you are using this medication to treat depression, it is recommended that you also make an appointment with a therapist. Talking with a therapist may help you see how this medication is changing how you feel about your environment.

Most Important Warnings

  • A small number of people, specifically those younger than 25, who take antidepressants for any condition may experience a worsening of depression symptoms or have suicidal thoughts or attempts. If you are under 25 or your child is prescribed this medication, talk about this with your doctor. Understand the risk. Tell your doctor if any of your mental symptoms worsen.

Other Warnings & Cautions

  • Tell your doctor if you have ever been told you have any heart rhythm problems. Rarely, nortriptyline may cause your heart to beat fast and unsteady. If you feel any severe dizziness or feel like your heart is racing or beating too fast, get medical help right away.
  • When someone under 25 years of age is taking this medication, family members should be aware. Family members can help watch for a worsening of depression and mood changes.
  • You are more likely to get a sunburn while taking this medication. If you can’t stay out of the sun, cover up with clothing and sunscreen.
  • Avoid eating grapefruit or drinking grapefruit juice while taking nortriptyline. Grapefruit may increase the level of this medication in your body and cause dangerous side effects.
  • The elderly may be more sensitive to the side effects of this medication, especially the drowsiness, dizziness, and difficulty urinating.
  • Let your pharmacist or doctor know if you are pregnant or breastfeeding before taking this medication. Babies born to mothers who have used nortriptyline during the last 3 months of pregnancy may develop withdrawal symptoms.
  • Nortriptyline passes into breast milk. Breast feeding is not recommended while taking this medication.
  • This medication may make you dizzy, drowsy, or blur your vision. Do not drive or do any activity that requires focus and attention until you are sure you can do them safely. Avoid alcoholic beverages while taking nortriptyline.

Interactions & Side Effects

  • Tell your pharmacist or doctor all your medication allergies so they may determine if nortriptyline is safe for you to take.
  • Avoid dangerous drug interactions. Tell your pharmacist or doctor all the other medication you are taking, including over the counter supplements, even if you don’t take them very often.
  • Ask your doctor if this medication is safe to take with your current health conditions. Tell your doctor if you have a family history of mental disease, any heart disease or blood pressure issues, a history of liver or kidney disease, eye problems such as glaucoma, thyroid disorder, or difficulty urinating
  • While taking nortriptyline, you may feel some nausea, drowsiness, dizziness, dry mouth, blurred vision, constipation or maybe some weight gain. If these or any other unwanted side effects persist, contact your doctor or pharmacist to talk about it with them.
  • Call your doctor right away if you have any easy bruising or bleeding, muscle spasms, persistent stomach or abdominal pain or enlarged or painful prostate or breasts.
  • Seek immediate medical attention if you have a significant worsening of your depression or experience any suicidal thoughts.

If you have any questions about what you have heard, contact your pharmacist or doctor. This session does not include all the potential interactions or side effects that this medication may cause. Ask your pharmacist how your medication should be stored and how you should dispose of it when you are done taking it. Do not share your medication with anyone, ever. Remember, this is not meant to replace your counseling session with your pharmacist. In case of overdose, call your local poison control center at 1-800-222-1222.

Updated 7/20