Tell your doctor if you have liver disease, kidney disease, asthma, thyroid disease, diabetes, stomach or intestinal problems, high blood pressure or heart disease, had a heart attack in the last 6 weeks, an enlarged prostate or difficulty urinating, or glaucoma. You may not be able to take nortriptyline, or you may require a dosage adjustment or special monitoring, if you have any of the conditions listed above.

Do not take nortriptyline if you have taken a monoamine oxidase inhibitor such as isocarboxazid (Marplan®), phenelzine (Nardil®), or tranylcypromine (Parnate®) within the last 14 days.

While you are taking nortriptyline you may need to be monitored for worsening symptoms of depression and/or suicidal thoughts at the start of therapy or when doses are changed. This concern about the increased risk of suicidal thoughts or behaviors may be greater if you are 18 years of age or younger and are taking nortriptyline. In patients younger than 18 years, the period of risk may extend beyond start of therapy or when doses are changed.

Your doctor may want you to monitor the following symptoms: anxiety, panic attacks, difficulty sleeping, irritability, hostility, impulsivity, severe restlessness, and mania (mental and/ or physical hyperactivity). These symptoms may be associated with the development of worsening symptoms of depression and/or suicidal thoughts or actions. Contact your healthcare provider if you develop any new or worsening mental health symptoms during treatment with nortriptyline. Do not stop taking nortriptyline.

It is not known whether nortriptyline will harm an unborn baby. Do not take nortriptyline without first talking to your doctor if you are pregnant or could become pregnant during treatment.

Furthermore, the effects of nortriptyline on a nursing baby are unknown. Do not take nortriptyline without first talking to your doctor if you are breast-feeding a baby.

Use cautiously when driving, operating machinery, or performing other hazardous activities. Nortriptyline may cause drowsiness or dizziness. If you experience drowsiness or dizziness, please avoid these activities completely.

Dizziness is likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall.

Additionally, consume alcohol in moderation. Alcohol may increase drowsiness and dizziness while you are taking nortriptyline.

 

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