Nortriptyline
Generic Details
Generic Name
Nortriptyline
Other Names
- Pamelor
- Aventyl
Drug Class
- Tricyclic antidepressant
Chemical Formula
C19H21N
Molecular Weight
263.38 g/mol
Mechanism of Action
- Blocks the reuptake of norepinephrine and serotonin
Indications
- Depression
- Neuropathic pain
- Migraine prophylaxis
- ADHD
Common Dosage Forms
- Tablet
- Capsule
Typical Dosage
- 25-150 mg/day in divided doses
Pediatric Dosage
- Not established; caution in children under 12 years
Geriatric Dosage
- Initiate at lower doses due to increased sensitivity
Side Effects
- Dry mouth
- Constipation
- Blurred vision
- Urinary retention
- Sedation
Contraindications
- Hypersensitivity to tricyclic antidepressants
- Recent MI
- Uncontrolled angle-closure glaucoma
Pregnancy Category
- Category D - Positive evidence of risk
Lactation Safety
- Caution advised; excreted in breast milk
Drug Interactions
- MAOIs
- SSRIs
- Cimetidine
Overdose Symptoms
- Seizures
- Cardiac arrhythmias
- Coma
Antidote for Overdose
- Activated charcoal
- Physostigmine
Storage Conditions
- Store at room temperature away from moisture and heat
Pharmacokinetics
- Absorption: Well absorbed orally
- Distribution: Crosses the blood-brain barrier; widely distributed in tissues
- Metabolism: Hepatic via CYP2D6
- Excretion: Primarily renal
Precautions
- Use with caution in patients with urinary retention, glaucoma, or cardiac conduction abnormalities
Warnings
- May increase the risk of suicidal thinking and behavior in children, adolescents, and young adults
Others
- May take several weeks for full therapeutic effects to be seen