nortriptyline
Brand names: Pamelor
Nortriptyline (Pamelor) is a medicine used to treat depression. It can help improve your mood.
Drug Shortage Alert
nortriptyline is currently listed as to be discontinued by the FDA. Affected manufacturer: Teva Pharmaceuticals USA, Inc..
View all drug shortages →Drug Pricing (NADAC)
Generic Price
$0.30/unit
Generic Available
Yes (6 manufacturers)
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
Nortriptyline is used to relieve the symptoms of depression.
Common side effects
Dry mouth, Blurred vision, Constipation
Key warnings
Antidepressants may increase the risk of suicidal thoughts or actions in children, teenagers, and young adults.
How It Works
Nortriptyline is a tricyclic antidepressant (TCA). It works by increasing the levels of certain natural chemicals in the brain. These chemicals help regulate mood.
How to Take It
Take nortriptyline capsules by mouth. Adults usually take 25 mg three or four times daily. Your doctor may adjust your dose as needed. You can also take your total daily dose once a day if your doctor approves.
Pregnancy & Breastfeeding
Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. Nortriptyline may not be safe for your baby. Talk to your doctor about the risks and benefits.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.
Storage
Store nortriptyline capsules at room temperature (68° to 77°F) in a tight, child-resistant container.
Side Effects (from patient reports)
Based on 5,736 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 5,503 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.
Total Reports
5,503
Death-Related Reports
674
Hospitalization Reports
1,439
Top Indication
Product Used For Unknown Indication
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | DRUG INEFFECTIVE | 777 |
| 2 | OFF LABEL USE | 705 |
| 3 | PAIN | 695 |
| 4 | HEADACHE | 679 |
| 5 | FATIGUE | 593 |
| 6 | NAUSEA | 513 |
| 7 | HYPERHIDROSIS | 485 |
| 8 | HYPERSENSITIVITY | 460 |
| 9 | DRUG HYPERSENSITIVITY | 430 |
| 10 | HYPERTENSION | 396 |
| 11 | CONSTIPATION | 395 |
| 12 | RHEUMATOID ARTHRITIS | 388 |
| 13 | HEPATIC ENZYME INCREASED | 383 |
| 14 | OVERDOSE | 374 |
| 15 | BACK PAIN | 365 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
Antidepressants may increase the risk of suicidal thoughts or actions in children, teenagers, and young adults. Your doctor will monitor you closely for worsening depression or unusual changes in behavior. Families and caregivers should also watch for these changes.
Known Drug Interactions
( 7.1 ) Drugs metabolized by CYP2D6: Bupropion inhibits CYP2D6 and can increase concentrations of: antidepressants (e.g., venlafaxine, nortriptyline, imipramine, desipramine, paroxetine, fluoxetine, sertraline), antipsychotics (e.g., haloperidol, risperidone, thioridazine), beta-blockers (e.g., metoprolol), and Type 1C antiarrhythmics (e.g., propafenone, flecainide). Such drugs include certain antidepressants (e.g., venlafaxine, nortriptyline, imipramine, desipramine, paroxetine, fluoxetine, and sertraline), antipsychotics (e.g., haloperidol, risperidone, and thioridazine), beta-blockers (e...
Mechanism: Bupropion blocks the enzyme that clears nortriptyline from your body, which can cause nortriptyline levels to rise.
What to do: Your doctor may need to lower your dose of nortriptyline and monitor you more closely for side effects.
In addition, carbamazepine causes, or would be expected to cause, decreased levels of the following drugs, for which monitoring of concentrations or dosage adjustment may be necessary: acetaminophen, albendazole, alprazolam, aprepitant, buprenorphone, bupropion, citalopram, clonazepam, clozapine, corticosteroids (e.g., prednisolone, dexamethasone), cyclosporine, dicumarol, dihydropyridine calcium channel blockers (e.g., felodipine), doxycycline, ethosuximide, everolimus, haloperidol, imatinib, itraconazole, lamotrigine, levothyroxine, methadone, methsuximide, mianserin, midazolam, olanzapin...
Mechanism: Carbamazepine speeds up how your body breaks down nortriptyline, which can lower the amount of medicine in your blood.
What to do: Your doctor may need to adjust your dose or check your blood levels to make sure the medicine is still working.
Tricyclic Antidepressants (TCAs): amitriptyline, desipramine, imipramine, nortriptyline ↑ amitriptyline ↑ desipramine ↑ imipramine ↑ nortriptyline Use a lower dose of the tricyclic antidepressants and trazodone due to potential increased adverse events such as nausea, dizziness, hypotension and syncope.
Mechanism: Darunavir slows down the body's ability to get rid of this antidepressant, leading to higher levels in your blood. This can cause side effects like nausea, dizziness, and fainting.
What to do: Your doctor should use a lower dose of nortriptyline and watch you for signs of low blood pressure or dizziness.
Examples: amitriptyline, desipramine, doxepin, imipramine, nortriptyline.
Mechanism: Nortriptyline makes the body more reactive to dopamine's effects. This can result in a much stronger effect on your blood pressure than intended.
What to do: Your doctor should monitor your heart and blood pressure frequently. They might need to adjust your dopamine dose.
Amitriptyline, nortriptyline : Fluconazole increases the effect of amitriptyline and nortriptyline. 5-Nortriptyline and/or S-amitriptyline may be measured at initiation of the combination therapy and after 1 week. Dosage of amitriptyline/nortriptyline should be adjusted, if necessary.
Mechanism: Fluconazole slows down how the body breaks down nortriptyline, which causes the drug to stay in the system longer.
What to do: Your doctor may need to check your blood levels and adjust your dose when starting this combination.
Common Questions
Can children take nortriptyline?
What should I do if I experience side effects?
Can I take nortriptyline with other medications?
How long does it take for nortriptyline to work?
Can I stop taking nortriptyline suddenly?
What is serotonin syndrome?
Can nortriptyline cause weight changes?
Can nortriptyline affect my heart?
Can nortriptyline cause confusion?
Is it safe to drive while taking nortriptyline?
What are the common side effects of nortriptyline?
Does nortriptyline interact with other medications?
What drug class is nortriptyline?
Is nortriptyline safe during pregnancy?
Is nortriptyline currently in shortage?
Related Medications in Tricyclic Antidepressant (TCA)
Other drugs grouped near nortriptyline — same-class peers and common alternatives.
acamprosate
Campral
Acamprosate is a medicine that can help you stay away from alcohol if you are alcohol-dependent and have already stopped drinking.
Compare with nortriptyline →
alprazolam
Xanax
Alprazolam (Xanax) is a medication that can help you with anxiety and panic disorders.
Compare with nortriptyline →
amitriptyline
Elavil
Amitriptyline is a medicine used to treat depression.
Compare with nortriptyline →
amphetamine/dextroamphetamine
Adderall, Adderall XR
Adderall XR is a stimulant medicine.
Compare with nortriptyline →
aripiprazole
Abilify
Aripiprazole (Abilify) is a medicine used to treat certain mental disorders and mood problems.
Compare with nortriptyline →
Medication Guides
Understanding Drug Interactions
How CYP450 enzymes, inhibitors, and inducers affect your medications
Generic vs Brand Name Drugs
FDA requirements, cost savings, and when the difference matters
Narrow Therapeutic Index Drugs
Why some drugs demand precise dosing and monitoring
Common Drug Interactions
Dangerous medication combinations and how to protect yourself
Related Health & Safety Data
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Search prescribers for Tricyclic Antidepressant (TCA)
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💉 Procedure Costs
Medicare procedure pricing for 9,297 procedures
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What the FDA Data Shows for nortriptyline
The FDA label for nortriptyline (sold under brand names such as Pamelor) classifies it as a prescription-only medication in the Tricyclic Antidepressant (TCA) class. Nortriptyline is used to relieve the symptoms of depression. Official labeling lists 10 commonly reported side effects, including Dry mouth, Blurred vision, Constipation.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 5,736 voluntary reports. The database also lists 8 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated minor severity. NADAC pricing from CMS shows a generic unit cost of $0.30.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC). Shortage status: FDA Drug Shortages Database.
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: January 13, 2026
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages