Nortriptyline

Administration

• Type: Tricyclic antidepressant
• Dosage Forms:
• Routes of Administration: oral
• Common Trade Names: Aventyl, Pamelor

Adult Dosing

• 25mg PO 3-4 times per day

Pediatric Dosing

• Adolescents: 30-50mg daily in single or divided doses

Special Populations

• Pregnancy Rating: C
• Lactation risk: Infant risk minimal
• Renal dosing: no adjustment
• Hepatic dosing

Contraindications

• Allergy to class/drug
• Use of MAOI currently or in past 14 days
• Recent MI
• Concomitant use with linezolid or methylene blue

Adverse Reactions

Serious

• Heart block, prolonged QT, dysrhythmia, MI, sudden cardiac death
• SIADH
• Bone marrow depression
• Fulminant hepatic failure
• Stroke
• Myoclonus, seizure
• Worsening depression, suicidality, mania, psychosis
• Angioedema

Common

• Constipation

Pharmacology

• Half-life:
• Metabolism: Hepatic via CYP2D6
• Excretion:

Mechanism of Action

• Affects transfer, release and storage of catecholamines, blocks effects of acetylcholine, 5HT, and histamine

See Also

• TCA toxicity