Nortrilen (nama lain Pamelor)

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

an alcohol problem

bipolar disorder or schizophrenia

difficulty passing urine, prostate trouble

glaucoma

heart disease or recent heart attack

liver disease

over active thyroid

seizures

thoughts or plans of suicide or a previous suicide attempt or family history of suicide attempt

an unusual or allergic reaction to nortriptyline, other medicines, foods, dyes, or preservatives

pregnant or trying to get pregnant

breast-feeding

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Take your doses at regular intervals. Do not take it more often than directed. If you have been taking this medicine regularly for some time, do not suddenly stop taking it. You must gradually reduce the dose or you may get severe side effects. Ask your doctor or health care professional for advice. Even after you stop taking this medicine it can still affect your body for several days.
Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.
Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is less than four hours to your next dose, take only that dose and skip the missed dose. Do not take double or extra doses.

What may interact with this medicine?

Do not take this medicine with any of the following medications:

arsenic trioxide

certain medicines used to regulate abnormal heartbeat or to treat other heart conditions

cisapride

halofantrine

MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate

other medicines for mental depression

phenothiazines like perphenazine, thioridazine and chlorpromazine

pimozide

probucol

procarbazine

sparfloxacin

St. John's Wort

ziprasidone

This medicine may also interact with the following medications:

atropine and related drugs like hyoscyamine, scopolamine, tolterodine and others

barbiturate medicines for inducing sleep or treating seizures, such as phenobarbital

cimetidine

medicines for diabetes

reserpine

seizure or epilepsy medicine such as carbamazepine or phenytoin

thyroid medicine

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress. It can take several days before you feel the full effect of this medicine.
Patients and their families should watch out for worsening depression or thoughts of suicide. Also watch out for sudden or severe changes in feelings such as feeling anxious, agitated, panicky, irritable, hostile, aggressive, impulsive, severely restless, overly excited and hyperactive, or not being able to sleep. If this happens, especially at the beginning of antidepressant treatment or after a change in dose, call your health care professional.
You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may increase dizziness and drowsiness. Avoid alcoholic drinks.
Do not treat yourself for coughs, colds, or allergies without asking your doctor or health care professional for advice. Some ingredients can increase possible side effects.
Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your doctor if the problem does not go away or is severe.
This medicine may cause dry eyes and blurred vision. If you wear contact lenses you may feel some discomfort. Lubricating drops may help. See your eye doctor if the problem does not go away or is severe.
This medicine can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and use sunscreen. Do not use sun lamps or tanning beds/booths.
If you are diabetic, check your blood sugar more often than usual, especially during the first few weeks of treatment with this medicine. This medicine can affect blood sugar levels. Call your doctor or health care professional for advice if you notice a change in the results of blood or urine glucose tests.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

abnormal production of milk in females

breast enlargement in both males and females

breathing problems

confusion, hallucinations

fever with increased sweating

rregular or fast, pounding heartbeat

muscle stiffness, or spasms

pain or difficulty passing urine, loss of bladder control

seizures

suicidal thoughts or other mood changes

swelling of the testicles

tingling, pain, or numbness in the feet or hands

yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

change in sex drive or performance

diarrhea

nausea, vomiting

weight gain or loss

Where should I keep my medicine?

Keep out of the reach of children.
Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Keep container tightly closed. Throw away any unused medicine after the expiration date.