Medicine :   
Nortriptyline is a Medicine belongs to Antidepressant Agents group whose properties about Brand can be referenced from   Book : Martindale    Page : 445   Edition : 37,

  ►   Brandname : Aventyl,Pamelor,Allegron,Sensival,Nortilen

  ►  Doseform : Capsule with 10  mg, Capsule with 25  mg, Capsule with 50  mg, Capsule with 75  mg, Solution with 2  mg/ml, Tablet with   ,

Reference of this Medicine for its Strength can be taken from   Book : Basic & Clinical pharmacology    Page : 539   Edition : 12, Martindale    Page : 445   Edition : 37,
A Route of administration in pharmacology and toxicology is the path by which a drug, fluid, poison, or other substance is taken into the body. Routes of administration are generally classified by the location at which the substance is applied. Common examples include oral and intravenous administration.

  ►  Route of administration : Oral,
Reference :-   Book : Martindale    Page : 444   Edition : 37,

  ►  Indication/uses : depression, nocturnal enuresis,
Reference :-   Book : Martindale    Page : 444   Edition : 37, Martindale    Page : 445   Edition : 37,
Dosing of Medicine differ in Adult & Pediatrics ↓


► Nortriptyline medicine for Adults :

S.No Ailment   Route   Dose Min   Dose Max   Unit   Dosage   Frequency   Additional Info
1 Depression Oral 75 100 mg Tablet In the treatment of depression a low starting dose is given gradually increasing to the equivalent of 75 to 100 mg daily in 3 or 4 divided doses. Up to a maximum of 150 mg daily may be required in patients with severe depression.

Ref :-  Book : Martindale    Page : 444   Edition : 37,




For Pediatric :
S.No Ailment   Age Min   Age Max   Weight ( Kg ) Route   Dose Min   Dose Max   Unit   Dosage   Additional Info  
1 Nocturnal enuresis in children in whom organic pathology has been excluded 6 Year 7 Year 20 to 25 kg Oral 10 mg
2 Nocturnal enuresis in children in whom organic pathology has been excluded 8 Year 11 Year 25 to 35 kg Oral 10 20 mg
3 Nocturnal enuresis in children in whom organic pathology has been excluded 11Year 35 to 54 kg Oral 25 35 mg

Ref :- Book : Martindale    Page : 445   Edition : 37,
Precaution :- If a Patient is using 'Nortriptyline' drug in  Hyperprolactinemia  disease, then Please not be used .

►  Side Effect : dry mouth, constipation, urinary retention, Blurred Vision, increased intraocular pressure, hyperthermia, drowsiness, headache, peripheral neuropathy, tremor, ataxia, epileptiform seizures, tinnitus, speech difficulties (dysarthria), Confusion, hallucinations, delirium, mania or hypomania, behavioural disturbances, sour taste, metallic taste, stomatitis, gastric irritation, nausea, vomiting, Orthostatic hypotension, tachycardia, hypersensitivity reactions, Urticaria, angioedema, photosensitisation, testicular enlargement, Gynaecomastia, breast enlargement, galactorrhoea, sexual dysfunction, Changes in blood sugar concentrations, hypernatraemia, Increased appetite, weight gain, sweating, ,
Ref :-   Book : Martindale    Page : 406,444   Edition : 37,

►  Interaction : , , Rifampicin , , Cimetidine , Methylphenidate , , , , Adapalene , , , Amiodarone , Quinidine , Astemizole, Terfenadine, Pimozide , Sertindole, Thioridazine , Cisapride , Halofantrine, Sotalol , ,
Ref :-   Book : Martindale    Page : 410,444   Edition : 37,


►  Contraindication : urinary retention, prostatic hyperplasia, chronic constipation , phaeochromocytoma, Epilepsy, cardiovascular disease, heart block , hyperthyroidism, Untreated angle-closure glaucoma, Cardiac arrhythmias, Recovery period after myocardial infarction, hepatic impairment, severe liver disease, Blood-sugar concentrations may be altered in diabetic patients, Patients should be closely monitored during early antidepressant therapy until significant improvement in depression is observed because suicide is an inherent risk in depressed patients, regular dental check-ups are recommended for patients on long-term therapy, Drowsiness often occurs, particularly at the start of therapy, and patients, if affected, should not drive or operate machinery, Elderly patients can be particularly sensitive to the adverse effects of tricyclic antidepressants and a reduced dose, especially initially, should be used, Tricyclic antidepressants are not recommended for depression in children,
Ref :-   Book : Martindale    Page : 408,444   Edition : 37,
  ►    Mechanism of Drug Drug Interaction :  Drugs that inhibit or induce the cytochrome P450 isoenzyme CYP2D6 may affect tricyclic metabolism and produce marked alterations in plasma concentrations. Adverse effects may be enhanced by antimuscarinic drugs or CNS depressants, including alcohol. Barbiturates and other enzyme inducers such as rifampicin and some antiepileptics can increase the metabolism of tricyclic antidepressants and may lower plasma concentrations and reduce antidepressant response. Cimetidine, methylphenidate, antipsychotics, and calciumchannel blockers can reduce the metabolism of the tricyclics, leading to the possibility of increased plasma concentrations and accompanying toxicity. Use of tricyclics with thyroid hormones may precipitate cardiac arrhythmias. The pressor effects of sympathomimetics, especially those of the direct-acting drugs adrenaline and noradrenaline, can be enhanced by tricyclic antidepressants. Drugs that prolong the QT interval, including antiarrhythmics such as amiodarone or quinidine, the antihistamines astemizole and terfenadine, some antipsychotics (notably pimozide, sertindole, and thioridazine), cisapride, halofantrine, and sotalol, may increase the likelihood of ventricular arrhythmias when taken with tricyclic antidepressants. Different antidepressants have been used together under expert supervision in refractory cases of depression, severe adverse reactions including the serotonin syndrome may occur. For this reason an appropriate. Tricyclic antidepressants should not generally be given to patients receiving MAOIs or for at least 2 weeks (3 weeks if starting clomipramine or imipramine) after their withdrawal,
Ref :-   Book : Martindale    Page : 410,444   Edition : 37,


  ►  Mechanism of Action :   Selectively inhibit reuptake of 5-HT and NE from the synaptic cleft by respectively blocking 5-HT and NE reuptake transporters, and thereby cause enhancement of postsynaptic responses,
Ref :-   Book : Principle of Pharmacology (The Pathophysiologic Basis of Drug Therapy)    Page : 221   Edition : 3,
 ►   

Dietary Products that produce same effect as  Nortriptyline






►   Route of Elimination :   Renal,
Ref :-   Book : Basic & Clinical pharmacology    Page : 40   Edition : 12,


►    Plasma Half-life :   Min value :-   31,    Max value :-   hours,
Ref :-   Book : Basic & Clinical pharmacology    Page : 41   Edition : 12,


►    Peak Plasma Concentration :   Min value :-   NA    Max value :-   NA