Apo-Nortriptyline

Brand Names: Motilium, Novo-Domperidone, ratio-Domperidone

Common Name: nortriptyline HCl

What is this drug used for?

Nortriptyline belongs to the group of medications known as tricylic antidepressants. It is used for the treatment of depression. It works by affecting the balance of chemicals in the brain.

Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Is there any reason not to take this drug?

Nortriptyline HCl should not be used by anyone who:

• is allergic to nortriptyline, any ingredient of the medication, or other antidepressants in the same family (e.g., amitriptyline, desipramine)
• takes MAO inhibitors (e.g., phenelzine, tranylcypromine) - MAO inhibitors should be stopped at least 2 weeks before nortriptyline treatment is started
• has recently had a heart attack

What about possible side effects?

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor. Your health professional may be able to help you deal with some of the effects.

The following side effects may go away as your body becomes used to the medicine; check with your doctor if they continue or become bothersome.

More common:

• dizziness
• drowsiness
• dryness of mouth
• headache
• increased appetite (may include a craving for sweets)
• nausea
• tiredness or weakness (mild)
• unpleasant taste
• weight gain

  Less common:

• diarrhea
• heartburn
• increased sweating
• trouble sleeping
• vomiting

Check with your doctor as soon as possible if any of the following side effects occur:

Less common:

• blurred vision
• confusion or delirium
• constipation (especially for seniors)
• decreased sexual ability
• difficulty speaking or swallowing
• eye pain
• fainting
• fast or irregular heartbeat (pounding, racing, skipping)
• hallucinations
• loss of balance control
• mask-like face
• nervousness or restlessness
• problems with urination
• shakiness or trembling
• shuffling walk
• slowed movements
• stiffness of arms and legs

  Rare:

• anxiety
• breast enlargement in both males and females
• hair loss
• inappropriate secretion of milk (females)
• increased sensitivity to sunlight
• irritability
• muscle twitching
• red or brownish spots on skin
• ringing, buzzing, or other unexplained sounds in the ears
• seizures
• skin rash and itching
• sore throat and fever
• swelling of face and tongue
• swelling of testicles
• trouble with teeth or gums
• weakness
• yellow eyes or skin

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

What if I am taking other drugs?

The following medications may affect the way nortriptyline works or increase the risk of side effects:

• anticholinergic medications (e.g., atropine, benztropine, pinaverium)
• carbamazepine
• certain anti-arrhythmic medications (e.g., propafenone, flecainide, encainide)
• cimetidine
• fluoxetine
• reserpine
• sympathomimetic medications (e.g., epinephrine)
• other antidepressants
• phenothiazines (e.g., perphenazine, chlorpromazine)
• quinidine

Nortriptyline may alter the effect of alcohol.

Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription) and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or illegal drugs can affect the action of many medications, you should let your prescriber know if you use them.

Other information:

Occupational hazards: People who take nortriptyline should avoid driving and operating hazardous machinery until they determine that the medication does not adversely affect their ability to do such activities.

Medical conditions: This medication should be used with caution by anyone with:

• heart disease
• glaucoma
• difficulties with urination
• hyperactive thyroid disease (or those receiving thyroid medication)
• epilepsy or a history of seizures
• diabetes (both increases and decreases in blood sugar levels have been noted for people with diabetes who take nortriptyline)

Withdrawal: Stopping treatment suddenly after prolonged therapy may produce nausea, headache, and malaise. These symptoms do not mean that you are addicted to the medication.

Pregnancy and breast-feeding: The safe use of nortriptyline during pregnancy and breast-feeding has not been established. If you are or may be pregnant, or if you are breast-feeding, talk to your doctor about the risks and benefits of taking this medication.

Children: Nortriptyline is not recommended for use by children under 12 years of age.

Special Instructions:

The recommended adult dose ranges from 30 mg to 150 mg daily in divided doses. The usual adult starting dose is 25 mg three or four times daily. The dosage can be increased until the desired effect is achieved.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is very important that this medication be taken regularly and exactly as prescribed by your doctor. Do not stop taking this medication without first talking with your doctor. If you miss a dose, take it as soon as possible and continue on with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue on with your regular dosing schedule. Do not double doses.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

© MediResource Inc. Terms and conditions of use: The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.