$Unique_ID{BRK02058}
$Pretitle{}
$Title{NORTRIPTYLINE}
$Subject{Aventyl (Lilly)
Pamelor (Sandoz)}
$Volume{}
$Log{
Pamelor*0205801.scf}

Copyright (C) 1991 Publications International, Ltd.


NORTRIPTYLINE
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BRAND NAMES (Manufacturers):
     Aventyl (Lilly)
     Pamelor (Sandoz)
TYPE OF DRUG:
     Tricyclic antidepressant
INGREDIENT:
     nortriptyline
DOSAGE FORMS:
     Capsules (10 mg, 25 mg, and 75 mg)
     Oral solution (10 mg per 5-ml spoonful, with 4% alcohol)
STORAGE:
     Store at room temperature in a tightly closed container.

USES

     Nortriptyline is used to relieve the symptoms of mental depression.  This
medication belongs to a group of drugs referred to as the tricyclic
antidepressants.  These medicines are thought to relieve depression by
increasing the concentration of certain chemicals necessary for nerve
transmission in the brain.

TREATMENT

     This medication should be taken exactly as your doctor prescribes.  It
can be taken with water or with food to lessen the chance of stomach
irritation, unless your doctor tells you to do otherwise.
     If you miss a dose of this medication, take the missed dose as soon as
possible, and then return to your regular dosing schedule.  However, if the
dose you missed was a once-a-day bedtime dose, do not take that dose in the
morning; check with your doctor instead.  If the dose is taken in the morning,
it may cause unwanted side effects.  Never double the dose.
     The effects of therapy with this medication may not become apparent for
two or three weeks.

SIDE EFFECTS

     Minor.

     Anxiety, blurred vision, confusion, constipation, cramps, diarrhea,
dizziness, drowsiness, dry mouth, fatigue, heartburn, insomnia, loss of
appetite, nausea, peculiar tastes in the mouth, restlessness, sweating,
vomiting, weakness, or weight gain or loss.  As your body adjusts to the
medication, these side effects should disappear.
     This medication may increase your sensitivity to sunlight.  You should,
therefore, avoid prolonged exposure to sunlight or sunlamps.  Wear protective
clothing and use sunscreen.
     Dry mouth caused by therapy with this medication can be relieved by
chewing sugarless gum or by sucking on ice chips or a piece of hard candy.
     To relieve constipation, increase the amount of fiber in your diet (fresh
fruits and vegetables, salads, bran, and whole-grain breads), and drink more
water (unless your doctor directs you to do otherwise).
     To avoid dizziness or light-headedness when you stand, contract and relax
the muscles of your legs for a few moments before rising.  Do this by pushing
one foot against the floor while raising the other foot slightly, alternating
feet so that you are "pumping" your legs in a pedaling motion.

     Major.

     Tell your doctor about any side effects that are persistent or
particularly bothersome.  IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
agitation, chest pain, convulsions, difficulty in urinating, enlarged or
painful breasts (in both sexes), fainting, fever, fluid retention, hair loss,
hallucinations, headaches, impotence, mood changes, mouth sores, nervousness,
nightmares, numbness in the fingers or toes, palpitations, ringing in the
ears, seizures, skin rash, sleep disorders, sore throat, swelling, tremors,
uncoordinated movements or balance problems, unusual bleeding or bruising, or
yellowing of the eyes or skin.

INTERACTIONS

     Nortriptyline interacts with several other types of medications:
     1. Extreme drowsiness can occur when this drug is taken with central
nervous system depressants (such as alcohol, antihistamines, barbiturates,
benzodiazepine tranquilizers, muscle relaxants, narcotics, pain medications,
phenothiazine tranquilizers, and sleeping medications) or other tricyclic
antidepressants.
     2. Nortriptyline may decrease the effectiveness of antiseizure
medications and may block the blood-pressure-lowering effects of clonidine and
guanethidine.
     3. Birth control pills and estrogen-containing drugs can increase the
side effects and reduce the effectiveness of the tricyclic antidepressants
(including nortriptyline).
     4. Tricyclic antidepressants may increase the side effects of thyroid
medication and over-the-counter (nonprescription) cough, cold, asthma,
allergy, sinus, and diet medications.
     5. The concurrent use of tricyclic antidepressants and monoamine oxidase
(MAO) inhibitors should be avoided because the combination may result in
fever, convulsions, or high blood pressure.  At least 14 days should separate
the use of this drug and the use of an MAO inhibitor.
     6. Cimetidine can decrease the elimination of nortriptyline from the
body, increasing the possibility of side effects.
     Before starting to take nortriptyline, BE SURE TO TELL YOUR DOCTOR about
any medications you are currently taking, especially any of those listed
above.

WARNINGS

     * Tell your doctor if you have had unusual or allergic reactions to any
medications, especially to nortriptyline or any of the other tricyclic
antidepressants (amitriptyline, imipramine, doxepin, trimipramine, amoxapine,
protriptyline, desipramine, or maprotiline).
     * Tell your doctor if you have a history of alcoholism or if you have
ever had asthma, high blood pressure, liver or kidney disease, heart disease,
a heart attack, circulatory disease, stomach problems, intestinal problems,
difficulty in urinating, enlarged prostate gland, epilepsy, glaucoma, thyroid
disease, mental illness, or electroshock therapy.
     * If this drug makes you dizzy or drowsy, do not take part in any
activity that requires alertness, such as driving a car or operating
potentially dangerous machinery.
     * Before having surgery or other medical or dental treatment, be sure to
tell your doctor or dentist about this drug.
     * Do not stop taking this drug suddenly.  Abruptly stopping it can cause
nausea, headache, stomach upset, fatigue, or a worsening of your condition.
Your doctor may want to reduce the dosage gradually.
     * The effects of nortriptyline may last as long as seven days after you
have stopped taking it, so continue to observe all precautions during that
period.
     * Be sure to tell your doctor if you are pregnant.  Problems in humans
have not been reported; however, studies in animals have shown that this type
of medication can cause side effects in the fetus when given to the mother in
large doses during pregnancy.  Also, tell your doctor if you are
breast-feeding an infant.  Small amounts of this drug can pass into breast
milk and may cause unwanted effects, such as irritability or sleeping
problems, in nursing infants.

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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
