Prescription medication · Tricyclic Antidepressant (TCA)

nortriptyline

Also sold as Pamelor. Nortriptyline is used to relieve the symptoms of depression.

Data updated 2026-05-15

5,503
FDA reportsLightly reported
8
InteractionsFew interactions
In shortage
FDA status

What the data shows

nortriptyline (Pamelor) is a prescription Tricyclic Antidepressant (TCA), reported less often than most tracked drugs (5,503 FDA reports), with 8 documented drug interactions.

Reporting volume reflects how widely a drug is used and studied, not how dangerous it is, a FAERS report documents a temporal association, never proof of cause.

nortriptyline (Pamelor) is a prescription Tricyclic Antidepressant (TCA). Nortriptyline is used to relieve the symptoms of depression.

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..

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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 →

View Alternatives → Compare with Another Drug → Full Side Effects Report →

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.

The sections below are summarized in plain English from nortriptyline's FDA-approved prescribing information. They describe what the official label says, and are not personal medical advice.

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.

Side Effects (from patient reports)

Based on 5,503 FDA adverse event reports.

Most-reported reactions

Adverse reactions in FAERS for nortriptyline, by number of reports

reports

What this shows Bars show how often each reaction was reported, not how likely it is to happen, a report records a temporal association, never proof that the drug caused it.

Source FDA Adverse Event Reporting System (FAERS) As of 2025

Reports over time

Adverse-event reports filed for nortriptyline each year to the FDA Adverse Event Reporting System (FAERS).

0200400600800 20042007201020132016201920222025 535

Year-to-year volume tracks usage, prescribing, and scrutiny, not a change in per-patient risk. Source: FDA FAERS.

Where nortriptyline sits

nortriptyline has more FDA adverse-event reports than 26% of the drugs FAERS tracks. A high position reflects how widely a drug is used and watched, not how dangerous it is.

fewest reports most reports

Percentile across all drugs PlainMeds tracks by FAERS report volume. The dot is nortriptyline; the line is the median (50th percentile).

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

Reports Mentioning Death

674

12.2% of reports — not proof of cause

Hospitalization Reports

1,439

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 3,671 (75%)
Male 1,179 (24%)

Age Distribution

0–17 53
18–44 852
45–64 1,575
65–74 500
75+ 292

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
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
16 JOINT SWELLING 361
17 IMMUNODEFICIENCY 358

Reactions in Death Reports

COMPLETED SUICIDE 203
OVERDOSE 131
PAIN 110
TOXICITY TO VARIOUS AGENTS 110
HYPERTENSION 105
PYREXIA 104
THROMBOCYTOPENIA 104
FATIGUE 103
CONSTIPATION 101
PSORIASIS 101

Reactions in Hospitalization Reports

SOMNOLENCE 226
GASTROOESOPHAGEAL REFLUX DISEASE 214
COMA 199
PNEUMONIA ASPIRATION 195
PAIN 175
NAUSEA 170
FATIGUE 148
DIARRHOEA 146
FALL 133
PAIN IN EXTREMITY 129

Source: 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...

Mechanism: Bupropion blocks the enzyme that clears nortriptyline from your body, which can cause nortriptyline levels to rise.

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,...

Mechanism: Carbamazepine speeds up how your body breaks down nortriptyline, which can lower the amount of medicine in your blood.

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.

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.

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.

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This is a plain-language summary of FDA-label interaction records and does not provide individual medication-combination directions.

Common Questions

Can children take nortriptyline?
Nortriptyline is not recommended for children.
What should I do if I experience side effects?
If you experience minor side effects, your doctor may lower your dose. If you experience serious side effects, stop taking the medicine and contact your doctor immediately.
Can I take nortriptyline with other medications?
Tell your doctor about all the medications you take, including over-the-counter drugs and supplements. Do not take nortriptyline with MAOIs.
How long does it take for nortriptyline to work?
It may take several weeks for nortriptyline to start working. Continue taking the medicine as prescribed, even if you do not feel better right away.
Can I stop taking nortriptyline suddenly?
Do not stop taking nortriptyline suddenly. This can cause withdrawal symptoms. Talk to your doctor about how to gradually stop taking the medicine.
What is serotonin syndrome?
Serotonin syndrome is a serious condition that can occur if you take nortriptyline with certain other medications. Symptoms include agitation, hallucinations, rapid heartbeat, and fever.
Can nortriptyline cause weight changes?
Nortriptyline can cause weight gain or weight loss in some people.
Can nortriptyline affect my heart?
Nortriptyline can cause heart problems, such as changes in heart rate or blood pressure. Tell your doctor if you have a history of heart problems.
Can nortriptyline cause confusion?
Nortriptyline can cause confusion, especially in elderly people.
Is it safe to drive while taking nortriptyline?
Nortriptyline can cause drowsiness or dizziness. Be careful driving or operating machinery until you know how the medicine affects you.
What are the common side effects of nortriptyline?
The registry lists Dry mouth, Blurred vision, Constipation, Drowsiness, Dizziness among the most-reported FAERS reaction terms for nortriptyline. The compiled record contains 5,503 FDA adverse-event reports. These counts are not an individual symptom assessment.
Does nortriptyline interact with other medications?
The registry has 8 documented interaction rows for nortriptyline. Notable source-record pairings include bupropion, carbamazepine, darunavir. These rows are not a complete medication review.
What drug class is nortriptyline?
nortriptyline belongs to the Tricyclic Antidepressant (TCA) drug class. It requires a prescription (Rx). Nortriptyline is used to relieve the symptoms of depression.
What pregnancy or breastfeeding source fields are listed for nortriptyline?
The FDA label for nortriptyline contains product-specific pregnancy or breastfeeding language. PlainMeds does not apply that source text to an individual.
Is nortriptyline currently in shortage?
Yes, nortriptyline is currently listed as to be discontinued by the FDA. Affected manufacturer: Teva Pharmaceuticals USA, Inc.. Visit the FDA Drug Shortages database for the latest updates.

Other drugs grouped near nortriptyline - same-class peers and common alternatives.

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Compare beyond drug class

Nationwide peers by FAERS volume & death-report share

Two PlainMeds-derived comparison paths for nortriptyline: nearest FDA FAERS report volume and nearest death-report share among drugs with at least 1,000 logged reports, excluding same-class neighbors listed above. Counts reflect reporting volume, not proven individual harm.

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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 5,503 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 are separate source-record fields. This page is a public FDA/CMS registry and does not provide medical, treatment, substitution, or medication-change directions.

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. This registry does not provide medication decisions.

Last updated: January 13, 2026

PlainMeds is rendered directly from FDA openFDA/FAERS extracts, DailyMed labels, and CMS drug-pricing files, no number is typed in by an editor. FAERS counts, recalls, shortages, and price figures on this page are queried live from those federal extracts. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of 2026-05-15. Primary sources: openFDA / FAERS, DailyMed and CMS Part B ASP.

Data currency: FDA FAERS adverse-event reports through 2025, CMS NADAC acquisition-cost pricing effective December 2024, compiled from the source snapshot dated . See our methodology for per-source dates and refresh cadence. Spot a figure that looks wrong? Report a data issue.

All federal data sources used on this page