Patient Handout: Nortriptyline

See FDA package insert for more complete information

Description, side effects, and instructions for the medicine Nortriptyline are included below. For more complete information you may refer to the package insert for the medication.

Description Nortriptyline is an antidepressant not approved by the Food and Drug Administration as a quit-smoking medication. Duration of treatment used in quit-smoking trials has been approximately 12 weeks.

How Well Does It Work? Studies have shown that nortriptyline almost doubles long-term quit rates when compared to a placebo (Fiore et al., 2008).

Warnings Precautions

  • Pregnant women: If you are pregnant or breast-feeding, you should try to quit first without using this medication. Nortriptyline has been associated with limb reduction problems and other effects on the unborn are not well understood.. It has not been shown to be effective for tobacco cessation in pregnant smokers and has not been evaluated in breastfeeding patients.
  • Cardiovascular effects: If you have cardiovascular disease, this medication might not be right for you because of risk of arrhythmias, changes in contractility, and blood flow.
  • Do not use with MAO inhibitors
  • Do not abruptly discontinue use; it can result in symptoms such as nervousness, headache, and tremor, accompanied or followed by a rapid rise in blood pressure and elevated catecholamine levels.
  • The patient should be warned that nortriptyline may impair mental and/or physical abilites needed for performing hazardous taks, such as driving a car or operating machinery.
Side Effects
  • Sedation
  • Dry mouth
  • Blurred vision
  • Urinary retention
  • Lightheadedness
  • Shaky hands
How Do I Take This Medication? Therapy is initiated 10 to 28 days before the quit date to allow nortriptyline to reach steady state at the target dose. This medication may make you drowsy, which is a hazard while driving or operating machinery. Follow your doctor's prescribing directions exactly.

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