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The text only version may be available in large print, Braille or audio CD. For further information call emc accessibility on 0800 198 5000. The product code(s) for this leaflet is: PL 29831/0706.
Nortriptyline Film-Coated Tablets
Nortriptyline 10mg film-coated tablets
Nortriptyline 25mg film-coated tablets
Nortriptyline 50mg film-coated tablets
1. What Nortriptyline is and what it is used for
2. What you need to know before you take Nortriptyline
3. How to take Nortriptyline
4. Possible side effects
5. How to store Nortriptyline
6. Contents of the pack and other information.
Nortriptyline contains the active ingredient nortriptyline hydrochloride, which is a tricyclic antidepressant. Nortriptyline is used to treat major depression in adults.
Talk to your doctor before taking these tablets if:
A heart problem called ‘prolonged QT interval’ (which is shown on your electrocardiogram, ECG) and heart rhythm disorders (rapid or irregular heart beat) have been reported with Nortriptyline. Tell your doctor if you:
If you are depressed you can sometimes have thoughts of harming or killing yourself. These may be increased when first starting antidepressants, since these medicines all take time to work, usually about two weeks but sometimes longer.
You may be more likely to think like this:
If you have thoughts of harming or killing yourself at any time, contact your doctor or go to a hospital straight away.
You may find it helpful to tell a relative or close friend that you are depressed and ask them to read this leaflet.
You might ask them to tell you if they think your depression is getting worse, or if they are worried about changes in your behaviour.
Do not give this medicine to children and adolescents aged below 18 years for these treatments as safety and efficacy have not been established in this age group.
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines:
You should also tell your doctor if you take or have recently taken medicine that may affect the heart´s rhythm. e.g.:
If you are going to have an operation and receive general or local anaesthetics, you should tell your doctor that you are taking this medicine. Likewise, you should tell your dentist that you take this medicine if you are to receive a local anaesthetic.
You should not drink alcohol while you are being treated with Nortriptyline as alcohol might increase the sedative effect.
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine. Nortriptyline should not be used during pregnancy unless your doctor considers it clearly necessary and only after careful consideration of the benefit and risk. If you have taken this medicine during the last part of the pregnancy, the newborn may have withdrawal symptoms such as irritability, increased muscle tension, tremor, irregular breathing, poor drinking, loud crying, urinary retention, and constipation.
Your doctor will advise you whether to start/ continue/ stop breast-feeding, or stop using this medicine taking into account the benefit of breastfeeding for your child and the benefit of therapy for you.
Do not drive or use machinery when you are on Nortriptyline unless you are sure your judgement and co-ordination are not affected. Antidepressants may affect your ability to drive or to operate machinery safely.
If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
The usual dose is 30 to 50mg/day in divided doses.
Treatment may start at a low level (10-20mg daily) and may be increased as required to the maximum dose of 50mg. If you require a dose of 50mg or over, your doctor will arrange for you to have a recording of your heart (ECG) and blood tests.
The 50mg tablets are not appropriate for use in elderly patients.
In case of renal impairment, your doctor will increase or decrease the dose carefully and gradually. In most cases, however, the usual dosage will be given.
Patients with liver diseases or people known as ‘poor metabolisers’ usually receive lower doses. Your doctor may take blood samples to determine the level of nortriptyline in the blood.
Nortriptyline should not be used in children and adolescents aged less than 18 years, as safety and efficacy have not been established. Lower dosages are recommended for outpatients than for patients in hospital who will be under close supervision.
The score line is only there to help you break the tablet if you have difficulty swallowing it whole.
It may take a few weeks before you feel any improvement. Following remission maintenance treatment may be needed longer term, usually up to 6 months. This should be at the lowest dose that stops the symptoms of depression coming back.
Do not take more tablets than your doctor tells you to. If you ever take too many, or if a child has taken any nortriptyline, go to the nearest hospital casualty department or tell your doctor at once. Symptoms of overdose include blurred vision, fast or irregular heartbeats, difficulties passing water, dry mouth and tongue, intestinal blockage, fits, fever, agitation, confusion, hallucinations, uncontrolled movements, low blood pressure, weak pulse, pallor, difficulty breathing, blue discolouration of the skin, decreased heart rate, drowsiness, loss of consciousness, coma, various cardiac symptoms such as heart block, heart failure, cardiogenic shock, metabolic acidosis, hypokalaemia.
An overdose can be very dangerous.
If you forget to take a dose, take it as soon as you remember. If it is almost time for your next dose do not take a double dose to make up for a forgotten dose, just carry on as before. If you have missed several doses, discuss this with your doctor.
Antidepressants may not make you feel better for the first two weeks or more of treatment, so keep taking Nortriptyline until your doctor tells you to stop. Do not stop these tablets without discussing it with your doctor first.
If you stop using Nortriptyline abruptly after prolong therapy you may have withdrawal symptoms, including not being able to sleep, headache, nausea, irritability and sweating.
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Rare (may affect up to 1 in 1,000 people):
Very rare (may affect up to 1 in 10,000 people):
Very common (may affect more than 1 in 10 people):
Common (may affect up to 1 in 10 people):
Uncommon (may affect up to 1 in 100 people):
Rare (may affect up to 1 in 1,000 people):
Very rare (may affect up to 1 in 10,000 people):
Not known (frequency cannot be estimated from the available data):
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
By reporting side effects you can help provide more information on the safety of this medicine.
Keep this medicine out of the sight and reach of children.
This medicinal product does not require any special storage conditions
Do not use this medicine after the expiry date which is stated on the blister, carton or bottle after EXP. The expiry date refers to the last day of that month.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
Each 10mg film-coated tablet contains nortriptyline hydrochloride equivalent to 10mg nortriptyline.
Each 25mg film-coated tablet contains nortriptyline hydrochloride equivalent to 25mg nortriptyline.
Each 50mg film-coated tablet contains nortriptyline hydrochloride equivalent to 50mg nortriptyline.
The other ingredients are:
Lactose monohydrate, Calcium hydrogen phosphate, Pregelatinized starch, Maize starch, Magnesium stereate, Hypromellose, Glycerol, Ethylcellulose, Isopropyl alcohol and Purified water.
Nortriptyline 10mg film-coated tablets are white to off white, round, biconvex film coated tablet debossed with ‘NT’ on one side and ‘10’on the other side.
Nortriptyline 25mg film-coated tablets are white to off white, round, biconvex film coated tablet debossed with ‘NT 25’ on one side and breakline on the other side.
Nortriptyline 50mg film-coated tablets are white to off white, round, biconvex film coated tablet debossed with ‘NT 50’ on one side and breakline on the other side.
Each strength of Nortriptyline Tablets is supplied in white opaque PVC/PVDC 250μm/90gsm and aluminium foil 25μm blisters.
Pack size: 30 and 100 tablets. Not all pack sizes may be marketed.
This leaflet was last revised in 03/2024
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Product Name Reference Number
Nortriptyline 10mg film-coated tablets 29831/0706
Nortriptyline 25mg film-coated tablets 29831/0707
Nortriptyline 50mg film-coated tablets 29831/0708
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