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Pamelor (Nortriptyline)
Patient Information
Pronounced: PAM-eh-lore
Generic name: Nortriptyline hydrochloride
Other brand name: Aventyl
Why is Pamelor prescribed?
Pamelor is prescribed for the relief of symptoms of depression. It is one
of the drugs known as tricyclic antidepressants.
Some doctors also prescribe Pamelor to treat chronic hives, premenstrual
depression, attention deficit hyperactivity disorder in children, and
bedwetting.
Most important fact about Pamelor
Pamelor must be taken regularly to be effective and it may be several
weeks before you begin to feel better. Do not skip doses, even if they seem
to make no difference.
How should you take Pamelor?
Take Pamelor exactly as prescribed. Pamelor may make your mouth dry.
Sucking on hard candy, chewing gum, or melting ice chips in your mouth can
provide relief.
--If you miss a dose...
Take it as soon as you remember. If it is almost time for the next dose,
skip the one you missed and go back to your regular schedule. If you take
Pamelor once a day at bedtime and you miss a dose, do not take it in the
morning, since disturbing side effects could occur. Never take 2 doses at
once.
--Storage instructions...
Keep Pamelor in the container it came in, tightly closed and away from
light. Be sure to keep this drug out of reach of children; an overdose is
particularly dangerous in the young. Store at room temperature.
What side effects may occur with Pamelor?
Side effects cannot be anticipated. If any develop or change in
intensity, inform your doctor as soon as possible. Only your doctor can
determine if it is safe for you to continue taking Pamelor.
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Side effects of Pamelor may include: Abdominal
cramps, agitation, anxiety, black tongue, blurred vision, breast
development in males, breast enlargement, confusion, constipation,
delusions, diarrhea, dilation of pupils, disorientation, dizziness,
drowsiness, dry mouth, excessive or spontaneous flow of milk, excessive
urination at night, fatigue, fever, fluid retention, flushing, frequent
urination, hair loss, hallucinations, headache, heart attack, high or
low blood pressure, high or low blood sugar, hives, impotence, inability
to sleep, inability to urinate, increased or decreased sex drive,
inflammation of the mouth, intestinal blockage, itching, loss of
appetite, loss of coordination, nausea, nightmares, numbness, panic,
perspiration, pins and needles in the arms and legs, rapid, fluttery, or
irregular heartbeat, rash, reddish or purplish spots on skin,
restlessness, ringing in the ears, seizures, sensitivity to light,
stomach upset, strange taste, stroke, swelling of the testicles, swollen
glands, tingling, tremors, vision problems, vomiting, weakness, weight
gain or loss, yellow eyes and skin
-
Side effects due to rapid decrease or
abrupt withdrawal from Pamelor after a long term of treatment include:
Headache, nausea, vague feeling of bodily discomfort
These side effects do not indicate addiction to this drug.
Why should Pamelor not be prescribed?
If you are sensitive to or have ever had an allergic reaction to Pamelor
or similar drugs, you should not take this medication. Make sure your doctor
is aware of any drug reactions you have experienced.
Do not take Pamelor if you are taking--or have taken within the past 14
days--a drug classified as an MAO inhibitor. Drugs in this category include
the antidepressants Nardil and Parnate. Combining these drugs with Pamelor
can cause fever and convulsions, and could even be fatal.
Unless you are directed to do so by your doctor, do not take this
medication if you are recovering from a heart attack or are taking any other
antidepressant drugs.
If you have been taking Prozac, you may have to wait at least 5 weeks
before beginning therapy with Pamelor. A drug interaction could result.
Special warnings about Pamelor
Pamelor may cause you to become drowsy or less alert; therefore, you
should not drive or operate dangerous machinery or participate in any
hazardous activity that requires full mental alertness until you know how
this drug affects you.
Use Pamelor with caution if you have a history of seizures, difficulty
urinating, diabetes, or chronic eye conditions such as glaucoma. Be careful,
also, if you have heart disease, high blood pressure, or an overactive
thyroid, or are receiving thyroid medication. You should discuss all of your
medical problems with your doctor before taking this medication.
If you are being treated for a severe mental disorder (schizophrenia or
manic depression), tell your doctor before taking Pamelor.
Pamelor may make your skin more sensitive to sunlight. Try to stay out of
the sun, wear protective clothing, and apply a sun block.
Before having surgery, dental treatment, or any diagnostic procedure,
tell your doctor that you are taking Pamelor. Certain drugs used during
these procedures, such as anesthetics and muscle relaxants, may interact
with Pamelor.
Possible food and drug interactions when taking Pamelor
Combining Pamelor and MAO inhibitors can be fatal.
Pamelor may intensify the effects of alcohol. Do not drink alcohol while
taking this medication.
If Pamelor is taken with certain other drugs, the effects of either can
be increased, decreased, or altered. It is especially important to check
with your doctor before combining Pamelor with the following:
Airway-opening drugs such as Ventolin and Proventil
Antidepressants such as Wellbutrin and Desyrel
Antidepressants that act on serotonin, such as Prozac, Paxil, and Zoloft
Blood pressure medications such as Catapres and Esimil
Cimetidine (Tagamet)
Chlorpropamide (Diabinese)
Drugs for heart irregularities, such as Tambocor and Rythmol
Drugs that control spasms, such as Donnatal and Bentyl
Levodopa (Larodopa)
Major tranquilizers such as Thorazine and Mellaril
Quinidine (Quinidex)
Reserpine (Diupres)
Stimulants such as Dexedrine
Thyroid medication such as Synthroid
Warfarin (Coumadin)
Special information if you are pregnant or breastfeeding
The effects of Pamelor during pregnancy have not been adequately studied.
If you are pregnant or planning to become pregnant, inform your doctor
immediately. Also consult your doctor before breastfeeding.
Recommended dosage of Pamelor
This medication is available in tablet and liquid form. Only tablet
dosages are listed. Consult your doctor if you cannot take the tablet form
of this medication.
ADULTS
Your doctor will monitor your response to this medication carefully and
will gradually increase or decrease the dose to suit your needs. The usual
starting dosage is 25 milligrams, 3 or 4 times per day.
Alternatively, your doctor may prescribe that the total daily dose be
taken once a day.
Doses above 150 milligrams per day are not recommended.
Your doctor may want to perform a blood test to help in deciding the best
dose you should receive.
CHILDREN
The safety and effectiveness of Pamelor have not been established for
children and its use is not recommended. However, adolescents may be given
30 to 50 milligrams per day, either in a single dose or divided into smaller
doses, as determined by your doctor. OLDER ADULTS
The usual dose is 30 to 50 milligrams taken in a single dose or divided
into smaller doses, as determined by your doctor.
Overdosage of Pamelor
An overdose of this type of antidepressant can be fatal. If you suspect
an overdose, seek medical help immediately.
Symptoms of Pamelor overdose may include: Agitation, coma, confusion,
congestive heart failure, convulsions, dilated pupils, disturbed
concentration, drowsiness, excessive reflexes, extremely high fever, fluid
in the lungs, hallucinations, irregular heartbeat, low body temperature,
restlessness, rigid muscles, severely low blood pressure, shock, stupor,
vomiting.
Full Pamelor Prescription Information
Last updated: 12/2005
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