Generic Pamelor

Generic Name: Nortriptyline

US Brand Name: Pamelor

Other Brand/Trade Names: Nortriptyline is marketed under many trade names around the world, including: Allegron; Norpress; Sensival

Uses

Nortriptyline is a tricyclic antidepressants used to treat endogenous depression, chronic skin disorders, depression, migraine headaches, panic disorder, severe arthritis, bed wetting, ringing ears and with other drugs to manage chronic or severe pain.

Active Ingredients: Nortriptyline

Inactive Ingredients: Colloidal silicon dioxide, corn starch, gelatin, placial acetic acid, glycerin, methylparaben, propylparaben, silicone fluid, sodium lauryl sulfate, and titanium dioxide and D&C Yellow #10.

Dosage and Forms

Nortriptyline comes as capsules and oral solutions.

The dose of Nortriptyline is tailored to the patient's needs. Sometimes, physicians will start with relatively low doses, such as 25mg, given three times a day to reduce the risk of excessive sedation early in the course of therapy; doses then will be increased slowly upwards. Elderly persons and patients with advanced liver disease may need lower doses. It may take several weeks after starting to take Nortriptyline until the full effects of a dose to be seen. Doses above 100 mg/day are not recommended.

Overdose symptoms include: confusion, convulsions, hallucinations, heart failure, loss of consciousness, lowered body temperature, sleepiness / deep sleep or tremors.

Contraindications and Precautions

The concurrent use of Nortriptyline or other tricyclic antidepressants with a MAO inhibitor is contraindicated. Patients hypersensitive to Nortriptyline should not be given the drug. Nortriptyline is contraindicated during the acute recovery period after myocardial infarction.

Side Effects

The most commonly encountered side effects associated with Nortriptyline include fast heart rate, blurred vision, urinary retention, dry mouth, constipation, weight gain or loss and low blood pressure on standing. Rash, hives, seizures, and hepatitis are rare side effects. Nortriptyline also can cause elevated pressure in the eyes of some patients with glaucoma.

Interactions

Nortriptyline exaggerates the effects of other medications and drugs that slow the brain's processes, such as alcohol, barbiturates, benzodiazepines and narcotics. Reserpine, given to patients taking TCAs, can have a stimulatory effect. Nortriptyline and other TCAs should not be used with monoamine oxidase inhibiting drugs, for example, isocarboxazid , phenelzine , tranylcypromine and procarbazine. High fever, convulsions and even death can occur when these drugs are used together.

Cimetidine can increase Nortriptyline blood levels and possibly cause side effects. Other drugs which share this effect include propafenone, flecainide, quinidine and fluoxetine.