Pronunciation: nor-TRIP-tih-leen HIGH-droe-KLOR-ide
Class: Tricyclic compound
Aventyl Hydrochloride Pulvules
- Capsules 10 mg
- Capsules 25 mg
- Solution 10 mg base/5 mL
- Capsules 10 mg
- Capsules 25 mg
- Capsules 50 mg
- Capsules 75 mg
Inhibits reuptake of norepinephrine and serotonin in CNS.
Indications and Usage
Relief of symptoms of depression.
Treatment of panic disorder, premenstrual depression, dermatologic disorders (eg, chronic urticaria, angioedema, nocturnal pruritus in atopic eczema).
Hypersensitivity to any tricyclic antidepressant. Generally, not to be given in combination with or within 14 days of treatment with MAOIs or during acute recovery phases of MI.
Dosage and AdministrationAdults
PO 25 mg 3 times daily to 4 times daily. Doses more than 150 mg/day are not recommended.Elderly and Adolescents
PO 30 to 50 mg/day in divided doses.
Store at room temperature (59° to 86°F) in tight container.
Dicumaral actions may increase.Carbamazepine
Carbamazepine levels may increase; nortriptyline levels may decrease.Cimetidine, fluoxetine
Coadministration may increase nortriptyline blood levels and effects.CNS depressants
Depressant effects may be additive.Clonidine
May result in hypertensive crisis.Guanethidine
Hypotensive action may be inhibited.MAO Inhibitors
Hyperpyretic crisis, convulsions and death may occur.Sympathomimetics
Pressor response may decrease.
Laboratory Test Interactions
None well documented.
Orthostatic hypotension; hypertension; tachycardia; palpitations; arrhythmias; ECG changes; stroke; heart block; CHF.
Confusion; hallucinations; delusions; nervousness; restlessness; agitation; panic; insomnia; nightmares; mania; exacerbation of psychosis; drowsiness; dizziness; weakness; fatigue; emotional lability; seizures; tremors; extrapyramidal symptoms (eg, pseudoparkinsonism, movement disorders, akathisia).
Rash; pruritus; photosensitivity reaction; dry skin; acne.
Nasal congestion; tinnitus; conjunctivitis; mydriasis; blurred vision; increased IOP; peculiar taste in mouth.
Nausea; vomiting; anorexia; GI distress; diarrhea; flatulence; dry mouth; constipation.
Impotence; sexual dysfunction; nocturia; urinary frequency; urinary tract infection; vaginitis; cystitis; dysmenorrhea; amenorrhea; urinary retention and hesitancy.
Bone marrow depression including agranulocytosis; eosinophilia; purpura; thrombocytopenia; leukopenia.
Elevation or depression of blood sugar.
Pharyngitis; rhinitis; sinusitis; laryngitis; coughing.
Numbness; breast enlargement.
Category D . Safety not established. Limb reduction anomalies have been reported with nortriptyline.
Excreted in breast milk.
Safety and efficacy not established.
Special Risk Patients
Use drug with caution in patients with history of seizures, urinary retention, urethral or ureteral spasm, angle-closure glaucoma or increased IOP, CV disorders, hyperthyroid patients or those receiving thyroid medication, patients with hepatic or renal impairment, schizophrenia, or paranoia.
Confusion, vomiting, muscle rigidity, ECG abnormalities, seizures, agitation, fever, hyperactive reflexes, CHF, coma, respiratory depression, death.
- Advise patient to avoid sudden position changes to prevent orthostatic hypotension.
- Explain that it may take up to 2 wk for therapeutic effects to become evident.
- Caution patient to avoid exposure to sunlight and to use sunscreen or wear protective clothing to avoid photosensitivity reaction.
- Instruct patient to notify health care provider of visual disturbances.
- Advise patient to take sips of water frequently, suck on ice chips or sugarless hard candy or chew sugarless gum if dry mouth occurs.
- Caution patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness.
- Instruct patient not to double dose if one is missed and to notify health care provider if more than 1 dose is missed.
- Advise that side effects will be decreased if taken at bedtime if prescribed as once-daily dose.
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