warnings

What is the most important information I should know about Nortriptyline (Pamelor)?

You should not use this medicine if:

you are allergic to nortriptyline or similar medicines (amitriptyline, amoxapine, clomipramine, desipramine, doxepin, imipramine, protriptyline, trimipramine);
you are allergic to certain seizure medications (carbamazepine, eslicarbazepine, oxcarbazepine, rufinamide); or
you recently had a heart attack.

Do not use nortriptyline if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, tranylcypromine, and others.

Tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone.

Tell your doctor if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. An interaction with nortriptyline could cause a serious condition called serotonin syndrome.

Tell your doctor if you have ever had:

unexplained fainting spells;
a genetic heart condition called Brugada syndrome;
a family history of unexplained death at younger than 45 years old;
heart disease;
a heart attack or stroke;
a seizure;
bipolar disorder (manic-depression);
schizophrenia or other mental illness;
a thyroid disorder;
problems with urination;
narrow-angle glaucoma; or
if you are receiving electroshock treatment.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Tell your doctor if you are pregnant or breastfeeding.

Not approved for use by anyone younger than 18 years old.

Side Effects

What are the side effects of Nortriptyline (Pamelor)?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
restless muscle movements in your eyes, tongue, jaw, or neck;
a light-headed feeling, like you might pass out;
seizure (convulsions);
new or worsening chest pain, pounding heartbeats or fluttering in your chest;
sudden numbness or weakness, problems with vision, speech, or balance;
fever, sore throat, easy bruising, unusual bleeding;
painful or difficult urination; or
jaundice (yellowing of the skin or eyes).

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Common side effects may include:

increased blood pressure;
numbness or tingling in your hands or feet;
dry mouth, nausea, vomiting, loss of appetite;
blurred vision;
rash, itching; or
breast swelling (in men or women).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Dosage Guidelines & Tips

How to take Nortriptyline (Pamelor)?

Use Nortriptyline (Pamelor) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Measure liquid medicine with the supplied syringe or a dose-measuring device (not a kitchen spoon).

Tell your doctor if you have a planned surgery.

You may have withdrawal symptoms if you stop using nortriptyline suddenly. Ask your doctor before stopping the medicine.

Your symptoms may not improve for a few weeks.

Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

What should I do if I missed a dose of Nortriptyline (Pamelor)?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Overdose Signs

What happens if I overdose on Nortriptyline (Pamelor)?

Overdose symptoms may include irregular heartbeats, severe drowsiness, vision problems, confusion, hallucinations, agitation, stiff muscles, overactive reflexes, vomiting, feeling hot or cold, feeling like you might pass out, seizures, or coma.

If you think you or someone else may have overdosed on: Nortriptyline (Pamelor), call your doctor or the Poison Control center

(800) 222-1222

If someone collapses or isn't breathing after taking Nortriptyline (Pamelor), call 911

911