Norventyl

The recommended adult dose ranges from 30 mg to 150 mg daily in divided doses. The usual adult starting dose is 25 mg 3 or 4 times daily. The dosage can be increased until the desired effect is achieved.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Norventyl (Nortriptyline) exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Norventyl is no longer being manufactured for sale in Canada. For brands that may still be available, search under Norventyl (Nortriptyline). This article is being kept available for reference purposes only. If you are using Norventyl (Nortriptyline), speak with your doctor or pharmacist for information about your treatment options.

Do not take Norventyl (Nortriptyline) if you:

• are allergic to Norventyl (Nortriptyline) or any ingredients of the medication
• are allergic to other antidepressants in the same family (tricyclic antidepressants; e.g., Amitriptyline, Desipramine)
• have recently had a Heart Attack
• take another tricyclic antidepressant
• take MAO inhibitors (e.g., Phenelzine, Tranylcypromine) - MAO inhibitors should be stopped at least 2 weeks before Norventyl (Nortriptyline) treatment is started

There may be an interaction between Norventyl (Nortriptyline) and any of the following:

• Abiraterone acetate
• aclidinium
• alcohol
• alpha-agonists (e.g., Clonidine, methyldopa)
• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• antihistamines (e.g., Diphenhydramine, Hydroxyzine)
• antipsychotic medications (e.g., Chlorpromazine, Haloperidol, Olanzapine, Quetiapine, Risperidone)
• asunaprevir
• atropine
• azelastine
• barbiturates (e.g., Phenobarbital, secobarbital)
• belladonna
• benzodiazepines (e.g., Alprazolam, Diazepam, Lorazepam)
• Benztropine
• beta-2 agonists (e.g., formoterol, salbutamol, salmeterol)
• botulinum toxin
• brimonidine
• Bromocriptine
• Bupropion
• Buspirone
• cannabis
• certain antiarrhythmic medications (e.g., Amiodarone, disopyramideflecainide, Propafenone, Sotalol)
• chloral hydrate
• Cimetidine
• Cinacalcet
• Cobicistat
• Darifenacin
• Desmopressin
• dexmethylphenidate
• Dextromethorphan
• diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide, triamterene)
• Domperidone
• Donepezil
• Dronedarone
• Eluxadoline
• ergot alkaloids (e.g., ergotamine, Dihydroergotamine)
• Fesoterodine
• Flavoxate
• Flibanserin
• Galantamine
• Guanfacine
• medication
• Glucagon
• glycopyrrolate
• guanfacine
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delavirdine, efavirenz, etravirine, nevirapine)
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• imatinib
• ipratropium
• kava kava
• ketoconazole
• ketotifen
• levodopa
• lithium
• Methadone
• methylene blue
• Methylphenidate
• Metoclopramide
• mifepristone
• Mirabegron
• Mirtazapine
• monoamine oxidase inhibitors (M.O.S. e.g., Moclobemide, Rasagiline, Selegiline, tranylcypromine)
• muscle relaxants (e.g., Baclofen, Cyclobenzaprine, methocarbamol, orphenadrine, Tizanidine)
• Nabilone
• narcotic pain relievers (e.g., Codeine, Fentanyl, Morphine, Oxycodone)
• Nilotinib
• Nitroglycerin
• Oxybutynin
• potassium chloride
• Pramipexole
• quinidine
• quinine
• rasagiline
• rifabutin
• rifampin
• Rivastigmine
• Ropinirole
• Rotigotine
• Rufinamide
• scopolamine
• seizure medications (e.g., Carbamazepine, Clobazam, , Levetiracetam, phenobarbital, Phenytoin, primidone, Topiramate, Valproic acid, zonisamide)
• selective serotonin reuptake inhibitors (e.g., Citalopram, Fluoxetine, Paroxetine, Sertraline)
• 5-HT3 antagonists (e.g., Granisetron, Ondansetron)
• serotonin/norepinephrine reuptake inhibitors (SNRIs; e.g., Desvenlafaxine, Duloxetine, Venlafaxine)
• sodium phosphates
• Solifenacin
• sotalol
• St. John's wort
• sulfonylureas (e.g., chlorpropamide, Glyburide)
• tedizolid
• terbinafine
• thalidomide
• thyroid replacements (e.g., dessicated thyroid, Levothyroxine)
• Ticlopidine
• tiotropium
• tolcapone
• Tolterodine
• topical decongestants (eye drops and nasal sprays; naphazoline, oxymetazoline, xylometazoline)
• Tramadol
• Trazodone
• other tricyclic antidepressants (e.g., amitriptyline, Clomipramine, Trimipramine)
• "triptan" migraine medications (e.g., Eletriptan, Sumatriptan)
• umeclidinium
• Warfarin
• Yohimbine
• Zolpidem
• Zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Norventyl (Nortriptyline). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Norventyl (Nortriptyline).

Behaviour changes and suicidal thoughts: Norventyl (Nortriptyline) may worsen symptoms of depression, including thoughts of suicide or wanting to harm others. It may also cause agitated or aggressive behaviour. If you experience these symptoms or any other behaviour change while taking Norventyl (Nortriptyline), contact your doctor immediately. Family members or caregivers of people who are taking Norventyl (Nortriptyline) should contact the person's doctor immediately if they notice unusual behaviour changes.

Diabetes: People with diabetes have noticed a loss of control of their blood sugars when taking Norventyl (Nortriptyline). Increases and decreases in blood sugars have been noticed. If you have diabetes or are at risk for developing diabetes, discuss with your doctor how Norventyl (Nortriptyline) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Norventyl (Nortriptyline), and whether any special monitoring is needed.

Drowsiness/reduced alertness: Like other similar medications, Norventyl (Nortriptyline) may cause drowsiness or dizziness, affecting your ability to drive or operate machinery. Avoid these and other hazardous tasks until you have determined how Norventyl (Nortriptyline) affects you.

Glaucoma: Norventyl (Nortriptyline) may cause symptoms of glaucoma to worsen. If you have glaucoma, discuss with your doctor how Norventyl (Nortriptyline) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Norventyl (Nortriptyline), and whether any special monitoring is needed.

If you notice changes to your vision, such as blurred vision or difficulty focusing, contact your doctor as soon as possible.

Heart disease: Norventyl (Nortriptyline) can cause slowed heart rate, resulting in heart attack, irregular heart rhythm and strokes. If you have heart disease, discuss with your doctor how Norventyl (Nortriptyline) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Norventyl (Nortriptyline), and whether any special monitoring is needed.

High blood pressure: Norventyl (Nortriptyline) can decrease the effectiveness of some medications that are taken to reduce high blood pressure. If you have high blood pressure, discuss with your doctor how Norventyl (Nortriptyline) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Norventyl (Nortriptyline), and whether any special monitoring is needed.

Seizure disorder: Norventyl (Nortriptyline) may increase the risk of seizures, particularly for people who have a seizure disorder. If you have a seizure disorder or a history of seizures, discuss with your doctor how Norventyl (Nortriptyline) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Norventyl (Nortriptyline), and whether any special monitoring is needed.

Serotonin syndrome: Severe reactions are possible when Norventyl (Nortriptyline) is combined with other medications that act on serotonin, such as medications used for nausea with chemotherapy and "triptan" migraine medications. Combining Norventyl (Nortriptyline) with other medications used to treat depression may also cause serotonin syndrome. These combinations should be avoided. Symptoms of a reaction may include muscle rigidity and spasms, difficulty moving, changes in mental state including delirium and agitation. Coma and death are possible.

Stopping the medication: Stopping treatment suddenly after prolonged therapy may produce nausea, headache, and a general feeling of being unwell. These symptoms do not mean that you are addicted to the medication; they mean that your body has become accustomed to the medication. If you are thinking of stopping the medication, check with your doctor first. Your doctor may want you to decrease the dose of the medication gradually when it is time to stop taking Norventyl (Nortriptyline).

Sun exposure: Norventyl (Nortriptyline) can make your skin more sensitive to sunlight. Sun exposure can lead to a rash, itching, redness, or severe Sunburn. Use a sunscreen and avoid sun exposure especially between the hours between 10 am and 3 pm.

Thyroid disease: Some people with an overactive thyroid gland have reported an irregular heartbeat when they have taken Norventyl (Nortriptyline). If you are taking medication for thyroid or have an overactive thyroid gland, discuss with your doctor how Norventyl (Nortriptyline) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Norventyl (Nortriptyline), and whether any special monitoring is needed.

Urinary problems: Norventyl (Nortriptyline) can cause difficulty with urination. If you have difficulties with urination or conditions that make urinating difficult, discuss with your doctor how Norventyl (Nortriptyline) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Norventyl (Nortriptyline), and whether any special monitoring is needed.

Pregnancy: Norventyl (Nortriptyline) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Norventyl (Nortriptyline), contact your doctor immediately.

Breast-feeding: Norventyl (Nortriptyline) passes into breast milk. If you are a breast-feeding mother and are taking Norventyl (Nortriptyline), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Norventyl (Nortriptyline) has not been established for children less than 12 years of age.

Seniors: Due to increased risk of side effects, seniors may require a lower dose of Norventyl (Nortriptyline).