Protriptyline

Generic Name: protriptyline (proe-TRIP-ti-leen)
Brand Name: Vivactil

Antidepressants may increase the risk of suicidal thoughts or actions in children, teenagers, and young adults. However, depression and certain other mental problems may also increase the risk of suicide. Talk with the patient's doctor to be sure that the benefits of using protriptyline outweigh the risks.

Family and caregivers must closely watch patients who take protriptyline. It is important to keep in close contact with the patient's doctor. Tell the doctor right away if the patient has symptoms like worsened depression, suicidal thoughts, or changes in behavior. Discuss any questions with the patient's doctor.


Protriptyline is used for:

Treating depression. It may also be used for other conditions as determined by your doctor.

Protriptyline is a tricyclic antidepressant. It works by increasing the activity of certain chemicals in the brain that help elevate mood.

Do NOT use protriptyline if:

  • you are allergic to any ingredient in protriptyline or to similar medicines
  • you have taken furazolidone, linezolid, or a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) within the last 14 days, or you are taking astemizole, droperidol, terfenadine, or cisapride
  • you are recovering from a recent heart attack

Contact your doctor or health care provider right away if any of these apply to you.

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Before using protriptyline:

Some medical conditions may interact with protriptyline. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you drink alcohol-containing beverages daily or you have a history of alcohol abuse
  • if you take thyroid medicine or you have a history of overactive thyroid, glaucoma, heart problems, kidney or liver problems, diabetes, seizures, the blood disease porphyria, an enlarged prostate, or difficulty urinating
  • if you have a suicidal thoughts or behavior, bipolar disorder, or any other mental disorders
  • if you are undergoing electroshock therapy or are scheduled to have any surgery
  • if you are taking a medicine that contains methylene blue

Some MEDICINES MAY INTERACT with protriptyline. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Azole antifungals (eg, fluconazole), cimetidine, duloxetine, flecainide, methylphenidate, mibefradil, phenothiazines (eg, chlorpromazine), propafenone, quinidine, selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine), or terbinafine because the side effects of protriptyline may be increased
  • Arsenic, astemizole, cisapride, droperidol, furazolidone, linezolid, MAOIs (eg, phenelzine), pimozide, quinolone antibiotics (eg, ciprofloxacin), streptogramins (eg, dalfopristin), terfenadine, tramadol, or ziprasidone because the risk of high blood pressure, serious heart problems (eg, irregular heartbeat), or seizures may be increased
  • Barbiturates (eg, phenobarbital) or phenytoin because the effectiveness of protriptyline may be decreased
  • Anticholinergics (eg, benztropine), carbamazepine, chlorpropamide, or sympathomimetics (eg, phenylephrine) because side effects may be increased by protriptyline
  • Clonidine, guanethidine, or guanfacine because effectiveness may be decreased by protriptyline

This may not be a complete list of all interactions that may occur. Ask your health care provider if protriptyline may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use protriptyline:

Use protriptyline as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Protriptyline comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get protriptyline refilled.
  • Take protriptyline by mouth with or without food.
  • If you miss a dose of protriptyline, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. If you take 1 dose daily at bedtime, do not take the missed dose the next morning.

Ask your health care provider any questions you may have about how to use protriptyline.

Important safety information:

  • Protriptyline may cause drowsiness, dizziness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use protriptyline with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using protriptyline; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
  • Protriptyline may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
  • Do not become overheated in hot weather or while you are being active; heatstroke may occur.
  • Children, teenagers, and young adults who take protriptyline may be at increased risk for suicidal thoughts or actions. Watch all patients who take protriptyline closely. Contact the doctor at once if new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.
  • Diabetes patients - Protriptyline may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
  • Protriptyline may cause increased sensitivity to the sun. Avoid exposure to the sun, sunlamps, or tanning booths until you know how you react to protriptyline. Use a sunscreen or protective clothing if you must be outside for a prolonged period.
  • Tell your doctor or dentist that you take protriptyline before you receive any medical or dental care, emergency care, or surgery.
  • Lab tests, including blood cell counts, may be performed while you use protriptyline. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Use protriptyline with caution in the ELDERLY; they may be more sensitive to its effects, especially confusion, blood pressure changes, and irregular heartbeat.
  • Protriptyline should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: It is not known if protriptyline can cause harm to the fetus. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using protriptyline while you are pregnant. It is not known if protriptyline is found in breast milk. Do not breast-feed while taking protriptyline.

If you stop taking protriptyline suddenly, you may have WITHDRAWAL symptoms. These may include headache, nausea, and tiredness.

Possible side effects of protriptyline:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Dizziness; drowsiness; dry mouth; excitement; headache; impotence; nausea; nightmares; pupil dilation; sensitivity to sunlight; sweating; tiredness; upset stomach; vomiting; weakness; weight loss or gain.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision or other vision changes; changes in sex drive; chest pain; confusion; constipation; fainting; fast, slow, or irregular heartbeat; fever; frequent or difficult urination; hallucinations; impulsive behavior or other unusual changes in behavior; jaw, neck, or muscle spasms; mental or mood changes (eg, increased anxiety, mood swings, agitation, irritability, nervousness, restlessness); panic attacks; ringing in the ears; seizures; severe dizziness or drowsiness; sore throat; stomach pain; suicidal thinking or behavior; swelling of the testicles; tremor; trouble sleeping; trouble walking or keeping your balance; twitching of the face or tongue; uncontrolled movements of arms and legs or stiffness; unusual bleeding or bruising; worsening of depression; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include agitation; bluish skin or mucous membranes; breathing problems; chest pain; coma; confusion; dry mouth; enlarged pupils; excess sweating; fainting; fast or irregular heartbeat; flushing; incoordination; involuntary movements; loss of consciousness; restlessness; rigid muscles; seizures; severe drowsiness; shock; stupor; trouble breathing; vomiting.

Proper storage of protriptyline:

Store protriptyline at room temperature, between 68 and 77 degrees F (20 and 25 degrees C), in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep protriptyline out of the reach of children and away from pets.

General information:

  • If you have any questions about protriptyline, please talk with your doctor, pharmacist, or other health care provider.
  • Protriptyline is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take protriptyline or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about protriptyline. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to protriptyline. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using protriptyline.

Issue Date: April 2, 2014
Database Edition 14.2.1.001
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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