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Nortriptyline: Uses, Dosage, Side Effects, and More

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Nortriptyline is a TCA (tricyclic antidepressant) used for the treatment of depression and nerve pain.

Medically reviewed by Dr. Nagaraj
Published At November 21, 2022
Reviewed At April 28, 2025

Education:

BDS

Professional Bio:

Dr. Ruchika Raj is a dedicated Oral And Maxillofacial Surgeon and Implantologist. She has been working as an Oral And Maxillofacial Surgeon and Implantologist for the last three years. She has completed her MDS in Oral and Maxillofacial Surgery from the Oxford Dental College & Hospital Bangalore and her BDS from Bapuji Dental College & Hospital Davangere. She has also done an implant training certified course in collaboration with BIOLINE dental implants, Germany. She has also completed certified training in advanced dental treatment and patient management at the Academy for Clinical Excellence in Dentistry in Davangere. She has also completed a certified course on rotary endodontics from ACE Academy, Davangere.

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Education:

MBBS

Professional Bio:

Dr. Nagaraj is a skilled MD in Pharmacology with over 13 years of clinical experience. Specializing in General Medicine, Diabetology, and Endocrinology, he has treated over 10,000 patients. He holds an MD from Rajiv Gandhi University and MRCP (UK). Currently practicing at TruCare Clinic, Bangalore, India.

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Table of Contents

Introduction:

Nortriptyline is a TCA (tricyclic antidepressant). It is an active metabolite of Amitriptyline. It has been approved by the Food and Drug Administration for the treatment of depression and nerve pain. It has been approved for use in children. Nortriptyline acts by blocking the norepinephrine receptors. It also helps in smoking cessation. Nortriptyline hydrochloride is available in oral capsule form in the dosages of 10 mg, 25 mg, and 50 mg. Read the article to learn more about the drug.

What Is Nortriptyline?

Nortriptyline is a prescription drug used to treat depression. It works by influencing the release of serotonin. Serotonin is a brain chemical that controls mood. Nortriptyline belongs to the tricyclic antidepressant class of medications.

Nortriptyline is also used to treat nerve pain. Nortriptyline acts by altering the pain perception in the nerves. It is available on tablets and in solution form.

How Does Nortriptyline Work?

Nortriptyline attaches to the adrenaline, noradrenaline, histamine, and choline receptors. Once attached, it inhibits the absorption of serotonin and norepinephrine at the nerve membrane. This leads to an increased amount of these brain chemicals at the motor end plate.

Nortriptyline Uses: Nortriptyline hydrochloride medications can be used to treat:

  • Depression.

  • Nerve pain, like stabbing and burning pains.

  • Children in the age group of six to 17 years are being prescribed Nortriptyline for the treatment of bedwetting.

  • It is used to treat panic disorders.

  • Headaches and migraines.

How to Take Nortriptyline?

Doses and Forms: The drug Nortriptyline hydrochloride is available in oral capsules and oral solution forms. Nortriptyline capsules are available in dosages of 10, 15, 25, and 75 mgs. An oral solution of 10mg/5ml is recommended by the FDA (Food and Drug Administration). A dose of more than 150 mg in a day should be avoided to prevent any serious side effects associated with the drug.

Missed Dose: You must take the dose as soon as you remember. If you forget to take it on time, avoid taking a double dose to compensate for the missed dose. Continue the regular dose as scheduled from the next day.

Overdose: If you have taken an extra dosage or overdosed, contact the poison control helpline. If you have serious side effects like breathing problems, seizures, or sudden collapse, call an emergency helpline immediately or visit a nearby doctor.

What Are the Side Effects of Nortriptyline?

Nortriptyline Side Effects: Look out for the Nortriptyline side effects as below:

Common side effects of Nortriptyline hydrochloride are:

  • Nausea.

  • Lethargy.

  • Drowsiness.

  • Dry mouth (xerostomia).

  • Constipation.

  • Excess sweating.

  • Weight loss due to a change in appetite.

  • Difficulty in urinating.

  • Anxiety.

Serious side effects of Nortriptyline hydrochloride are:

  • Muscle spasms in the neck, jaw, and back muscles.

  • Difficulty in speech.

  • Body tremors.

  • Fever.

  • Rash.

  • Yellowing of eyes.

  • Irregular heartbeat.

  • Difficulty in swallowing.

  • Difficulty in breathing.

There are various other side effects associated with the use of Nortriptyline drugs. If any of the side effects are observed, it is important to inform the doctor immediately.

Warnings and Precautions:

You must know the following warnings and precautions for Nortriptyline use:

  • Nortriptyline in epileptic patients increases the risk of seizures. You must inform your doctor if you have epilepsy or are on epileptic drugs.

  • If you have any cardiac disorder, let your doctor know. Nortriptyline drugs worsen cardiac symptoms.

  • In glaucoma, Nortriptyline is to be used cautiously as it carries the risk of increased intraocular pressure.

  • For diabetes, Nortriptyline hydrochloride has a risk of increased blood sugar levels.

  • The safety index of Nortriptyline use is not yet established, according to the research. So, the drug should be avoided in pregnant patients as it can cause harm to the fetus.

Drug Interactions: Nortriptyline’s interaction with other medications and supplements includes:

  • Nortriptyline hydrochloride decreases the hypoglycemic actions of Acarbose.

  • There is an increased risk of gastrointestinal bleeding when the drug Nortriptyline hydrochloride is combined with Aceclofenac and Acemetacin.

  • The metabolism of Nortriptyline hydrochloride is increased when combined with Abatacept.

  • The metabolism of Nortriptyline hydrochloride is decreased when combined with Abiraterone and Acebutolol.

  • The CNS (central nervous system) depressant effects of Nortriptyline hydrochloride increase when given along with the drug Benzodiazepines.

  • When combined with the drug Abametapir, the serum concentration of Nortriptyline hydrochloride increases.

Contraindications:

  • The drug Nortriptyline hydrochloride, in combination with monoamine oxidase inhibitors and methylene blue, is contraindicated as it is associated with the risk of serotonin syndrome. Serotonin syndrome is a life-threatening disorder that can result in altered mental status, neuromuscular changes, seizures, and gastrointestinal symptoms.

  • It is advised to discontinue monoamine oxidase inhibitors for a minimum of 14 days before starting the Nortriptyline drug.

What Should I Watch for While Using This Medication?

Things to watch for while using Nortriptyline medications are:

It is a prescription drug and is available using a doctor’s prescription. Children are to be away from this drug. If anyone you know has the same experiences as you, do not give them Nortriptyline. Ask them to visit the doctor and get checked.

If you are involved in coordination activities or driving, be watchful as it can affect coordination. Also, you must avoid alcohol when taking Nortriptyline. Nortriptyline also causes photosensitivity. It means skin exposure to light causes rashes, blisters, swelling, and sunburns.

If you are advised to take Nortriptyline in solution form, you must use the given measuring device. A spoon may not be appropriate for the prescribed dose. If you are to undergo electroconvulsive therapy, you are recommended to inform your doctor.

Conclusion

Nortriptyline is used in depression and to treat nerve pain. It is used when your doctor prescribes it to you. Like other drugs, Nortriptyline also comes with side effects. After taking Nortriptyline, if you notice changes, then you are advised to visit or inform your doctor immediately. It is available in different dosages and forms. Nortriptyline may interact with a few medicines and carries a risk for seizures, diabetes, and cardiac diseases. So, informed consent is important.

Key Takeaway/ Note from iCliniq:

Nortriptyline is a tricyclic antidepressant that comes in different dosage forms. It is generally used for depression and nerve pain. This medicine is only taken on prescription and should not be self-prescribed.

Icliniq doctors will advise you if you have any questions about Nortriptyline and guide you through its usage. Be watchful of your symptoms and risk factors while taking Nortriptyline.

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Frequently Asked Questions

What Is the Use of Nortriptyline?

Nortriptyline is a tricyclic form of antidepressant that works by restoration of chemical imbalances in the brain. The drug Nortriptyline is used in the treatment of the following conditions. 
- Neuropathic or nerve pain.
- Depression.
- Bedwetting in children.
- Attention deficit hyperactivity disorder.
- Anxiety. 
- Smoking cessation. 

Is Nortriptyline a Sleeping Medicine?

Nortriptyline is not a typical sleeping pill. Nevertheless, it is an antidepressant that can make one feel drowsy. However, in addition to depression, it can relieve pain and improve sleep. Hence, Nortriptyline is also used to treat mood concerns and feelings. 

What Are the Common Side Effects of the Drug Nortriptyline?

The side effects are encountered and improved gradually with Nortriptyline. The most common side effects of Nortriptyline include the following.
- Dizziness.
- Constipation.
- Dryness of mouth.
- Headaches.
- Blurred vision.
- Weight gain.
- Trouble with urination. 

Is Nortriptyline an Antianxiety Medication?

Nortriptyline sorts with the class of medication known as tricyclic antidepressants. This medication is primarily prescribed for the treatment of depression. Nortriptyline can also help relieve tension, stress, and anxiety. In addition, it helps improve mood, energy level, and feelings. So, it can be used for treating anxiety. 

Why Is Nortriptyline Advised to Take at Night?

The doctors generally advise taking Nortriptyline in the evening or at night before moving on to bed. This is because the drug can make one feel drowsy or sleepy. Also, the doctors terminate the Nortriptyline therapy with a gradual decline in the dose since it could cause withdrawal syndrome. 

Is Nortriptyline a Steroid Medication?

Nortriptyline hydrochloride is not a steroid but a tetracycline antidepressant. It is used in the treatment of significant symptoms of major depressive disorder. It is primarily prescribed for nerve pain. In certain instances, it is prescribed for bedwetting in children.

Is Nortriptyline a Potent Painkiller?

Nortriptyline belongs to the class of medications known as tricyclic antidepressants. However, it is used to treat many forms of chronic pain. It is considered a good and effective one for treating nerve pain, including stabbing, shooting, burning, and nocturnal types. 

Does Nortriptyline Belong to Muscle Relaxants?

Nortriptyline is not a muscle relaxant, and it is a typical antidepressant used in the treatment of depression. It is also prescribed to relieve pain. Certain clinical findings show that Nortriptyline can aid in the relaxation of vascular smooth muscles. Overdose or adversity of Nortryptine can cause muscle stiffness or tremors. 

Is Nortriptyline a Safe Medication?

Nortriptyline is primarily prescribed for depression and nerve pain concerns. It is considered to be a safe drug even when taken for a longer span. In addition, the medicine does not cause any severe or harmful side effects. 

Does Nortriptyline Cause Damage to the Liver?

Nortriptyline does not cause severe adverse reactions. Nevertheless, it can result in mild and transient elevations in serum enzymes. It can rarely cause acute and chronic forms of cholestatic liver injury. Older adults are at high risk of kidney and liver concerns with Nortriptyline. 

Can Nortriptyline Affect One’s Memory?

Nortriptyline can culminate in drowsiness, concentration impairment, and memory issues. Moreover, drugs incorporating anticholinergic properties could influence and impair memory part, while Nortriptyline holds such properties. 

Does Nortriptyline Cam One Down?

Nortriptyline is used in the treatment of improvement over mood and feeling concerns. It works effectively for anxiety attacks by calming one down. It helps individuals think clearly and conscientiously. So, it lowers the signs of mood and mental disorders. 

How Long Will Nortriptyline Last?

Nortriptyline has a varied half-life with a range of sixteen to ninety hours. It can attain the peak concentration between seven and nine hours. However, it may take a few weeks to evident the antidepressant and other effects. 

How Potent Drug Is Nortriptyline?

Nortriptyline is available in capsules holding four strengths such as 10 mg, 25 mg, 50 mg, and 75 mg. The doctors include the dose according to the age and condition to be treated. It shows a potent effect in treating depression, nerve pain, and other mood-related concerns.

Which Is the Right Time to Take the Nortriptyline?

The drug Nortriptyline is generally prescribed for one dosage per day. One should take this medication orally. The doctors usually advise taking it in the evening or night as the drug can make one tired or sleepy. 
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Dr. Nagaraj from iCliniq
Dr. Nagaraj

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