Drug Title

Pamelor (Nortriptyline)

Indications for the use

Pamelor is a tricyclic antidepressant used for treating depression. However, it may also be used for other conditions like chronic hives, premenstrual depression and attention deficit hyperactivity disorder in children.

Medication

Use Pamelor as prescribed by your doctor.

• Pamelor may be taken orally independently or during the meal.
• Swallow Pamelor whole. Do not crush or chew before swallowing.
• Continue taking Pamelor even if you feel well. Do not miss any dose. Taking Pamelor at the fixed time each day will help you not to forget to take it.

Ask your doctor any questions you may have about using Pamelor.

Drug class and its mechanism of action

Pamelor is a tricyclic antidepressant. It works by enhancing the activity of certain brain chemicals that help to elevate the mood.

Missed dose

If you miss a dose of Pamelor then you may take it as soon as you remember and adjust the remaining doses accordingly. However, if it is nearly time for the next dose then you may skip this dose and continue with the regular dosage. Do not take a double dose to make up for the missed dose.

Storage

Store Pamelor at temperature from 59 to 77 F (15 and 25 C). Keep away from heat, moisture and light. Do not store in the bathroom. Keep Pamelor out of reach of children and pets.

Overdose

Pamelor overdose might require immediate medical attention because the symptoms can be quite severe. They include agitation, bluish skin or mucous membranes, breathing problems, chest pain, coma, confusion, dry mouth, enlarged pupils, excess sweating, fainting, fast or irregular heartbeat, flushing, incoordination, involuntary movements, loss of consciousness, restlessness, rigid muscles, seizures, severe drowsiness, shock, stupor, trouble breathing and vomiting.

Precautions

Discuss with your doctor about any prior medical condition that you may have including allergies to medicines, food or other substances, f you have a history of suicidal thoughts or behavior, bipolar disorder, or any other mental disorders, you are undergoing electroshock therapy, or you are scheduled to have any surgery, if you consume alcohol–containing beverages daily or you have a history of alcohol abuse, if you take thyroid medicine or you have a history of overactive thyroid, glaucoma, heart problems, kidney or liver problems, diabetes, seizures, the blood disease porphyria, or difficulty urinating.

You must not take if you are allergic to any ingredient in it or if you have taken furazolidone or a monoamine oxidase (MAO) inhibitor (eg, phenelzine) within the last 14 days, or you are taking astemizole, dofetilide, droperidol, terfenadine, or cisapride, or if you are recovering from a recent heart attack.

If you are pregnant or suspect that you are, then stop using Pamelor and contact your doctor immediately.

It is unknown whether Pamelor is secreted in breast milk. Avoid breast feeding while using the drug.

Certain drugs can interact with Pamelor and hence, mention clearly to your doctor or pharmacist all medicines, dietary supplements and herbal prescriptions that you are taking.

Antidepressants may increase suicidal thoughts and behaviors in some children and teenagers. Symptoms like depression, anxiety, restlessness or irritability, panic attacks, thoughts or attempts of suicide, or other unusual changes in behavior or mood should immediately be reported to the doctor. The risk of this happening increases significantly if the patient has bipolar illness (also called manic–depressive illness), a family history of bipolar illness, or a history of attempting suicide.

Alcohol, hot weather, exercise, and fever can increase dizziness. To prevent dizziness or fainting, sit up or stand slowly, especially in the morning. Also, sit or lie down at the first sign of dizziness, lightheadedness, or weakness. Do not become overheated in hot weather or during exercise or other activities, heatstroke may occur.

Pamelor should be used with extreme caution in children as the safety and effectiveness of the drug have not been confirmed yet.

Ensure that you inform your doctor and your dentist about Pamelor before receiving any form of medical treatment or dental treatment or emergency surgery.

Pamelor may make you more sensitive to the sun so please avoid the sun, sunlamps or a tanning booth until you know how your body reacts to the drug. If you cannot avoid going out in the sun for a long while, then wear protective clothing or use a proper sunscreen.

It has been noted that elderly patients are more sensitive to the side effects of the drug. They might need a dosage adjustment or special monitoring throughout the treatment.

Side effects

Consult your doctor if any of these most common side effects persist or become bothersome:

• dizziness, drowsiness, dry mouth, agitation, headache, impotence, nausea, nightmares, dilated pupils, sensitivity to sunlight, sweating, fatigue, upset stomach, vomiting, weakness, loss or weight gain.

Seek medical help immediately in case of any serious side effects listed below:

• Severe allergic reactions (rash, hives, itching, shortness of breath, chest tightness, swelling of the mouth, face, lips, or tongue), blurred vision or other vision changes, changes in sex drive, chest pain, confusion, constipation; fainting, fast, slow, or irregular heartbeat, fever, frequent or difficult urination, hallucinations, impulsive behavior or other unusual changes in behavior, spasms of the jaw, neck, or muscle, mental changes, or mood (eg, increased anxiety, mood swings, agitation, irritability, nervousness, restlessness), panic attacks, ringing in the ears, seizures, severe dizziness or drowsiness, sore throat, abdominal pain, suicidal thoughts and behavior, swelling of the testicles, tremor, insomnia, difficulty walking or maintaining balance, twitching the face or tongue, uncontrolled movements of arms and legs, unusual bleeding or bruising; worsening of depression, yellowing of the skin or eyes.

Additional information

Pamelor should be used only by the patient the drug is prescribed to. Do not share it with others.