Pamelor

(Nortriptyline Hydrochloride)

The active ingredient in Pamelor is nortriptyline hydrochloride, which is a tricyclic antidepressant (TCA). While its mechanism of action is not well understood, it is thought to increase the amounts of certain neurotransmitters in the brain, such as serotonin and norepinephrine. These are key substances that influence your mood.

Follow all directions given to you by your doctor and read all documents provided, including the full Prescribing Information, FDA-Approved Product Labeling, Instructions for Use, and Medication Guide before using Pamelor. However, the following is a synopsis of the general guidelines for the use of Pamelor:

• You can take Pamelor at any time of day with or without food. If it upsets your stomach, take it with food.
• Use the supplied syringe or dose-measuring device to measure the oral solution.
• Inform your doctor if you have a planned surgery.
• If you suddenly stop using Pamelor, you may have withdrawal symptoms. Ask your doctor before discontinuing the medication.

Some common side effects of Pamelor include:

• Blurred vision.
• Drowsiness.
• Nausea.
• Vomiting.
• Constipation.
• Changes in your blood pressure.
• Difficulty urinating or urinary retention.
• Skin rash.

Some individuals may experience serious side effects while using Pamelor. These side effects may require immediate medical attention. If you experience any of the following, contact your healthcare provider or seek emergency medical help:

• Worsening depression and suicidal thoughts or behavior. Seek immediate medical attention if this occurs or you have any unusual behavior such as anxiety, panic attacks, feeling angry or irritated, trouble sleeping, or restlessness.
• Increased risk of a heart attack. Symptoms include chest pain, cold chills, left arm pain, and difficulty breathing.
• Increased risk of stroke. Symptoms include abrupt numbness, weakness, bewilderment, or difficulty speaking.
• New or worsening angle-closure glaucoma. Symptoms include eye pain, severe headache, nausea, and seeing halos around lights.
• Serious, life-threatening allergic reactions include trouble breathing, throat tightness, hives, itching, rapid heartbeat, disorientation, and swelling of the face or tongue.

These are not all of the possible side effects of Pamelor. You should always seek medical advice from your healthcare provider for any questions or concerns about your medical condition or treatment. Read all patient information, medication guides, or drug information sheets that come with this medication. You can also report adverse effects to the Food and Drug Administration at www.fda.gov/medwatch or 1-800-FDA-1088.

Before starting Pamelor, it is crucial to discuss any existing health conditions with your healthcare provider. You should be sure that your healthcare provider is aware of all your medical conditions, including:

• You are allergic to Pamelor or comparable medications (amitriptyline, amoxapine, clomipramine, desipramine, doxepin, imipramine, protriptyline, or trimipramine).
• You are allergic to some seizure drugs (carbamazepine, eslicarbazepine, oxcarbazepine, and rufinamide).
• You recently suffered a heart attack.
• A genetic heart condition called Brugada syndrome.
• Heart disease, or heart rhythm issues.
• Irregular heartbeat or arrhythmia.
• Bipolar disorder.
• Seizures.
• Schizophrenia or other mental illnesses.
• Hyperthyroidism (overactive thyroid).
• Narrow-angle glaucoma.
• Receiving electroshock treatment.
• Pamelor should not be used if you have taken an MAO inhibitor within the last 14 days. A hazardous medication interaction may occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, and tranylcypromine, among others.
• Tell your doctor if you've used a "SSRI" (selective serotonin reuptake inhibitor) antidepressant in the last 5 weeks, such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone.

Inform your doctor if you are also using stimulants, opioids, herbal supplements, or medications for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or nausea and vomiting prevention. An interaction with Pamelor may result in a dangerous illness known as serotonin syndrome.

Boxed Warning

Antidepressants may increase the risk of suicidal thoughts and behaviours in children, adolescents, and young adults under the age of 24; however, this risk does not exist in individuals above the age of 24 and may somewhat reduce in persons over the age of 65. In younger patients, the benefits and hazards should be carefully considered. Close monitoring is required during the first 1-2 months of treatment and following dose modifications, and families are encouraged to report any unexpected behavioural changes. New or severe suicidal thoughts may necessitate discontinuing the medicine. This medication is not approved for use in children.

• Other TCAs trigger an allergic reaction.
• Are taking or have used a monoamine oxidase inhibitor (MAOI) within the last 14 days.
• Currently recovering from a heart attack.

Keep in mind that Pamelor may take 1 to 2 months to improve your depression symptoms. And you may experience adverse effects from the medicine first. Work with your doctor to determine the optimal dose for you.

When Pamelor is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, it may change how they work or increase the frequency or severity of side effects. Make sure that you tell your healthcare professional about anything that you are taking to avoid any negative drug interactions, including:

• Cimetidine.
• St. John’s Wort.
• Buspirone.
• Lithium.
• Quinidine.
• Tramadol.
• Tryptophan.

For depression.

Adults aged 18 to 64: The typical starting dose is 25 mg taken orally three or four times each day. Alternatively, the complete daily dose can be administered once a day. The highest suggested daily dose is 150 mg.

Adolescents and adults 65 and older: The normal dose is 30 mg to 50 mg orally each day, either all at once or divided into smaller amounts during the day.

Store your Pamelor at room temperature and keep it out of reach of children.

Mallinckrodt Pharmaceuticals is the company that manufactures this medication.

There are several lower-cost generic-name versions available.

You should not suddenly stop taking Pamelor, as it could cause you to have withdrawal symptoms. Talk to your doctor so they can gradually reduce your dose over time to avoid this.

Talk to your doctor if you are already pregnant or if you have any plans to become pregnant. They will know or recommend what is best for you.

Talk to your doctor if you are already breastfeeding or if you have any plans to breastfeed. They will know or recommend what is best for you.