nortriptyline, Pamelor, Aventyl (cont.)

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PREPARATIONS: Capsules: 10, 25, 50, and 75mg. Oral solution: 10 mg/teaspoon

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

PRESCRIBED FOR: Nortriptyline is used to elevate the mood of patients with depression. Non-FDA approved (off-label) use of nortriptyline includes attention deficit hyperactivity disorder (ADHD) in adults, children and adolescents as second-line therapy due to failed or partial response to other FDA-approved therapies. Another off-label use for nortriptyline is as adjunctive therapy (added to other therapy) for chronic pain (for example, migraine, tension headaches, diabetic neuropathy, cancer pain, arthritic pain).

DOSING: The usual dose of nortriptyline in adults is 25 mg given 3 to 4 times daily. In children, doses usually are 30 to 50 mg once daily or in divided doses. It is advisable to begin at a low dose and increase the dose slowly.

DRUG INTERACTIONS: TCAs, including nortriptyline, should not be used concurrently with a monoamine oxidase inhibitors such as tranylcypromine (Parnate), isocarboxazid (Marplan), phenelzine (Nardil), and procarbazine (Matulane) because of the possibility of hyperpyretic crises (high fever), convulsions, and even death.

Cimetidine (Tagamet) can increase blood levels of nortriptyline in the blood by interfering with the metabolism (breakdown) of nortriptyline by the liver. Increased levels of nortriptyline may possibly lead to side effects. Other drugs which share this effect on nortriptyline include propafenone (Rythmol), flecainide (Tonocard), quinidine (Quinidex, Quinaglute), and fluoxetine (Prozac).



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