A tiny percentage of youngsters, teenagers, and young adults (up to 24 years old) who took mood-elevating antidepressants like nortriptyline during clinical research developed suicidal thoughts (thinking about harming or killing oneself or planning or trying to do so). Children, teenagers, and young adults who take antidepressants to treat depression or other mental diseases may have a higher risk of committing suicide than those who do not take these medications. However, experts disagree on how significant this risk is and how much it has to be taken into account when determining whether or not a kid or adolescent should take an antidepressant. Nortriptyline is typically not recommended for use in people under the age of 18, however in some circumstances, a doctor may determine that it is the best treatment option for a child’s illness.

Even if you are an adult above the age of 24, you should be aware that taking nortriptyline or other antidepressants may cause your mental health to change in unexpected ways. Suicidal thoughts may come to mind, especially at the start of treatment and whenever your dose is changed. Any of the following symptoms should prompt you, your family, or your caregiver to call your doctor immediately away: Depressive symptoms that are new or increasing; thoughts of self-harm or suicide, or plans or attempts to do so; excessive concern; agitation; panic attacks; trouble falling or staying asleep; aggressive behaviour; impatience; acting without thinking; intense restlessness; and abnormally feverish excitement. Make sure your family or caregiver is aware of any symptoms that could be significant so they can contact the doctor on your behalf if you are unable to call for help.

While you are taking nortriptyline, your doctor will want to visit you frequently, especially at the start of your treatment. Be sure to show up for all of your doctor’s appointment times.

When you start your nortriptyline treatment, your doctor or pharmacist will give you the manufacturer’s patient information leaflet (Medication Guide). If you have any questions, carefully read the material and contact your doctor or pharmacist. The FDA website also offers the Medication Guide.

No of your age, you, your parent, or your caregiver should discuss the advantages and disadvantages of treating your disease with an antidepressant or with alternative treatments with your doctor before starting an antidepressant. The dangers and advantages of not treating your ailment should also be discussed. You should be aware that your chance of committing suicide is significantly increased if you suffer from depression or any mental disorder. This risk is increased if you or a family member currently has, or previously had, bipolar disorder (depression followed by periods of extreme excitement) or mania (frenzied, abnormally excited mood), or if you have ever considered or tried suicide. Discuss your ailment, symptoms, and personal and family medical history with your doctor. What kind of treatment is best for you will be decided by both you and your doctor.

In order to cure depression, nortriptyline is employed. Nortriptyline belongs to a class of drugs known as tricyclic antidepressants. It functions by raising the levels of specific organic compounds in the brain that are essential for maintaining mental equilibrium.

Both a pill and an oral liquid form of nortriptyline are available. It can be taken with or without food and is typically taken one to four times per day. Take nortriptyline every day at roughly the same time. Ask your doctor or pharmacist to explain any instructions on your prescription label that you are unsure about following. Adhere to the medication’s directions precisely. Never take it in larger or less amounts or more frequently than directed by your doctor.

Most likely, your doctor will start you on a low dose of nortriptyline and then gradually raise it.

Even if you are feeling fine, keep taking nortriptyline. Without consulting your doctor, do not discontinue taking nortriptyline. You can have withdrawal symptoms such a headache, nausea, and weakness if you stop taking nortriptyline abruptly. Your dose should be gradually reduced, as recommended by your doctor.

Additionally, post-herpetic neuralgia and panic disorders are occasionally treated with nortriptyline (the burning, stabbing pains, or aches that may last for months or years after a shingles infection). Additionally, some people utilise nortriptyline to aid in quitting smoking. Discuss the potential dangers of using this medicine for your illness with your doctor.

Other prescriptions for this drug are possible. For more information, consult your physician or pharmacist.

Before taking nortriptyline,

• If you have an allergy to nortriptyline, other tricyclic antidepressants like desipramine (Norpramin), clomipramine (Anafranil), imipramine (Tofranil), or trimipramine (Surmontil), any other medications, or any of the ingredients in nortriptyline capsules or liquid, let your doctor and pharmacist know right away. For a list of the ingredients, ask your doctor or pharmacist.
• Inform your doctor if you are currently using an MAO inhibitor, such as isocarboxazid (Marplan), linezolid (Zyvox), methylene blue, phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate), or if you have just discontinued taking one. Most likely, your doctor will advise against taking nortriptyline. You should wait at least 14 days after stopping nortriptyline before starting an MAO inhibitor.
• Inform your doctor and pharmacist about all prescription and over-the-counter drugs, vitamins, dietary supplements, and herbal products that you are now taking or intend to use. Incorporate any of the following: Warfarin (Coumadin, Jantoven), antihistamines, chlorpropamide (Diabinese), cimetidine (Tagamet), flecainide (Tambocor), guanethidine (Ismelin), lithium (Eskalith, Lithobid), drugs for high blood pressure, seizures, Parkinson’s disease, diabetes, asthma, nausea, mental illness, colds, or allergies, methylphenidate (Ritalin), muscle relaxants, Your physician might need to adjust the dosage of your drugs or keep a close eye on you for side effects.
• If you’ve suffered a heart attack recently, let your doctor know. Your physician might advise against taking nortriptyline.
• Inform your physician if you currently have or ever had any of the following conditions: an enlarged prostate (a male reproductive gland), trouble urinating, diabetes, seizures, schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions), an overactive thyroid gland, liver, kidney, or heart disease).
• Inform your doctor if you are expecting, intend to get pregnant, or are nursing a baby. Call your doctor if you become pregnant while taking nortriptyline.
• You should let your doctor or dentist know if you are taking nortriptyline if you are having surgery, including dental surgery.
• You should be aware that this medicine may cause you to feel sleepy. Prior to understanding how this drug affects you, avoid using machinery or driving a car.
• The safe consumption of alcohol while taking this medicine should be discussed with your doctor.
• Make a plan to limit your time spent in the sun and to use sunscreen, sunglasses, and protective clothes. Your skin could become sun-sensitive if you use nortriptyline.

It’s important to be aware that nortriptyline may result in angle-closure glaucoma (a condition where the fluid is suddenly blocked and unable to flow out of the eye causing a quick, severe increase in eye pressure which may lead to a loss of vision). Ask your doctor if you should get your eyes checked before beginning this medicine. Call your doctor or get emergency medical attention right away if you are experiencing nausea, eye pain, changes in your vision, such as seeing coloured rings around lights, or swelling or redness in or around your eyes.

If you miss a dosage, take it as soon as you recall. If the next dose is soon due, skip the missed one and carry on with your regular dosing plan. To make up for a missing dose, do not take a second one.

There may be negative effects from nortriptyline. If any of these symptoms are severe or do not go away, let your doctor know right once:

• Nausea
• Drowsiness
• Weakness or exhaustion
• Either excitement or worry
• Nightmares
• Mouth ache
• Alterations in weight or appetite
• Constipation
• Having trouble urinating
• Often urinating
• Alterations in sex ability or drive
• Excessive perspiration

There could be some severe negative effects. Call your doctor right away or seek emergency medical attention if you experience any of the following symptoms or those noted in the IMPORTANT WARNING or SPECIAL PRECAUTIONS sections:

• Muscle spasms in the jaw, neck, and back
• Slow or challenging speech
• Shuffled walking
• Body part shaking that is uncontrollable
• Fever
• Breathing or swallowing challenges
• Rash
• The skin or eyes turning yellow
• Abnormal heartbeat

Other negative effects of nortriptyline may occur. If you have any strange side effects while taking this medicine, contact your doctor right once.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).

Keep this medication tightly closed in the original container and out of the reach of children. Store it away from excessive heat and moisture at room temperature (not in the bathroom).

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the easiest approach to get rid of your medication. To find out about take-back programmes in your area, speak with your pharmacist or the garbage/recycling department in your city. If you do not have access to a take-back programme, see the FDA’s Safe Disposal of Medicines website at http://goo.gl/c4Rm4p for additional information.

As many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning. http://www.upandaway.org

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Additionally, information can be found online at https://www.poisonhelp.org/help. Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

Overdose symptoms could include

• Abnormal heartbeat
• Seizures
• Coma (loss of consciousness for a period of time)
• Confusion
• Hallucination (seeing things that do not exist)
• Widening eyes (dark circles in the middle of the eyes)
• Drowsiness
• Agitation
• Fever
• Decreased body temperature
• Stiff muscles
• Vomiting

Keep all of your appointments with your physician and the lab. To determine how you are responding to nortriptyline, your doctor may request specific lab tests.

No one else should take your medication. Any queries you may have regarding medication refills should be directed to your pharmacist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.