You should not use nortriptyline if you recently had a heart attack.
Do not use nortriptyline if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, tranylcypromine and others.
Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms.
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.
Before taking this medicine
You should not use nortriptyline if:
you are allergic to it 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 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 used an "SSRI" antidepressant in the past 5 weeks, such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone.
To make sure nortriptyline is safe for you, 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.
Nortriptyline is not approved for use by anyone younger than 18 years old.
How should I take nortriptyline?
Take nortriptyline exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.
Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).
If you need surgery, tell your surgeon you currently use nortriptyline. You may need to stop for a short time.
You may have unpleasant withdrawal symptoms if you stop using nortriptyline suddenly. Ask your doctor how to safely stop using this medicine.
It may take a few weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.
Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.
