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Protriptyline Side Effects

It is possible that some side effects of protriptyline may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

For the Consumer

Applies to protriptyline: oral tablet

As well as its needed effects, protriptyline may cause unwanted side effects that require medical attention.

If any of the following side effects occur while taking protriptyline, check with your doctor immediately:

Incidence not known
  • Abdominal or stomach pain
  • agitation or irritability
  • blurred vision
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • change in urination
  • chest pain or discomfort
  • clay-colored stools
  • cold sweats
  • confusion about identity, place, and time
  • continuing ringing, buzzing, or other unexplained noise in the ears
  • convulsions
  • cool, pale skin
  • difficulty with speaking
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • double vision
  • drooling
  • false beliefs that cannot be changed by facts
  • fast, pounding, or irregular heartbeat or pulse
  • feeling of warmth
  • feeling, seeing, or hearing things that are not there
  • feeling that others are watching you or controlling your behavior
  • feeling that others can hear your thoughts
  • fever with or without chills
  • hearing loss
  • hostility
  • hyperventilation
  • inability to move the arms, legs, or facial muscles
  • lack of coordination
  • lower back or side pain
  • mood or mental changes
  • muscle spasm or jerking of all extremities
  • muscle trembling or twitching
  • nightmares
  • pain or discomfort in the arms, jaw, back, or neck
  • panic
  • pinpoint red or purple spots on the skin
  • pounding in the ears
  • redness of the face, neck, arms, and occasionally, upper chest
  • shakiness and unsteady walk
  • slurred speech
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • stiffness of the limbs
  • stupor
  • sweating
  • swelling of face, ankles, or hands
  • swollen glands
  • talking, feeling, and acting with excitement
  • trouble sleeping
  • twisting movements of body uncontrolled movements, especially of the face, neck, and back
  • unusual behavior
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • weakness in the arms, hands, legs, or feet
  • weight gain or loss
  • yellow eyes or skin

If any of the following symptoms of overdose occur while taking protriptyline, get emergency help immediately:

Symptoms of overdose
  • Change in consciousness
  • clumsiness
  • disorientation
  • disturbed concentration
  • drowsiness to profound coma
  • enlarged pupils
  • increased or excessive unconscious or jerking movements
  • low body temperature
  • muscle aches or tightness
  • muscle weakness
  • severe sleepiness
  • shivering
  • trouble breathing
  • weak or feeble pulse

Some protriptyline side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

Incidence not known
  • Abdominal or stomach cramps
  • bigger, dilated, or enlarged pupils (black part of the eye)
  • black tongue
  • difficulty having a bowel movement (stool)
  • enlargement or swelling of the breasts
  • hair loss or thinning of the hair
  • heartburn
  • hives or welts
  • increased in sexual ability, desire, drive, or performance
  • increased sensitivity of the eyes to light
  • increased sensitivity of the skin to sunlight
  • pain or discomfort in the chest, upper stomach, or throat
  • peculiar taste
  • severe sunburn
  • small red or purple spots on the skin
  • swelling of the testicles
  • swelling or inflammation of the mouth
  • swollen, painful, or tender lymph glands on side of the face or neck
  • unexpected or excess milk flow from the breasts
  • waking to urinate at night

For Healthcare Professionals

Applies to protriptyline: oral tablet


The most commonly reported side effects were dry mouth, constipation, and blurred vision.[Ref]


Frequency not reported: Confusional states (particularly in the elderly) with hallucinations, disorientation, delusions, anxiety, restlessness, agitation, hypomania, exacerbation of psychosis, insomnia, panic, nightmares, suicidal behaviors[Ref]


Frequency not reported: Myocardial infarction, stroke, heart block, arrhythmias, hypotension (particularly orthostatic hypotension), hypertension, tachycardia, palpitation, flushing[Ref]


Frequency not reported: Agranulocytosis, petechiae, bone marrow depression, leukopenia, thrombocytopenia, purpura, eosinophilia[Ref]

Nervous system

Frequency not reported: Seizures, incoordination, ataxia, tremors, peripheral neuropathy, numbness, tingling and paresthesias of extremities, sleep abnormalities, extrapyramidal symptoms, drowsiness, dizziness, weakness and fatigue, headache, tinnitus, alteration in EEG patterns[Ref]


Frequency not reported: Nausea, vomiting, anorexia, epigastric distress, diarrhea, peculiar taste, stomatitis, abdominal cramps, black tongue, paralytic ileus, constipation, dry mouth, sublingual adenitis[Ref]


Frequency not reported: Elevation or depression of blood sugar levels, weight gain or loss[Ref]


Frequency not reported: Blurred vision, disturbance of accommodation, increased intraocular pressure, mydriasis[Ref]


Frequency not reported: Alopecia, photosensitization, perspiration[Ref]


Frequency not reported: Drug fever, skin rash, urticaria, itching, edema (face and tongue)[Ref]


Frequency not reported: Gynecomastia in the male, breast enlargement and galactorrhea in the female, testicular swelling, syndrome of inappropriate antidiuretic hormone secretion[Ref]


Frequency not reported: Urinary frequency, nocturia, impotence, increased or decreased libido, delayed micturition, dilatation of the urinary tract[Ref]


Frequency not reported: Jaundice, altered liver function[Ref]


Frequency not reported: Parotid swelling, general edema, hyperpyrexia, malaise[Ref]


1. "Product Information. Vivactil (protriptyline)" Merck & Co, Inc, West Point, PA.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.