section name header

Pronunciation

nor-TRIP-ti-leen

Classifications

Therapeutic Classification: antidepressants

Pharmacologic Classification: tricyclic antidepressants

Indications

BEERS REMS


Unlabeled Use:
  • Chronic neuropathic pain.

Action

  • Potentiates the effect of serotonin and norepinephrine.
  • Has significant anticholinergic properties.
Therapeutic effects:
  • Antidepressant action that develops slowly over several wk.

Pharmacokinetics

Absorption: Well absorbed after oral administration.

Distribution: Widely distributed to tissues.

Protein Binding: 92%.

Metabolism/Excretion: Mostly metabolized by the liver by the CYP2D6 isoenzyme;the CYP2D6 enzyme system exhibits genetic polymorphism; 7% of population may be poor metabolizers and may have significantly nortriptyline concentrations and an risk of adverse effects.

Half-Life: 18–28 hr.

Time/Action Profile

(antidepressant effect)

ROUTEONSETPEAKDURATION
PO2–3 wk6 wkunknown



Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: hypotension, ARRHYTHMIAS, ECG changes

Derm: photosensitivity

EENT: blurred vision, dry eyes

Endo: gynecomastia

GI: constipation, dry mouth, nausea, paralytic ileus, unpleasant taste

GU: urinary retention

Hemat: blood dyscrasias

Metab: weight gain

Neuro: drowsiness, fatigue, lethargy, agitation, confusion, extrapyramidal reactions, hallucinations, headache, insomnia, SUICIDAL THOUGHTS

Interactions

Drug-drug:

Drug-Natural Products:

Route/Dosage

Availability

(Generic available)

Assessment

Lab Test Considerations:

Toxicity and Overdose:

Implementation

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

Pamelor

Canadian Brand Names

Aventyl

Code

NDC Code