-- tell your doctor and pharmacist if you are allergic to Pamelor or any other drugs.
-- tell your doctor and pharmacist if you are allergic to sulfites; some preparations of Pamelor contain sodium bisulfite.
-- tell your doctor and pharmacist what prescription and nonprescription drugs you are taking or have taken within the last 2 weeks, especially anticoagulants [warfarin (Coumadin)]; antihistamines; antipsychotics; cimetidine (Tagamet); estrogens; levodopa (Sinemet, Larodopa); lithium (Eskalith, Lithobid); MAO inhibitors [phenelzine (Nardil), tranylcypromine (Parnate)]; medication for high blood pressure, seizures, Parkinson's disease, diabetes, asthma, nausea, colds, or allergies; methylphenidate (Ritalin); muscle relaxants; oral contraceptives; quinidine (Quinidex); sedatives; selective serotonin reuptake inhibitors such as fluoxetine (Prozac, Sarafem); sleeping pills; thyroid medication; tranquilizers; and vitamins.
-- tell your doctor if you have or have ever had glaucoma, an enlarged prostate, difficulty urinating, diabetes, seizures, an overactive thyroid gland, or liver, kidney, or heart disease.
-- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking Pamelor, call your doctor immediately.
-- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking Pamelor.
you should know that Nortriptyline hydrochloride may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.
-- remember that alcohol can add to the drowsiness caused by Nortriptyline hydrochloride.
tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of Nortriptyline hydrochloride.

What should I do if I forget a dose?

If you take several doses per day, take the missed dose as soon as you remember it and take any remaining doses for that day at evenly spaced intervals. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule.

If you take Pamelor once a day at bedtime and do not remember to take it until the next morning, skip the missed dose. Do not take a double dose to make up for a missed one.

What side effects can Pamelor cause?

Side effects from pamelor are common:

- upset stomach
- drowsiness
- weakness or tiredness
- excitement or anxiety
- insomnia
- nightmares
- dry mouth
- skin more sensitive to sunlight than usual
- changes in appetite or weight

Tell your doctor if any of these symptoms are severe or do not go away:

- constipation
- difficulty urinating
- frequent urination
- blurred vision
- changes in sex drive or ability
- excessive sweating

If you experience any of the following symptoms, call your doctor immediately:

- jaw, neck, and back muscle spasms
- slow or difficult speech
- shuffling walk
- persistent fine tremor or inability to sit still
- fever
- difficulty breathing or swallowing
- severe skin rash
- yellowing of the skin or eyes
- irregular heartbeat

What storage conditions are needed for Pamelor?

Keep Nortriptyline hydrochloride in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to Pamelor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Pamelor : Full Prescribing Information