What does it do?

Nortriptyline is used to treat depression, and sometimes other conditions such as some types of pain.

Before you start

• Tell your doctor if you have heart, bladder, prostate or bowel problems.
• Tell your doctor if you have angle-closure glaucoma, bipolar disorder or if you have ever had a seizure.
• Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding.
• Your doctor may do a heart test (ECG) before you start and while you are taking nortriptyline.

How should you take it?

Take nortriptyline regularly as directed with a glass of water, usually at night time. You can take it with or without food.

What if you forget a dose?

If it is nearly time for your next dose, skip the missed dose and take your next dose at the usual time. Otherwise, take the missed dose as soon as you remember. Do not take two doses at the same time.

Can you take other medicines?

Some medicines available without a prescription may react with nortriptyline including:

• some antihistamines or anti-nausea medicines such as promethazine (e.g. Phenergan®), hyoscine (e.g. Scopoderm®), meclozine (e.g. Sea-legs®)
• cold and flu medicines containing dextromethorphan (e.g. Robitussin Dry Cough Forte®)

Tell your pharmacist or doctor about all medicines or treatments that you may be taking, including vitamins, herbal products (e.g. St John's wort) or recreational drugs (e.g. ecstasy).

What side effects might you notice?

Side Effects	Recommended action
Suicidal thoughts Symptoms of a fast or irregular heartbeat including: fluttering, pounding or pain in your chest, dizziness or fainting Muscle twitching or shaking you can’t control, confusion, heavy sweating, fever Seizures	Tell your doctor immediately
Anxiety, restlessness	Tell your doctor
Dry mouth, blurred vision, constipation or trouble peeing (anticholinergic effects) Drowsiness, dizziness Weight gain More sensitive to sunlight (sunburn or rash) Less interest in, or trouble having sex	Tell your doctor if troublesome

If you notice any other effects, discuss them with your doctor or pharmacist.

Other information:

• Nortriptyline can impair your ability to do tasks such as driving or using machines. Alcohol makes this worse. Discuss your risk with your health professional. (search NZTA - Are you safe to drive?)
• Protect yourself from too much sunlight while being treated with nortriptyline. Always cover up and apply a thick layer of broad spectrum sunscreen (at least SPF 30) when outside. Do not use sunbeds.
• It may take a few weeks for nortriptyline to start working.
• Do not stop taking nortriptyline without talking to your doctor first.