
(nor trip’ ti leen)
Apo-Nortriptyline (CAN), Aventyl, Gen-Nortriptyline (CAN), Pamelor, ratio-Nortriptyline (CAN)
PREGNANCY CATEGORY D
Drug class
TCA (secondary amine)
Therapeutic Actions
Mechanism of action unknown; the TCAs are structurally related to the phenothiazine antipsychotic drugs (eg, chlorpromazine), but inhibit the presynaptic reuptake of the neurotransmitters norepinephrine and serotonin; anticholinergic at CNS and peripheral
receptors; sedating; the relationship of these effects to clinical efficacy is unknown.
receptors; sedating; the relationship of these effects to clinical efficacy is unknown.
Indications
Relief of symptoms of depression (endogenous depression most responsive)
Unlabeled uses: Treatment of panic disorders (25–75 mg/day), premenstrual depression (50–125 mg/day), dermatologic disorders (75 mg/day), chronic pain, headache prophylaxis
Contraindications and Cautions
Contraindicated with hypersensitivity to any tricyclic drug, concomitant therapy with an MAOI, within 2 wk of MAOI use, recent MI, myelography within previous 24 hr or scheduled within 48 hr, pregnancy (limb reduction abnormalities), lactation.
Use cautiously with EST (increased hazard with TCAs); pre-existing CV disorders (possibly increased risk of serious CVS toxicity); angle-closure glaucoma, increased IOP; urinary retention, ureteral or urethral spasm (anticholinergic effects may exacerbate these conditions); seizure disorders; hyperthyroidism (predisposes to CVS toxicity, including cardiac arrhythmias); impaired hepatic, renal function; psychiatric patients (schizophrenic or paranoid patients may exhibit a worsening of psychosis); bipolar disorder (may shift to hypomanic or manic phase); elective surgery (discontinued as long as possible before surgery).
Available Forms
Capsules—10, 25, 50, 75 mg; solution—10 mg/5 mL
Dosages
Adults
25 mg tid–qid PO. Begin with low dosage and gradually increase as required and tolerated. Doses of more than 150 mg/day are not recommended.
Pediatric patients 12 yr and older
30–50 mg/day PO in divided doses.
Pediatric patients younger than 12 yr
Not recommended.
Geriatric patients
30–50 mg/day PO in divided doses.
Pharmacokinetics
|

Stay updated, free articles. Join our Telegram channel

Full access? Get Clinical Tree

