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years with psychiatric conditions who were treated with an
If you have thoughts of harming or killing yourself at any time,
contact your doctor or go to hospital straight away.
You may find it helpful to tell a relative or close friend that you are
depressed or have an anxiety disorder, and ask them to read this
leaflet. You might ask them to tell you if they think your depression
or anxiety is getting worse, or if they are worried about changes in
your behaviour.
If any of these points apply to you, tell your doctor or pharmacist.


Nortriptyline 10mg Film-coated tablets
Nortriptyline 25mg Film-coated tablets
Read all of this leaflet carefully before you start taking this
- Keep this leaflet. You may need to read it again
- If you have any further questions, ask your doctor or pharmacist
- This medicine has been prescribed for you. Do not pass it on to others.
It may harm them, even if their symptoms are the same as yours
- If any of the side effects gets serious, or if you notice any side
effects not listed in this leaflet, please tell your doctor or pharmacist

Taking other medicines
You should tell your doctor if you are taking or have taken any
medicines, including medicines obtained without a prescription.
The following medicines may interact with your Nortriptyline Tablets:
• guanethidine, debrisoquine, bethanidine, clonidine (used to treat
high blood pressure);
• barbiturates (used for anxiety or to make you feel sleepy);
• alcohol (you should not drink alcohol);
• fluoxetine (another antidepressant);
• cimetidine (for heartburn and ulcers);
• phenothiazines (for mental illness);
• carbamazepine (for epilepsy);
• propafenone, flecainide, encainide, quinidine (for heartbeat disorders)
It may still be all right for you to be given Nortriptyline Tablets.
Your doctor will be able to decide what is suitable for you.

In this leaflet:
1. What Nortriptyline Tablets are and what they are used for
2. Before you take Nortriptyline Tablets
3. How to take Nortriptyline Tablets
4. Possible Side effects.
5. How to store Nortriptyline Tablets
6. Contents of pack and other information
This medicine contains nortriptyline.
Nortriptyline Tablets are used in the treatment of symptoms of
depression. Nortriptyline Tablets may also be used for the
treatment of bedwetting in children 6 years and older.

Driving and using machines
Nortriptyline Tablets may affect alertness. Use caution when
driving or operating heavy machinery until you’re aware of how
this drug affects you. If you feel Nortriptyline Tablets affect your
ability to drive or use machines, tell your doctor immediately.

Do not take Nortriptyline if you are:
• you are allergic (hypersensitive) to Nortriptyline or any of the
other ingredients of Nortriptyline Tablets (see list of ingredients
in Section 6). An allergic reaction may include rash, itching,
difficulty breathing or swelling of the face, lips, throat or tongue;
• you have had a recent heart attack or heartbeat disorder;
• you have severe liver disease;
• you suffer from mania (abnormally raised mood);
• you are breast-feeding;
• the child is under 6 years of age;
• you are taking, or have taken in the last two weeks, monoamine
oxidase inhibitors (another type of antidepressant);
• you are taking adrenaline-like drugs including ephedrine,
isoprenaline, noradrenaline, phenylephrine and phenylpropanolamine. These drugs are often contained in cough and cold remedies
Take special care with Nortriptyline Tablets
• you feel suicidal or aggressive - tell your doctor;
• you are agitated, overactive, or suffer from schizophrenia;
• you have heart disease;
• you have a thyroid condition;
• you have a history of epilepsy;
• you have high pressure in the eyes (glaucoma);
• you have an enlarged prostate;
• your child taking Nortriptyline Tablets has a change in behaviour;
• you are going to have electroconvulsive therapy (electric shock);
• you are diabetic;
• you are going to receive an anaesthetic, e.g. for an operation tell your doctor;
• you have had an allergic reaction to another tricyclic antidepressant in the past;
• you are pregnant, think you might be pregnant or planning to
become pregnant or breast-feeding you should not take
Nortriptyline Tablets unless your doctor tells you to
Thoughts of suicide and worsening of your depression or anxiety
disorder, if you are depressed and/or have anxiety disorders
You can sometimes have thoughts of harming or killing yourself.
These may be increased when first starting antidepressants, since
these medicines all take time to work, usually about two weeks but
sometimes longer.
You may be more:
If you have previously had thoughts about killing or harming
If you are a young adult, information from clinical trials has shown
an increased risk of suicidal behaviour in adults aged less than 25

Important information about some of the ingredients of
Nortriptyline Tablets
Nortriptyline Tablets contain lactose. If you are lactose intolerant,
contact your doctor before taking this medicine. Nortriptyline 25 mg
Tablets contain sunset yellow (E 110), which may cause allergic reactions
3. How to take Nortriptyline Tablets
Always take Nortriptyline Tablets exactly as your doctor has told you.
You should check with your doctor or pharmacist if you are not sure
The usual adult dose is 25mg three or four times daily or the dose
may be given once a day, usually at night. The dose should begin at
a low level, 10mg, 3-4 times daily, for example and be increased
gradually as required. The maximum dose is 150mg per day.
The elderly:
The usual dose is 30 to 50mg/day in divided doses. Treatment may
start with 10mg three times a day.
Adolescent patients:
The usual dose is 30 to 50mg/day in divided doses. Treatment may
start with 10mg three times a day. Lower dosages are recommended
for outpatients than for patients in hospital who will be under close
Following remission maintenance treatment may be needed longer
term. This should be at the lowest dose that stops the symptoms of
depression coming back. Children (for bed-wetting only).
Age (years)
Over 11


Dose (mg)


The dose should be given thirty minutes before bedtime. The
maximum length of treatment should be three months. Another
course of treatment should not be started until a full physical
examination has been made.
If you take more Nortriptyline Tablets than you should
Go to the nearest casualty department or contact your doctor
immediately. Take the tablet carton with you.
This section is continued overleaf


If you forget to take Nortriptyline Tablets
If you miss a dose, take one as soon as you can. If you have missed
several doses, tell your doctor. Do not take a double dose to make
up for a forgotten dose.
If you stop taking Nortriptyline Tablets
Do not stop taking the tablets or reduce the dose without telling
your doctor first.
If you suddenly stop taking the tablets you may feel sick (nausea),
have a headache or feel generally unwell.
If you have any further questions on the use of this product, ask
your doctor or pharmacist.

4. Possible side effects
Like all medicines, Nortriptyline Tablets can cause side effects,
although not everybody gets them. If any of the side effects gets
serious, or if you notice any side effects not listed in this leaflet,
please tell your doctor or pharmacist.
All medicines can cause allergic reactions, although serious
allergic reactions are very rare.
Tell your doctor straight away if you get any sudden wheeziness,
difficulty in breathing, swelling of the eyelids, face or lips, rash or
itching, especially affecting your whole body.
The following side effects have been reported:
• low or high blood pressure
• fast or irregular heartbeat
• palpitations
• heart attack (myocardial infarction)
• stroke
• oedema (swelling of the ankles)
• confusion (especially in the elderly) with seeing or hearing
things (hallucinations)
• not knowing where you are (disorientation)
• false beliefs (delusions)
• anxiety, restlessness, agitation
• not sleeping (insomnia)
• nightmares
• panic
• long-lasting abnormal mood
• worsening of mental illness
• numbness, tingling, pins and needles in the hands or feet
• co-ordination problems
• tremors
• abnormal movements
• fits (seizures)
• altered brainwave (ECG) patterns
• ringing in the ears (tinnitus)
• dry mouth
• rarely, inflamed glands under the tongue or inflammation of the
gums (gingivitis)
• blurred vision, difficulty in focusing, dilated pupils
• constipation, blockage of the digestive tract
• unable to urinate or delayed urination
• rash
• itching
• light sensitivity
• swelling (oedema)
• fever
• reaction to other similar drugs
• blood disorders which may cause you to bruise easily, become
anaemic or be unable to fight off infections
• feeling sick (nausea) and vomiting
• not eating (anorexia)
• indigestion
• diarrhoea
• constipation.
• peculiar taste
• inflamed mouth
• abdominal cramps
• black tongue
• development of breasts in men, breast enlargement and milk
production in women
• increased or decreased sex drive
• failure to have an erection (impotence)
• swollen testicles
• altered blood sugar levels

yellow eyes and skin (jaundice)
altered liver function
inflamed liver (hepatitis) and liver damage
weight gain or loss
urinating often and at night
swollen glands
hair loss (alopecia)

Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist. This
includes any possible side effects not listed in this leaflet. You can
also report side effects directly via the national reporting system via
the Yellow Card Scheme at: By
reporting side effects, you can help provide more information on
the safety of this medicine.
Keep out of the sight and reach of children.
Do not use the drug after the date indicated on the carton.
Medicines should not be disposed of via wastewater or household
waste. Ask your pharmacist how to dispose of medicines no longer
needed. These measures will help to protect the environment.
What Nortriptyline Tablets contain:
The active substance is nortriptyline hydrochloride. Each tablet
contains the equivalent to 10mg or 25mg of nortriptyline base.
The other ingredients are:
Nortriptyline 10 mg
Lactose Monohydrate, Anhydrous Calcium Hydrogen Phosphate,
Maize Starch, Magnesium Stearate, Hypromellose (HPMC E-5),
Macrogol (PEG 6000).
Nortriptyline 25 mg
Lactose Monohydrate, Anhydrous Calcium Hydrogen Phosphate,
Maize Starch, Magnesium Stearate, Hypromellose (HPMC E-5),
Macrogol (PEG 6000), Sunset Yellow Lake (E-110) and Titanium
dioxide (E-171).
What Nortriptyline Tablets looks like and contents of the pack
Nortriptyline 10 mg Tablets are white to off coloured, round
biconvex, film-coated tablets, debossed with ‘N’ on one side and 10
on other side.
Nortriptyline 25 mg Tablets are orange coloured, round biconvex,
film-coated tablets, debossed with ‘N25’ on one side and scored on
other side.
The Tablets are available in PVC/aluminium blister packs of 10s,
30s, 100s.
The Tablets are available in HDPE container with Polypropylene
screw on cap pack size: 100 tablets.
Discard 60 days after first opening the container
Nortriptyline 10mg tablets: PL 21880/0150
Nortriptyline 25mg tablets: PL 21880/0151
This leaflet was last revised on March 2015

Marketing Authorisation Holder and Manufacturer:
Warwick House, Plane Tree Crescent,
Feltham TW13 7HF, UK
E-mail :


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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.