Nortriptyline

Indications & formulation #

Depression in adults. This reference covers the selected formulation; other indications and products need their own evidence.

Dose reference #

Adult educational reference · Oral capsule · United States. The clinician selects treatment after assessment; this page does not calculate or change a prescription.

Start low and increase gradually; the selected usual adult regimen is 25 mg three or four times daily. Above 100 mg/day, monitor plasma levels; doses above 150 mg/day are not recommended.

Contraindications & important cautions #

Avoid MAOIs; contraindicated during acute recovery after myocardial infarction. Consider conduction, anticholinergic and overdose risks.

Selected important cautions; consult the full product information for all contraindications and warnings.

Adverse effects #

Anticholinergic effects, orthostasis, sedation and cardiac toxicity remain relevant despite within-class differences.

Interactions #

CYP2D6 modifiers and additive anticholinergic, sedative or cardiac effects can alter tolerability/exposure.

Monitoring #

Review cardiac risk, function, adverse effects and interactions; drug-level use depends on the clinical question and local practice.

Special populations #

Older/debilitated patients require lower doses. CYP2D6 inhibition or poor metabolism can increase concentrations.

Adult scope. Pregnancy, breastfeeding and pediatric use require the exact product’s population-specific guidance and individual assessment.

Discontinuation, restarting & counseling #

Taper with review of sleep, gastrointestinal withdrawal symptoms and mood.

Brands & products #

Reference coverage #

Structured summary of selected adult uses, not an exhaustive monograph. Indian product authorization and local prescribing requirements have not been reconciled.