Nortriptyline (Dosage)

Nortriptyline is a second-generation tricyclic antidepressant (TCA) that blocks the reuptake of some neurotransmitters such as noradrenaline or serotonin, primarily norepinephrine reuptake.


Dry mouth, sedation, constipation, urinary retention, blurred vision, accommodation disorders, glaucoma, hyperthermia.

Sudden suppression after prolonged therapy: nausea, headache and discomfort.


Nortriptyline is not recommended if there is hypersensitivity to nortriptyline or other tricyclic antidepressants, recent myocardial infarction, arrhythmias and is not recommended in the manic phase of bipolar disorder or in case of severe hepatic disease.

Do not prescribe concomitantly with MAO inhibitors (monoamine oxidase inhibitors).

Contraindicated in children under 6 years old.


Nortriptyline potentiates the depressive effects on CNS (central nervous system) with alcohol and central depressants.

The intake of nortriptyline produces potentiation of anticholinergic effects and toxicity in concomitancy with anticholinergics, antidiscinetics or antihistamines.

The drug increases the risk of agranulocytosis if prescribed in concomitancy with antithyroid medication.

Nortriptyline decreases the effects of anticonvulsants and

inhibits hypotensive effect of clonidine, guanadrel or guanethidine.

The effects of nortriptyline are diminished by phenobarbital or carbamazepine.

Cimetidine increases the toxicity of nortriptyline.

The effects of the drug and its toxicity are potentiated if thyroid hormones are prescribed in concomitancy.


  • Norfenazin ®
  • Paxtibi ®
  • Martimil ®

Gene or region studied

  • CYP2D6
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