Pamelor

Nortriptyline Hydrochloride tablet

What is it used for?

NORTRIPTYLINE is used for the treatment of depression.

What should I discuss with my physician prior to taking this medicine?

Please do tell your physician if you have any of the following conditions:

• an alcohol problem
• bipolar disorder or schizophrenia
• difficulty passing urine, prostate trouble
• glaucoma
• heart disease or recent heart attack
• liver disease
• over active thyroid
• seizures
• thoughts or plans of suicide or a previous suicide attempt or family history of suicide attempt
• an unusual or allergic reaction to nortriptyline, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How is this medicine should be taken?

Take it orally accompanied with a glass of water. Your doses should be taken at the regular intervals. It should never be taken more often than prescribed. If you have been using this medicine regularly for some time period, you should never stop using it abruptly. You must gradually reduce the dose or you may get severe side effects. Consult with your physician for more information on the issue. Even after you stopped taking this medicine, it will still have an effect on your body for a few more days.

Contact your pediatrician regarding the use of this medicine by children. Special care might be necessary.

Overdosage: If you suspect an overdosage, get in touch with the nearest poison control center or emergency room immediately.

NOTE: This medicine is only intended for your use. You should never share it with the others.

What to do if I missed a dose?

If you missed a dose, it should be taken as soon as possible. If the time has almost come for the next dose, only that one should be taken. You should never take double or extra doses; a single doze is sufficient for the purposes.

What are the possible interactions with the other medicine/food/etc?

Do not take this medicine with any of the following:

• arsenic trioxide
• certain medicines used to regulate abnormal heartbeat or to treat other heart conditions
• cisapride
• halofantrine
• MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
• other medicines for mental depression
• phenothiazines like perphenazine, thioridazine and chlorpromazine
• pimozide
• probucol
• procarbazine
• sparfloxacin
• St. John's Wort
• ziprasidone

This medicine may also interact with any of the following:

• atropine and related drugs like hyoscyamine, scopolamine, tolterodine and others
• barbiturate medicines for inducing sleep or treating seizures, such as phenobarbital
• cimetidine
• medicines for diabetes
• reserpine
• seizure or epilepsy medicine such as carbamazepine or phenytoin
• thyroid medicine

This list is not all-inclusive and may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you are using. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some of those items may also interact with your medicine.

Is there anything I should pay attention to while taking it?

Pay regular visits to your doctor or health care professional to undergo checks on your progress. It can take several days before you feel the full effect of this medicine.

Patients and their families should pay attention to the worsening depression or thoughts of suicide. You should also keep an eye on the sudden or severe feeling changes such as anxiety, agitation, feeling panicky, irritable, hostile, aggressive, impulsive, severely restless, overly excited and hyperactive, or having trouble sleeping. If this is happening, especially during the beginning of the treatment course or after a dosage change, inform your health care professional right away.

You may experience drowsiness or dizziness symptoms. You shouldn’t drive, use machinery, or do anything that needs mental alertness until you know how exactly this medicine affects you. Do not stand up or sit up quickly, especially if you are a senior patient. This is to reduce the risk of possible dizziness or fainting spells. Alcohol may increase dizziness and drowsiness. Refrain from using alcohol at all costs.

You should never attempt to treat yourself for coughs, colds, or allergies without a prior consultation with your doctor or health care professional. Some ingredients used in those medications can increase possible side effects for this drug.

Your might experience dry mouth symptom. Chewing sugarless gum or sucking a sugar candy, and drinking plenty of water may help. Contact your doctor if the problem does not go away or is severe.

This medicine might sometimes cause blurred vision and dry eyes. If you are a contact lense user, it is possible that you feel some discomfort during the treatment course. In that case use the lubricating drops to remedy the issue. Refer to your ophthalmologist if the problem does not disappear or the symptoms are severe.

This drug can make you more sensitive to the sun, that is why you should keep out of it during the treatment course. If sun can’t be avoided, at least wear protective clothes and always use a sunscreen.You shouldn’t use sun lamps or tanning beds/booths during the treatment course.

If you are diabetic, check your blood sugar more often than usual, especially during the first few weeks of the treatment with this medicine. This medicine can affect blood sugar levels. Call your doctor or health care professional for advice if you notice a change in the results of blood or urine glucose tests.

Does this medicine have any possible side effects?

The following side effects should be reported to your doctor or health care professional as soon as they are noticed:

• allergic reactions like skin rashes, itching or hives,face, lips, or tongue swelling
• abnormal production of milk in females
• breast enlargement in both males and females
• issues with breathing
• confusion, hallucinations
• fever with increased sweating
• irregular or fast, pounding heartbeat
• muscle stiffness, or spasms
• pain or difficulty passing urine, loss of bladder control
• seizures
• suicidal thoughts or other mood changes
• swelling of the testicles
• tingling, pain, or numbness in the feet or hands
• yellowing of the eyes or skin

The side effects listed below usually do not necessarily require any medical attention (please do report them to your physician if they are recurrent or bothersome):

• change in sex drive or performance
• diarrhea
• nausea, vomiting
• weight gain or loss

Other side effects are also possible, the above list is not all inclusive.

Where should I keep my medicine?

Keep this medicine out of the children’s reach.

This medicine should be stored at the room temperatures between 15 and 30 degrees C (59 and 86 degrees F). Keep container tightly closed. Dispose of any unused medicine after the expiry date is reached.