Skip to Content

Nortriptyline Side Effects

For the Consumer

Applies to nortriptyline: oral capsule, oral solution, oral tablet

Along with its needed effects, nortriptyline may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking nortriptyline:

Incidence not known
  • Abdominal or stomach pain
  • agitation
  • blurred vision
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • chest pain or discomfort
  • clay-colored stools
  • cold sweats
  • confusion about identity, place, and time false beliefs that cannot be changed by facts
  • continuing ringing or buzzing or other unexplained noise in the ears
  • decreased urination
  • depression
  • difficulty in passing urine (dribbling)
  • difficulty with speaking
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • double vision
  • 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
  • general feeling of tiredness or weakness
  • hostility
  • hyperventilation
  • inability to move the arms, legs, or facial muscles
  • inability to speak
  • irritability
  • loss of balance control
  • lower back or side pain
  • mood or mental changes
  • muscle spasm or jerking of all extremities
  • muscle trembling, jerking, or stiffness
  • nightmares
  • pain or discomfort in the arms, jaw, back, or neck
  • painful or difficult urination
  • panic
  • perspiration
  • pinpoint red or purple spots on the skin
  • redness of the face, neck, arms, and occasionally, upper chest
  • restlessness
  • seizures
  • slurred speech
  • sores, ulcers, or white spots on the lips or in the mouth
  • stiffness of the limbs
  • sweating
  • swelling of the face, ankles, legs, or hands
  • talking, feeling, and acting with excitement
  • trouble sleeping
  • twisting movements of the body uncontrolled movements, especially of the face, neck, and back
  • weakness in the arms, hands, legs, or feet

Some side effects of nortriptyline may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known
  • Bigger, dilated, or enlarged pupils (black part of the eye)
  • black tongue
  • decreased interest in sexual ability or desire
  • difficulty having a bowel movement (stool)
  • enlargement of the breast
  • hair loss or thinning of the hair
  • heartburn
  • hives or welts
  • increase in sexual ability or desire
  • increased sensitivity of the eyes or skin to light
  • 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 face or neck
  • vision changes
  • waking to urinate at night

For Healthcare Professionals

Applies to nortriptyline: compounding powder, oral capsule, oral solution

Nervous system

Frequency not reported: Alteration in electroencephalogram (EEG) patterns, ataxia, dizziness, drowsiness, extrapyramidal symptoms, extremity paresthesia, headache, incoordination, mydriasis, numbness, peculiar taste, peripheral neuropathy, seizures, stroke, tingling, tremors[Ref]


Frequency not reported: Agitation, anxiety, confusional states with hallucinations, delusions, disorientation, exacerbation of psychosis, hypomania, increased/decreased libido, insomnia, nightmares, panic, restlessness, suicidal behaviors, suicidal ideation[Ref]


Frequency not reported: Abdominal cramps, black tongue, constipation, diarrhea, dry mouth, epigastric distress, gingivitis, nausea, paralytic ileus, parotid swelling, stomatitis, sublingual adenitis, tongue edema, vomiting[Ref]


Frequency not reported: Arrhythmias, edema, flushing, general edema, heart block, hypertension, hypotension, myocardial infarction, palpitation, tachycardia
Postmarketing reports: Brugada syndrome[Ref]


Frequency not reported: Breast enlargement, delayed micturition, dilation of the urinary tract, galactorrhea, impotence, nocturia, urinary frequency, urinary retention, testicular swelling[Ref]


Frequency not reported: Alopecia, face edema, itching, perspiration, petechia, photosensitization, skin rash, urticaria[Ref]


Frequency not reported: Agranulocytosis, aplastic anemia, bone marrow depression, eosinophilia, purpura, thrombocytopenia[Ref]


Frequency not reported: Drug fever, fatigue, malaise, tinnitus, weakness[Ref]


Frequency not reported: Altered liver function, hepatitis, jaundice (simulating obstructive), liver necrosis[Ref]


Frequency not reported: Anorexia, elevation/depression of blood sugar levels, weight gain/loss[Ref]


Frequency not reported: Blurred vision, disturbance of accommodation
Postmarketing reports: Angle-closure glaucoma[Ref]


Frequency not reported: Gynecomastia, syndrome of inappropriate antidiuretic hormone (SIADH) secretion[Ref]


Frequency not reported: Cross sensitivity (with other tricyclic drugs)[Ref]


Frequency not reported: Increased risk of bone fractures[Ref]


1. "Product Information. Pamelor (nortriptyline)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.

2. Cerner Multum, Inc. "Australian Product Information." O 0

3. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

Some side effects of nortriptyline may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

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.