Common name:



去甲替林 (Chinese)






What is Nortriptyline?

Nortriptyline is a tricyclic antidepressant that is commonly used to treat depression. It is also used to relieve nerve pain.
The main cause of depression is unknown, but the purpose of drug treatment along with medical counseling is to eliminate depressive symptoms such as low mood, lethargy, lack of motivation, dangerous thoughts, sleep disorders and loss of appetite, etc. to bring the person to daily activity and function. The surface is normal.
Medications such as nortriptyline can significantly help relieve depressive symptoms such as insomnia or loss of appetite.

Continue taking this medicine even if you feel well. Do not stop taking this medicine without consulting your doctor. Some conditions may get worse when you stop taking this medicine suddenly. You may also experience symptoms such as mood swings, headaches, fatigue and sleep disturbances. Your doctor may gradually reduce your dose to prevent these symptoms when you stop treatment with this medicine. Consult your doctor or pharmacist for more details. Report any new or worsening symptoms immediately.

How does Nortriptyline work in the body?

This drug relieves the symptoms of depression by increasing the level of chemical carriers in the brain that play a role in neurotransmission between nerve cells.

Before taking Nortriptyline

Tell your doctor if you are pregnant or trying to become pregnant or breast-feeding.
Tell your doctor if you have a history of diseases such as an overactive thyroid, liver problems, epilepsy, diabetes, chronic constipation, urinary incontinence, cardiovascular disease, eye or nerve disease, and other illnesses.
-Because this drug can interfere with the function of other drugs in the body, it is necessary to start a list of all your medications (especially other medications that you have used so far and in the last month to treat depression and sleep) before starting to use. Tell your doctor or pharmacist.

How to take Nortriptyline

How and how much to take this medicine varies according to the patient’s problem and condition. This medicine may be prescribed three to four times a day or only once.
If nortriptyline is given once a day, the best time to take it is at night before bed. But some doctors prefer to prescribe the drug in smaller amounts but two to three times a day to treat depression. Be sure to take the medicine exactly as your doctor advised.
– Your doctor may start treatment with a small amount of medication and after your body gets used to it, increase the amount of your medication to reduce the risk of side effects from the medication.
– This medicine does not interfere with food and you can take it before or after food.
– If you forget to take a dose, take it immediately after the reminder, unless the reminder time is close to the next dose. In this case, do not take the missed dose and take the next dose on time, but to Never double the dose.

 Tell your doctor if any of these symptoms are severe or do not go away

  • nausea
  • drowsiness
  • weakness or tiredness
  • excitement or anxiety
  • nightmares
  • dry mouth
  • changes in appetite or weight
  • constipation
  • difficulty urinating
  • frequent urination
  • changes in sex drive or ability
  • excessive sweating

Precautions Nortriptyline

This drug should be used with extreme caution in the following cases:
Alcoholism, asthma, bipolar disorder, blood and gastrointestinal disorders, narrow-angle glaucoma, hypertension, hyperthyroidism, prostate hypertrophy, renal failure, schizophrenia, seizures, anthrax, seizures.

Nortriptyline drug recommendations

. Abrupt discontinuation of the drug should be avoided. If necessary, the dose should be reduced gradually over a period of at least 4 weeks.
2. In the first weeks of treatment, due to the increased tendency to suicide, the patient should be monitored
3. More than one antidepressant should not be prescribed at a time.
4. It takes at least two weeks to start the therapeutic effects of this drug.
5. Treatment of the elderly should be started with a minimum amount, because they are more sensitive to the side effects of this drug.
6. Due to the long half-life of the drug, single administration of the drug at bedtime is sufficient.
7. The patient should be reminded to continue treatment if antimuscarinic symptoms occur, as these effects are somewhat tolerated.
8. If the patient has a history of MAO inhibitors, the drug should be started two weeks after discontinuation.
9. If MAO inhibitors are needed, there should be a gap of at least one week between stopping the drug and starting a new one.
10. This drug may cause drowsiness by affecting actions that require skill and alertness, such as driving.
11. The course of treatment with this drug should be completed. This drug should not be taken more than the recommended amount.
12. If you miss a dose, if the treatment regimen is several times a day, that dose should be taken as soon as you remember, unless it is almost time for your next dose, in which case the amount The next consumption should not be doubled. If the treatment regimen is taken at bedtime, the drug should not be taken in the morning. It is better to consult a doctor in these cases.
13. Caution should be exercised due to the possibility of dizziness and lightheadedness, and when waking up suddenly from a lying or sitting position.
14. With the use of this drug, dry mouth may occur. If this complication persists for more than two weeks, you should see a doctor.
15. There is a possibility of photosensitivity with the use of this drug. Therefore, it is necessary to use sunscreen.
16. The patient should be monitored for 3-7 days after stopping the drug.
17. If any surgery or emergency treatment is needed, the doctor should be informed of the medication.

Nortriptyline drug interactions

– CYP2D6 substrate
– CYP3A4 substrate
Intensification of anticholinergic effects
Intensifying CNS debilitating effects
Reduce the central effects of histamine
Intensification of extrapyramidal effects
Intensifying the antihypertensive effects
Exacerbation of hyponatremia
Intensify the antihypertensive effects
Interference with the radiolibrant analgesic effect of norepinephrine
Seizure threshold reduction
Intensification of serotonergic effects

Reduction of the effects of drugs by nortriptyline:

Acetylcholinesterase inhibitors, alpha 1 agonists, alpha 2 agonists, alpha 2 (ophthalmic) agonists, gastrointestinal (prokinetic) drugs, guantidine, Ayubenguan radiopharmaceuticals, etoperidine, levozolite, levozolite, levozolite

Reducing the effects of nortriptyline by drugs:

Acetylcholinesterase inhibitors, barbiturates, carbamazepine, peg interferon alfa-b2, herb tea, tobacco

Food interference:
has not been stated.


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