Nortin 25 - Capsule Nortriptyline - 25mg 10 Capsule(s) / Strip Navana Pharmaceuticals Ltd. Introduction: Nortin 25 is known as a tricyclic antidepressant. It is used to treat depression and night time bedwetting (nocturnal enuresis) by older children at different doses. Additionally, it may also be prescribed for neuropathic pain. Nortin 25 works by increasing the levels of chemical messengers in the brain that stabilizes and enhances the mood. It is better to take it before bedtime because it can make you feel drowsy. It can be taken with or without food, but you should take it at a fixed time each day for better efficacy. The dose and duration will be decided by your... Uses of Nortin 25: DepressionBed-wetting Side effects of Nortin 25: Increased heart rateWeight gainDifficulty in urinationOrthostatic hypotension (sudden lowering of blood pressure on standing)Dryness in mouthConstipation How to use Nortin 25: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Nortin 25 may be taken with or without food, but it is better to take it at a fixed time. How Nortin 25 works: Nortin 25 is a tricyclic antidepressant. It increases the levels of chemical messengers in the brain that help in regulating the mood and treat depression. What if you forget to take Nortin 25?: If you miss a dose of Nortin 25, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose. Indication: Depression, Nocturnal enuresis Administration: May be taken with or without food. Adult Dose: Oral Depression Adult: 75-100 mg/day in 3 or 4 divided doses. Max: 150 mg/day in severe depression. Elderly: 30-50 mg/day in divided doses. Hepatic impairment: Administer lower dose and titrate at a slower rate Child Dose: Oral Depression Child: Adolescent: 30-50 mg/day in divided doses. Nocturnal enuresis Child: 6-7 yr (20-25 kg): 10 mg; 8-11 yr (25-35kg): 10-20 mg; >11 yr (35-54 kg): 25-35 mg. All doses are given 30 minutes before bedtime and treatment should continue for not >3 mth. Contraindication: Mania, recent MI, arrhythmias (particularly heart block); severe liver disease; children <6 yr. Mode of Action: Nortriptyline, a dibenzocycloheptadiene tricyclic antidepressant, is the primary active metabolite of amitriptyline. It increases synaptic concentration of serotonin and/or norepinephrine in the CNS by blocking the neuronal reuptake of norepinephrine and serotonin. Precaution: Not intended for treatment of bipolar depression. Avoid abrupt withdrawal. Patient at risk of seizures, w/ DM, narrow angle glaucoma, urinary retention, prostatic hyperplasia, chronic constipation, history of CV disease. Renal and hepatic impairment. Elderly, childn. Pregnancy and lactation. Patient Counselling May impair ability to perform tasks requiring mental and physical alertness (e.g. driving or operating machinery). Monitoring Parameters Monitor BP and pulse rate prior to or during initial therapy, wt. Monitor for emergence of serotonin syndrome. Closely monitor for clinical worsening, suicidality and unusual changes in behaviour. Lactation: Excreted in breast milk; do not nurse (AAP states effect on... Side Effect: Hypotension, HTN, tachycardia, palpitation, MI, arrhythmias, heart block, stroke; confusional states w/ hallucinations, disorientation, delusions; anxiety, restlessness, agitation; insomnia, panic, nightmares; hypomania; exacerbation of psychosis; suicidal ideation and behaviours; numbness, tingling, paraesthesia; incoordination, ataxia, tremors; peripheral neuropathy; extrapyramidal symptoms; seizures; tinnitus, dry mouth, blurred vision, accommodation disturbances, mydriasis; constipation, paralytic ileus; urinary retention, delayed micturition, dilation of the urinary tract. Rash, itching, urticaria, photosensitisation; oedema (general or of face and tongue); bone-marrow depression including agranulocytosis, aplastic anaemia, eosinophilia, thrombocytopenia. Nausea, vomiting, anorexia, epigastric distress, diarrhoea, peculiar taste, stomatitis, abdominal cramps, malaise, jaundice, hepatitis and liver necrosis. Sweating, flushing, urinary frequency,... Interaction: Increased risk of serotonin syndrome w/ SSRIs, SNRIs, TCAs, triptans, fentanyl, lithium, tramadol, tryptophan, buspirone. May reduce antihypertensive effect of bethanidine, guanethidine, debrisoquine, clonidine. May increase metabolism w/ barbiturates. Increased risk of arrhythmias and hypotension w/ anaesth. Increased plasma level w/ fluoxetine. Potentially Fatal: Increased risk of serotonin syndrome w/ MAOIs, linezolid and methylene blue.