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 Nortriptyline.
Behaviour changes and suicidal thoughts: 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 Nortriptyline, contact your doctor immediately. Family members or caregivers of people who are taking 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 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 Nortriptyline may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Nortriptyline, and whether any special monitoring is needed.
Drowsiness/reduced alertness: Like other similar medications, 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 Nortriptyline affects you.
Glaucoma: Nortriptyline may cause symptoms of glaucoma to worsen. If you have glaucoma, discuss with your doctor how Nortriptyline may affect your medical condition, how your medical condition may affect the dosing and effectiveness of 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: 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 Nortriptyline may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Nortriptyline, and whether any special monitoring is needed.
High blood pressure: 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 Nortriptyline may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Nortriptyline, and whether any special monitoring is needed.
Seizure disorder: 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 Nortriptyline may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Nortriptyline, and whether any special monitoring is needed.
Serotonin syndrome: Severe reactions are possible when nortriptyline is combined with other medications that act on serotonin, such as medications used for nausea with chemotherapy and "triptan" migraine medications. Combining 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 nortriptyline.
Sun exposure: 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 nortriptyline. If you are taking medication for thyroid or have an overactive thyroid gland, discuss with your doctor how Nortriptyline may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Nortriptyline, and whether any special monitoring is needed.
Urinary problems: Nortriptyline can cause difficulty with urination. If you have difficulties with urination or conditions that make urinating difficult, discuss with your doctor how Nortriptyline may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Nortriptyline, and whether any special monitoring is needed.
Pregnancy: Nortriptyline should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Nortriptyline, contact your doctor immediately.
Breast-feeding: Nortriptyline passes into breast milk. If you are a breast-feeding mother and are taking nortriptyline, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using 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 Nortriptyline.
