Pamelor

Generic name: Nortriptyline hydrochloride

What is Pamelor?

Pamelor is prescribed for the relief of symptoms of depression.

What is the most important information I should know about Pamelor?

Antidepressants can increase the risk of suicidal thinking and behavior in children and teenagers. Adult and pediatric patients taking antidepressants should be watched closely for changes in moods and actions, especially when their dose is increased or decreased. Patients and their families should contact the doctor immediately if new symptoms develop or seem to get worse. Signs to watch for include anxiety, hostility, insomnia, restlessness, impulsive or dangerous behavior, and thoughts about suicide or dying.

Who should not take Pamelor?

Do not use Pamelor Solution if you are allergic to any ingredient in Pamelor Solution or to similar medicines. Also, do not take Pamelor if you are recovering from a recent heart attack.

If you have taken furazolidone or a monoamine oxidase inhibitor (MAOI) like phenelzine within the last 14 days, or if you are taking astemizole, dofetilide, droperidol, terfenadine, or cisapride, you should not take Pamelor.

What should I tell my doctor before I take the first dose of Pamelor?

Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Pamelor. Also, talk to your doctor about your complete medical history, especially if you have a history of suicidal thoughts or behavior; an overactive thyroid; bipolar disorder or any other mental disorder; diabetes; difficulty urinating; glaucoma; heart, kidney, or liver problems; seizures; or porphyria (a blood disorder).

Be sure to let your doctor know if you are undergoing electroshock therapy, if you are scheduled to have any surgery, if you drink alcohol-containing beverages daily, or if you have a history of alcohol abuse.

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

This medication is available in tablet and liquid form. Only tablet dosages are listed. Consult your doctor if you cannot take the tablet form of Pamelor.

Adults: The usual starting dosage is 25 milligrams (mg) taken 3 or 4 times per day. Alternatively, your doctor may prescribe that the total daily dose be taken once a day. Doses above 150 mg per day are not recommended. Your doctor will monitor your response to Pamelor carefully and will gradually increase or decrease the dose to suit your needs.

Elderly: The usual dose is 30 to 50 mg taken in a single dose or divided into smaller doses, as determined by your doctor.

How should I take Pamelor?

Take Pamelor exactly as prescribed. Pamelor Solution may be taken with or without food. Pamelor may make your mouth dry. Sucking on hard candy, chewing gum, or melting ice chips in your mouth can provide relief.

What should I avoid while taking Pamelor?

Pamelor may cause you to become drowsy or less alert. Do not drive or operate dangerous machinery or participate in any hazardous activity that requires full mental alertness until you know how Pamelor affects you.

Pamelor may make your skin more sensitive to sunlight. Try to stay out of the sun, wear protective clothing, and apply sunblock.

Avoid drinking alcohol or taking other medications that cause drowsiness, such as sedatives.

What are possible food and drug interactions associated with Pamelor?

If Pamelor is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Pamelor with the following: albuterol, alcohol, antiarrhythmics, antidepressants, antihistamines, antispasmodics, blood pressure medication, cimetidine, chlorpropamide, levodopa, MAO inhibitors (combination with Pamelor can be fatal), quinidine, reserpine, stimulants such as dextroamphetamine, thyroid medication, tranquilizers, and warfarin.

What are the possible side effects of Pamelor?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

Side effects may include: anxiety, blurred vision, confusion, dry mouth, hallucinations, heart attack or vascular heart blockage, heartbeat irregularities, high blood pressure, insomnia, loss of muscle coordination, low blood pressure, rapid heartbeat, sensitivity to sunlight, skin rash, stroke, tremors, weight loss

Side effects due to rapid decrease in dose or abrupt withdrawal from Pamelor after prolonged treatment include: headache, nausea, vague feeling of bodily discomfort

Can I receive Pamelor if I am pregnant or breastfeeding?

The effects of Pamelor during pregnancy and breastfeeding are unknown. Tell your doctor immediately if you are pregnant, plan to become pregnant, or are breastfeeding.

What should I do if I miss a dose of Pamelor?

Take it as soon as you remember. If it is almost time for the next dose, skip the dose you missed and go back to your regular schedule. If you take Pamelor once a day at bedtime and you miss a dose, do not take it in the morning, since disturbing side effects could occur. Never take two doses at once.

How should I store Pamelor?

Store at room temperature in a tightly closed container and away from light.