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Pamelor (nortriptyline) is an antidepressant medication. Depression is an all-pervasive sense of sadness and gloom. In some patients with depression, abnormal levels of brain neurotransmitters (chemicals that the nerve cells use to communicate with each other) may be responsible for the depression. Nortriptyline elevates the mood ("anti-depresses") by raising the level of neurotransmitters in brain tissue.

Generic Pamelor 25mg capsules

Uses

Nortriptyline is used to elevate the mood of patients with depression. Nortriptyline is also a sedative and is useful in depressed patients with insomnia, restlessness, and nervousness. It also

How to take

Take nortriptyline exactly as prescribed. Nortriptyline may make your mouth dry. Sucking on hard candy, chewing gum, or melting ice chips in your mouth can provide relief.
Nortriptyline must be taken regularly to be effective and it may be several weeks before you begin to feel better. Do not skip doses, even if they seem to make no difference.

Side effects

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking nortriptyline.
·1 More common side effects may include: Anxiety, blurred vision, confusion, dry mouth, hallucinations, heart attack or vascular heart blockage, heartbeat irregularities, high blood pressure, insomnia, loss of muscle coordination, low blood pressure, rapid heartbeat, sensitivity to sunlight, skin rash, stroke, tremors, weight loss
·2 Side effects due to rapid decrease in dose or abrupt withdrawal from nortriptyline after prolonged treatment include:
Headache, nausea, vague feeling of bodily discomfort
These side effects do not indicate addiction to nortriptyline.

Precaution

The use of nortriptyline in schizophrenic patients may result in an exacerbation of the psychosis or may activate latent schizophrenic symptoms. If the drug is given to overactive or agitated patients, increased anxiety and agitation may occur. In manic-depressive patients, nortriptyline may cause symptoms of the manic phase to emerge.
Troublesome patient hostility may be aroused by the use of nortriptyline. Epileptiform seizures may accompany its administration, as may happen with other drugs of its class.
Close supervision and careful adjustment of the dosage are required when nortriptyline is used with other anti-cholinergic drugs and sympathomimetic drugs.
When possible, the drug should be discontinued several days before elective surgery.
The possibility of a suicidal attempt by a depressed patient remains after the initiation of treatment; in this regard, it is important that the least possible quantity of drug be dispensed at any given time.
Both elevation and lowering of blood sugar levels have been reported.

Drug interactions

Combining nortriptyline and MAO inhibitors can be fatal.
Nortriptyline may intensify the effects of alcohol. Do not drink alcohol while taking nortriptyline.
If nortriptyline is taken with certain other drugs, the effects of can be either increased, decreased, or altered. It is especially important to check with your doctor before combining nortriptyline with the following:

Airway-opening drugs such as Ventolin and Proventil
Antidepressants such as Wellbutrin and Desyrel
Antidepressants that act on serotonin, such as Prozac, Paxil, and Zoloft
Blood pressure medications such as Catapres and Esimil
Cimetidine (Tagamet)
Chlorpropamide (Diabinese)
Drugs for heart irregularities, such as Tambocor and Rythmol
Drugs that control spasms, such as Donnatal and Bentyl
Levodopa (Larodopa)
Major tranquilizers such as Thorazine and Mellaril
Quinidine (Quinidex)
Reserpine (Diupres)
Stimulants such as Dexedrine
Thyroid medication such as Synthroid
Warfarin (Coumadin)

Missed dose

If you miss a dose, take as soon as remembered; do not take if it is almost time for the next dose, instead, skip the missed dose and resume your usual dosing schedule. If you take Nortriptyline once a day at bedtime and you miss a dose, do not take it in the morning, since disturbing side effects could occur. Do not "double-up" the dose to catch up.

Storage

Nortriptyline should be stored below 86°F (30°C) in a tight, light resistant container.