Nortriptyline

(nor TRIP ti leen)

Dosage Forms

• This medicine is available as a capsule and a liquid.

Pharmacologic Category

• Antidepressant, Tricyclic (Secondary Amine)

What key warnings should I know about before giving this medicine to my child?

• Watch your child closely for signs or symptoms of depression or a desire to harm him/herself. These feelings may last until the depression is completely treated. Ask your child to talk with you if he/she is planning to harm him/herself. Take your child to the nearest emergency room if he/she wants to harm him/herself. Talk with healthcare provider.
• Sometimes depression can worsen after starting treatment. Watch your child closely for signs of this. Talk with healthcare provider now if you notice this change.
• This medicine does not mix well with many medicines. Serious reactions may occur. Check all medicines with child's healthcare provider.
• Please read the medication guide.

Is it safe for my child to take this medicine?

• Not if your child has an allergy to nortriptyline or any other part of this medicine.
• Be sure to let healthcare provider know if your child has any allergies or reactions to medicine, food preservatives, or dyes. Make sure to tell about the allergy and how it affected your child. This includes telling about rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other symptoms involved.

Why does my child need this medicine?

• This medicine is used to relieve chronic pain conditions.
• This medicine is used to treat depression.

How does this medicine work?

• Nortriptyline increases chemicals in the brain.

How is this medicine given?

• Give this medicine at bedtime if it causes sleepiness.
• Give this medicine with or without food. Give with food if it causes an upset stomach.
• A liquid (solution) is available if your child cannot swallow pills.
• Children who have feeding tubes can also use the liquid. Flush the feeding tube before and after medicine is given.
• Measure liquid doses carefully. Use measuring device that comes with the medicine. If none is available, get an oral syringe, a medicine dropper, a medicine spoon, or a medicine cup (only for older children) from your pharmacist.

How long does this medicine take to work?

• Your child may start feeling better several weeks after starting this medicine.
• In depression, sleep and appetite may improve quickly. Other depressive symptoms may take up to 4-6 weeks to improve.

What do I do if my child misses a dose? (does not apply to patients in the hospital)

• Give a missed dose as soon as possible.
• If it is almost time for the next dose, skip the missed dose and return to your child's regular schedule.
• Do not give a double dose or extra doses.
• Do not change dose or stop your child's medicine. Talk with healthcare provider.

What safety measures should I take while my child is using this medicine?

• If your child has been taking this medicine for several weeks, talk with healthcare provider before stopping. You may want to gradually withdraw this medicine.
• Check your child's medicines with healthcare provider. This medicine may not mix well with other medicines.
• Avoid giving your child other medicines and natural products that slow actions and reactions.
• Avoid giving your child grapefruit and grapefruit juice.
• If your child has asthma, talk with healthcare provider.
• If your child has gastrointestinal disease, talk with healthcare provider.
• If your child has heart disease, talk with healthcare provider.
• If your child has seizures, talk with healthcare provider.
• If your child has an overactive thyroid, talk with healthcare provider.
• This medicine may cause your child to be less alert. Have your child avoid tasks or activities that require alertness. These include playing (for example, riding a bicycle, rollerblading, contact sports) or using items that require concentration or coordination (for example, scissors, lawnmower, electric scooters, or toy cars). Your child's activities should be closely monitored until you see how this medicine affects him/her. School work may be more difficult for your child to focus on and complete.
• Your child can get sunburned more easily. Avoid lots of sun, sunlamps, and tanning beds. Use sunscreen; dress your child in protective clothing and encourage use of protective eyewear.
• Your child may have a higher risk of cavities.

What are some possible side effects of this medicine?

• Feeling lightheaded, sleepy, having blurred vision, or a change in thinking clearly. Have your child avoid tasks or activities that require alertness or clear vision until you see how this medicine affects him/her.
• Feeling dizzy. Rising slowly over several minutes from sitting or lying position is recommended. Children should be extra careful climbing stairs.
• Blurred vision. Have your child use caution when doing activities that require clear vision.
• Constipation. More liquids, regular exercise, or a fiber-containing diet may help. Talk with healthcare provider about a stool softener or laxative.
• Dry mouth. Frequent mouth care may help. Older children may suck hard, sugar-free candy.
• Unexpected excitement can rarely occur.

What should I monitor?

• Change in condition being treated. Is it better, worse, or about the same?
• For the occurrence of side effects.
• Take care of your child's teeth. See a dentist regularly.

When should I call my child's healthcare provider?

• If any of this information causes you to be concerned, any of the common side effects occur, or if your child's symptoms do not improve after taking this medicine.
• If you suspect an overdose, call your local poison control center or emergency department immediately.
• If your child shows signs of a life-threatening reaction, call healthcare provider or emergency department immediately. These include wheezing; chest tightness; fever; itching; bad cough; blue skin color; fits; swelling of face, lips, tongue, or throat; or if your child exhibits any other unusual behavior.
• If your child shows signs of severe dizziness or passes out.
• If your child has significant change in thinking clearly and logically.
• If your child is feeling extremely nervous and excitable.
• If your child is feeling extremely tired or weak.
• If your child develops a rash.
• No improvement in condition or if you believe your child's condition is worse.

How should I store and/or dispose of this medicine?

• Store at room temperature.
• Protect from light.
• Protect capsules from moisture. Do not store in a bathroom or kitchen.

General statements

• If your child has a life-threatening allergy, he/she should wear an allergy identification bracelet at all times.
• This medicine is available by prescription only. If there are refills, contact your pharmacy. If no refills remain, you may need to contact your child's healthcare provider.
• This medicine should be thrown out when your child no longer needs it or if the medicine becomes outdated.
• Most medicines can be thrown away in household trash after mixing with coffee grounds or kitty litter and sealing in a plastic bag.
• Do not share your child's medicine with others and do not give anyone else's medicine to your child.
• Keep all medicine out of the reach of children and pets.
• Many medications interact with other medications. Keep a list of all your child's medicines (prescription, natural products, supplements, vitamins, over-the-counter) with you. Give this list to your child's healthcare provider (doctor, nurse, nurse practitioner, pharmacist, physician assistant).
• Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or in Canada to Health Canada's Canada Vigilance Program at 1-866-234-2345.
• Talk with your child's healthcare provider before giving him/her any new medicine, including over-the-counter, natural products, or vitamins.
• Medicine can be dangerous if used incorrectly. Follow directions given by healthcare provider.

Copyright © 1978- Lexi-Comp Inc., The Children's Hospital, Denver, CO., and Pediatric Pharmacy Advocacy Group, Inc. All Rights Reserved. This information is protected under US and international copyright law. Unauthorized use or reproduction is prohibited.

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