Two medicines, side by side
Imipramine vs nortriptyline
Imipramine and nortriptyline are both labeled for depression. Drugs@FDA records approvals of imipramine since 1959 and of nortriptyline since 1964. Pharmacies paid $0.0698 per imipramine HCl 10 mg tablet and $0.113 per nortriptyline HCl 10 mg capsule (NADAC, October 7, 2026).
Check it at the source: the imipramine FDA label on DailyMed (effective August 11, 2026); the nortriptyline FDA label on DailyMed (effective December 4, 2024).
Highlights of the imipramine record
Imipramine (Presamine) · label of August 11, 2026
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 imipramine 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: indicationsDepression - For the relief of symptoms of depression. Endogenous depression is more likely to be alleviated than other depressive states. One to three weeks of treatment may be needed before optimal therapeutic effects are evident. […]
On the market
- Earliest approval on file
- April 16, 1959
- Generic labelers
- 14 labelers
- Pharmacy cost
- $0.0698 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 4
Highlights of the nortriptyline record
Nortriptyline (Pamelor) · label of December 4, 2024
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: indicationsPamelor™ (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 (Imipramine label of August 11, 2026, Nortriptyline label of December 4, 2024); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do imipramine 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: imipramine since 1974; nortriptyline since 1992 (Drugs@FDA).
| Imipramine | Nortriptyline | |
|---|---|---|
| Labeled for | Depression | Depression |
| Pharmacologic class | Tricyclic Antidepressant | Tricyclic Antidepressant |
| How it works (label) | of imipramine hydrochloride, is not definitely known. However, 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 16, 1959 | November 6, 1964 |
| First generic approved | June 27, 1974 | March 30, 1992 |
| Generic labelers (NDC) | 14 labelers | 25 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0698 per tablet (Imipramine HCl 10 mg tablet) | $0.113 per capsule (Nortriptyline HCl 10 mg capsule) |
| 12-month price change | -12% | -2% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 4 | 2 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 723 | 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?
Nortriptyline label, warningsIf 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?
- Alternatives to imipramine
- every medicine labeled for the same conditions