Two medicines, side by side

Amitriptyline vs nortriptyline

Amitriptyline and nortriptyline are both labeled for depression. Drugs@FDA records approvals of amitriptyline since 1961 and of nortriptyline since 1964. Pharmacies paid $0.03 per amitriptyline HCl 10 mg tablet and $0.113 per nortriptyline HCl 10 mg capsule (NADAC, October 7, 2026).

Check it at the source: the amitriptyline FDA label on DailyMed (effective September 8, 2026); the nortriptyline FDA label on DailyMed (effective December 4, 2024).

Highlights of the amitriptyline record

Amitriptyline (Elavil) · label of September 8, 2026

Boxed warning

Suicidality and Antidepressant Drugs: Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of amitriptyline hydrochloride or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need.

Used for

From the label: indications
For the relief of symptoms of depression. Endogenous depression is more likely to be alleviated than are other depressive states.

On the market

Earliest approval on file: April 7, 1961
Generic labelers: 34 labelers
Pharmacy cost: $0.03 per tablet

Supply and safety

Shortage: No current entry
Recalls: 2

Highlights of the nortriptyline record

Nortriptyline (Pamelor) · label of December 4, 2024

Boxed warning

Suicidality and Antidepressant Drugs Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of nortriptyline hydrochloride or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need.

Used for

From the label: indications
Pamelor™ (nortriptyline HCl) is indicated for the relief of symptoms of depression. Endogenous depressions are more likely to be alleviated than are other depressive states.

On the market

Earliest approval on file: November 6, 1964
Generic labelers: 25 labelers
Pharmacy cost: $0.113 per capsule

Supply and safety

Shortage: No current entry
Recalls: 2

Source: FDA drug labels via openFDA (Amitriptyline label of September 8, 2026, Nortriptyline label of December 4, 2024); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)

How do amitriptyline and nortriptyline differ on the record?

Both are in FDA's class tricyclic antidepressants.

Both labels carry a boxed warning; the records quote them.

Generics: amitriptyline since 1976; nortriptyline since 1992 (Drugs@FDA).

	Amitriptyline	Nortriptyline
Labeled for	Depression	Depression
Pharmacologic class	Tricyclic Antidepressant	Tricyclic Antidepressant
How it works (label)	in man is not known. It is not a monoamine oxidase inhibitor and it does not act primarily by stimulation of the central nervous system.	n/a
Half-life (label)	n/a	n/a
Earliest approval on file (Drugs@FDA)	April 7, 1961	November 6, 1964
First generic approved	November 16, 1976	March 30, 1992
Generic labelers (NDC)	34 labelers	25 labelers
Pharmacy cost (NADAC, each one's most listed form; strengths differ)	$0.03 per tablet (Amitriptyline HCl 10 mg tablet)	$0.113 per capsule (Nortriptyline HCl 10 mg capsule)
12-month price change	-19%	-2%
Boxed warning	Yes	Yes
Shortage now	No current entry	No current entry
Recalls recorded	2	2
FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used)	17,441	5,761
DEA schedule	none	none

Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)

What do the labels say about using others of their kind?

Amitriptyline label, warnings
If concomitant use of amitriptyline hydrochloride with other serotonergic drugs, including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, buspirone, tryptophan, and St. John’s Wort is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases.

Nortriptyline label, warnings
If concomitant use of Pamelor with other serotonergic drugs, including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, buspirone, tryptophan, and St. John’s Wort is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases.

Source: FDA drug labels via openFDA

What next?

Amitriptyline: the full record
Nortriptyline: the full record
Alternatives to amitriptyline: every medicine labeled for the same conditions