Nortriptyline: Price, Dosage & Where to Buy

Nortriptyline is a tricyclic antidepressant used to relieve symptoms of depression, and it requires a prescription in the United Kingdom. It is available as oral capsules and an oral solution, with generic versions also available. Treatment is adjusted by the prescriber according to the response and any unwanted effects, with close monitoring for worsening mood or unusual changes in behaviour.

Nortriptyline is indicated for the relief of symptoms of depression. The label states that depression described as endogenous, meaning arising from within rather than clearly linked to outside events, is more likely to improve than other depressive states. Its listed indication is depression, rather than every condition for which antidepressants might be used.

The label does not approve nortriptyline for bipolar depression or for use in children. After symptoms improve, continued treatment may be needed to maintain that improvement, with the prescriber reviewing the response and any unwanted effects.

The label lists oral capsules in strengths of 10 mg, 25 mg, 50 mg and 75 mg, and an oral solution containing 10 mg/5 mL. The label lists the usual adult dose as 25 mg three or four times daily, with the total daily dosage also permitted as a once-daily regimen. The label lists initiation at a low dosage followed by gradual increases according to response and tolerance.

The label lists blood-level monitoring when doses above 100 mg daily are used, with a target range of 50 to 150 ng/mL. The label lists doses above 150 mg/day as not recommended. The label lists 30 to 50 mg/day for elderly and adolescent patients, in divided doses or once daily.

The label lists lower dosages for outpatients than for hospitalised patients under close supervision. Nortriptyline is not recommended for children. Treatment and any changes are managed by the prescriber, including review of unwanted effects and the need for continued treatment after improvement.

Tricyclic antidepressants affect chemical messengers that carry signals between nerve cells in the brain. They reduce the reuptake of messengers such as noradrenaline and serotonin, allowing these chemicals to remain available between nerve cells for longer.

This changes signalling in pathways involved in mood. Medicines in this class also affect other receptors in the body, which helps explain unwanted effects such as dry mouth, constipation, blurred vision and drowsiness.

The label does not specify pregnancy or breastfeeding data. Anyone who is pregnant, planning a pregnancy or breastfeeding should discuss nortriptyline with a doctor or pharmacist. This allows the treatment plan to be reviewed rather than making changes independently.

A missed dose can interrupt the prescribed treatment routine. Usual pharmacy advice is to resume the prescribed schedule if the next dose is nearly due, rather than doubling a dose to make up for one missed.

A pharmacist can clarify what to do for the particular schedule. Repeated missed doses or stopping suddenly should be discussed with the prescriber.

The label specifies storage at 20° to 25°C in a tight container with a child-resistant closure. Keep the medicine out of the sight and reach of children, and follow the storage directions on the pack to maintain quality.