Mental Health Book

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Anxiety Disorders

Chemical Dependency

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Nortriptyline

Aka: Nortriptyline, Aventyl, Pamelor
  1. Background
    1. Cost: $60 per month
  2. Dosing: Depression
    1. Start at 25mg PO qhs for 3 days
    2. Next: 50 mg PO qhs for 3 days
    3. Therapeutic Dose: 75 mg PO qhs
  3. Pharmacokinetics
    1. Not effective at low dose
    2. Therapeutic serum level: 50 to 150 ng/ml
    3. Serum Half Life: 36 hours
    4. Narrow therapeutic window
      1. Always obtain a serum level after 75 mg for 7 days
  4. Adverse effects
    1. See Tricyclic Antidepressants
    2. Much less adverse effects than tertiary amines
    3. Moderate adverse effects
      1. Sedation
      2. Cardiac arrhythmia
  5. Precautions
    1. See Tricyclic Antidepressants
    2. Serious cardiotoxicity in overdosage
  6. Advantages
    1. Good nighttime sleep without daytime grogginess
    2. Inexpensive (generic)
Medication Costs
Nortriptyline (on 6/18/2017 at Walmart.com)
Nortriptyline 10mg #30 capsules for $4.00 $0.13 each
Nortriptyline 10mg #90 capsules for $10.00 $0.11 each
Nortriptyline 25mg #30 capsules for $4.00 $0.13 each
Nortriptyline 25mg #90 capsules for $10.00 $0.11 each
nortriptyline (on 5/17/2017 at Medicaid.Gov Pharmacy Drug pricing)
NORTRIPTYLINE 10 MG/5 ML SOL Generic $0.25 per ml
NORTRIPTYLINE HCL 10 MG CAP Generic $0.09 each
NORTRIPTYLINE HCL 25 MG CAP Generic $0.13 each
NORTRIPTYLINE HCL 50 MG CAP Generic $0.17 each
NORTRIPTYLINE HCL 75 MG CAP Generic $0.25 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

Nortriptyline (C0028420)

Definition (NCI) A tricyclic antidepressant agent used for short-term treatment of various forms of depression. Nortriptyline blocks the norepinephrine presynaptic receptors, thereby blocking the reuptake of this neurotransmitter and raising the concentration in the synaptic cleft in the CNS. Nortriptyline also binds to alpha-adrenergic, histaminergic and cholinergic receptors. Long-term treatment with nortriptyline produces a downregulation of adrenergic receptors due to the increased stimulation of these receptors.
Definition (CSP) tricyclic antidepressant of the dibenzocycloheptadiene class used to treat symptoms of depression and to relieve chronic, severe pain.
Definition (MSH) A metabolite of AMITRIPTYLINE that is also used as an antidepressive agent. Nortriptyline is used in major depression, dysthymia, and atypical depressions.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D009661
SnomedCT 321855000, 13432000, 372652004
LNC LP14984-6, MTHU005025
English Desitriptyline, Desmethylamitriptylin, Nortriptyline, nortriptyline, 1-Propanamine, 3-(10,11-dihydro-5H-dibenzo(a,d)cyclohepten-5-ylidene)-N-methyl-, Nortriptyline [Chemical/Ingredient], nortryptyline, NORTRIPTYLINE, Nortryptyline, Nortriptyline (product), Nortriptyline (substance), NTPL
Swedish Nortriptylin
Czech nortriptylin
Finnish Nortriptyliini
Russian NORTRIPTILIN, DESITRIPTILIN, DESMETILAMITRIPTILIN, DEZITRIPTILIN, ДЕСИТРИПТИЛИН, ДЕСМЕТИЛАМИТРИПТИЛИН, НОРТРИПТИЛИН, ДЕЗИТРИПТИЛИН
Japanese デシトリプチリン, デスメチルアミトリプチリン, 塩酸ノルトリプチリン, ノルトリプチリン
Polish Nortryptylina
Spanish nortriptilina (producto), nortriptilina (sustancia), nortriptilina, Nortriptilina, Desitriptilina, Desmetilamitriptilina
French Nortriptyline
German Desitriptylin, Desmethylamitriptylin, Nortriptylin
Italian Nortriptilina
Portuguese Desitriptilina, Desmetilamitriptilina, Nortriptilina
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Pamelor (C0030256)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D009661
English pamelor, Mallinckrodt Brand of Nortriptyline Hydrochloride, Pamelor
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Aventyl (C0528314)

Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH D009661
English aventyl, Allegron, Dista Brand of Nortriptyline Hydrochloride, Lilly Brand of Nortriptyline Hydrochloride, Paxtibi, Aventyl
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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