Mental Health
NortriptylineNortriptyline hydrochloride
Nortriptyline is a tricyclic antidepressant labeled for depression and sometimes prescribed for nerve pain after shingles. Generic capsules from many makers are inexpensive; the Pamelor brand is listed as discontinued in the FDA Orange Book, and the oral solution has only a few makers.
This page is general information about a medication and how cash prices for it are set. It is not medical advice and does not replace the label, your prescriber or your pharmacist. How we handle medical information
Capsules are made by many companies and the oral solution by a few; Pamelor capsules are listed as discontinued in the FDA Orange Book.
About Nortriptyline
Nortriptyline is labeled for the relief of symptoms of depression; how tricyclic antidepressants lift mood is not known. MedlinePlus notes it is also sometimes used for panic disorder, nerve pain after shingles and to help people stop smoking. The dose starts low and is raised as needed, with lower doses for older adults; the label advises against more than 150 mg a day and recommends blood level checks above 100 mg a day.
Its boxed warning, shared by all antidepressants, says they increased suicidal thoughts and behavior in children, teenagers and young adults in short-term studies. Anyone starting it should be watched for worsening mood or unusual behavior, especially early on and after dose changes. It is not approved for children.
It is not used just after a heart attack, and people with heart disease take it only under close supervision because it can speed the heart and slow its electrical conduction; heart attacks, abnormal rhythms and strokes have occurred. It must not be taken with an MAO inhibitor for a psychiatric condition or within 14 days of one, or started during linezolid or intravenous methylene blue treatment, because of the risk of serotonin syndrome.
Side effects include drowsiness, dry mouth, constipation, nausea and difficulty urinating. It can trigger angle-closure glaucoma in people with narrow eye angles, lower the seizure threshold and, in overdose, cause dangerous heart rhythms. Stopping suddenly can cause nausea, headache and weakness.
Taking Nortriptyline
- How to take it
- Usually one to four times a day, with or without food; some people take the whole daily dose at once. Keep taking it unless your prescriber says otherwise, since stopping suddenly can cause withdrawal symptoms.
- If you miss a dose
- Take it when you remember, unless the next dose is almost due; then skip it. Do not take a double dose.
- Storage
- At room temperature, tightly closed, away from excess heat and moisture (not in a bathroom), and out of reach of children.
- Interactions to know about
- MAO inhibitors, linezolid and intravenous methylene blue are not combined with it. Cimetidine, quinidine and SSRIs such as fluoxetine, sertraline and paroxetine can raise its level, and other serotonin-affecting medicines add to the risk of serotonin syndrome. The response to alcohol may be exaggerated, and thyroid medicine adds to the risk of abnormal heart rhythms. Avoid prolonged sun exposure, take care driving, and tell any surgeon you take it.
This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.
Why the cash price for Nortriptyline differs from pharmacy to pharmacy
Nortriptyline capsules are an old generic with many makers, so a quote is mostly fee and markup, and the drug often appears on flat-price generic lists. A dose made up of several small capsules means more capsules per fill, which costs more where a pharmacy prices by the capsule. The oral solution has only a few makers, so fewer pharmacies stock it and its quotes vary more.
Upload it and licensed pharmacies reply with their own cash price. You pay the pharmacy, not us.
Ways to pay less for Nortriptyline without insurance
- Ask whether nortriptyline is on the pharmacy’s flat-price generic list.
- Once the dose is settled, ask the prescriber to write it in the fewest capsules, such as one 50 mg capsule rather than two 25 mg capsules.
- If the liquid was chosen only for convenience, ask the prescriber whether capsules would suit you.
- Ask for a ninety-day supply once you are stable.
- Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.
How Script Unlock gets you a cash price for Nortriptyline
Prices on this site come from pharmacies responding to a real prescription. We do not publish estimated, average or "typical" prices, because none of those would be your price.
- 1You upload your prescription
A photo of your Nortriptyline prescription is enough. Nothing is sold on the site; you are asking pharmacies to quote.
- 2Licensed pharmacies respond
Pharmacies that Script Unlock has verified see the request and each can reply with its own cash price for your exact drug, strength and quantity.
- 3You choose and pay the pharmacy
You compare the responses, pick a pharmacy, and pay that pharmacy directly when you collect. Script Unlock never takes a patient payment and never sets the price.
Questions to ask your pharmacist about Nortriptyline
- 1.Which mood or behavior changes should my family and I watch for?
- 2.Is it safe with my heart condition or thyroid medicine?
- 3.Do my other antidepressants or migraine medicines interact with it?
- 4.Will my blood level be checked?
- 5.How should it be stopped when the time comes?
Where Nortriptyline fits
Related medications
Sources
Script Unlock is a marketplace that lets licensed pharmacies quote a cash price on your prescription. It does not prescribe, dispense or sell medication, does not process patient payments, and does not give medical advice. Always follow the instructions of your prescriber and pharmacist and read the medication guide supplied with your medicine.