Nortriptyline oral solution

What is this medicine?

NORTRIPTYLINE (nor TRIP ti leen) is used to treat depression.

How should I use this medicine?

Take this medicine by mouth. Follow the directions on the prescription label. Use a specially marked spoon or container to measure each dose. Ask your pharmacist if you do not have one. Household spoons are not accurate. Take your medicine at regular intervals. Do not take your medicine more often than directed. Do not stop taking this medicine suddenly except upon the advice of your doctor. Stopping this medicine too quickly may cause serious side effects or your condition may worsen.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

• anxious

• breathing problems

• changes in vision

• confusion

• elevated mood, decreased need for sleep, racing thoughts, impulsive behavior

• eye pain

• fast, irregular heartbeat

• feeling faint or lightheaded, falls

• feeling agitated, angry, or irritable

• fever with increased sweating

• hallucination, loss of contact with reality

• seizures

• stiff muscles

• suicidal thoughts or other mood changes

• tingling, pain, or numbness in the feet or hands

• trouble passing urine or change in the amount of urine

• trouble sleeping

• unusually weak or tired

• vomiting

• yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• change in sex drive or performance

• change in appetite or weight

• constipation

• dizziness

• dry mouth

• nausea

• tired

• tremors

• upset stomach

What may interact with this medicine?

Do not take this medicine with any of the following medications:

• arsenic trioxide

• certain medicines medicines for irregular heart beat

• cisapride

• halofantrine

• linezolid

• MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate

• methylene blue (injected into a vein)

• other medicines for mental depression

• phenothiazines like perphenazine, thioridazine and chlorpromazine

• pimozide

• probucol

• procarbazine

• sparfloxacin

• St. John's Wort

• ziprasidone

This medicine may also interact with any of the following medications:

• atropine and related drugs like hyoscyamine, scopolamine, tolterodine and others

• barbiturate medicines for inducing sleep or treating seizures, such as phenobarbital

• cimetidine

• medicines for diabetes

• medicines for seizures like carbamazepine or phenytoin

• reserpine

• thyroid medicine

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Keep container tightly closed. Protect from light. Throw away any unused medicine after the expiration date.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• bipolar disorder or schizophrenia

• glaucoma

• heart disease or recent heart attack

• if you frequently drink alcohol containing drinks

• liver disease

• over active thyroid

• seizures

• thoughts or plans of suicide or a previous suicide attempt or family history of suicide attempt

• trouble passing urine or prostate trouble

• an unusual or allergic reaction to nortriptyline, other medicines, foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

What should I watch for while using this medicine?

Tell your doctor if your symptoms do not get better or if they get worse. Visit your doctor or health care professional for regular checks on your progress. Because it may take several weeks to see the full effects of this medicine, it is important to continue your treatment as prescribed by your doctor.

Patients and their families should watch out for new or worsening thoughts of suicide or depression. Also watch out for sudden changes in feelings such as feeling anxious, agitated, panicky, irritable, hostile, aggressive, impulsive, severely restless, overly excited and hyperactive, or not being able to sleep. If this happens, especially at the beginning of treatment or after a change in dose, call your health care professional.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medicine. Avoid alcoholic drinks.

Do not treat yourself for coughs, colds, or allergies without asking your doctor or health care professional for advice. Some ingredients can increase possible side effects.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your doctor if the problem does not go away or is severe.

This medicine may cause dry eyes and blurred vision. If you wear contact lenses you may feel some discomfort. Lubricating drops may help. See your eye doctor if the problem does not go away or is severe.

This medicine can cause constipation. Try to have a bowel movement at least every 2 to 3 days. If you do not have a bowel movement for 3 days, call your doctor or health care professional.

This medicine can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and use sunscreen. Do not use sun lamps or tanning beds/booths.