নির্দেশনা
Nortriptyline is indicated in Depressive illness, Panic disorder & Neuropathic pain.
Composition
ফার্মাকোলজি
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.
মাত্রা ও সেবনবিধি
Depression, low dose initially increased as necessary to 75-100 mg daily in divided doses or as a single dose (max. 150 mg daily); Adolescent and Elderly patient: 30-50 mg daily in divided doses. Neuropathic pain, initially 10 mg daily at night, gradually increased if necessary to 75 mg daily; higher doses under specialist supervision. Or as directed by the physician.
প্রতিনির্দেশনা
Concurrently treatment with a monoamine oxidase (MAO) inhibitor is contraindicated. Hyperpyretic crises, severe convulsions, and fatalities have occurred when similar tricyclic antidepressants were used in such combinations. It is advisable to have discontinued the MAO inhibitor for at least two weeks before treatment with Nortriptyline is started. Patients hypersensitive to Nortriptyline should not be given the drug. Cross-sensitivity between Nortriptyline and other dibenzazepines is a possibility. It is contraindicated during the acute recovery period after myocardial infarction.
পার্শ্ব প্রতিক্রিয়া
Dry mouth, Constipation, Blurred vision, Tremor, Sedation, Sweating, Rashes, Behavioral disturbances.
গর্ভাবস্থায় ও স্তন্যদানকালে
Pregnancy category C. Nortriptyline should only be used in pregnancy if considered necessary, taking into account the risks of untreated depression, and under the close supervision of a physician.
সতর্কতা
Nortriptyline should be used with caution in patients with cardiovascular disease, including heart failure, or arrhythmias. Cardiovascular and ECG monitoring should be undertaken in such patients. When given in high doses patient have been reported to produce QTc prolongation, arrhythmias, sinus tachycardia, and prolongation of the conduction time. Myocardial Infarction and stroke have also been reported with medicines of this class.
থেরাপিউটিক ক্লাস
Tricyclic & related anti-depressant drugs, Tricyclic Anti-depressant