Nortriptyline - Revision history

MDElliottMD: parser-claude: Nortriptyline MedTemplate refill, Top 300 stub upgrade

2026-05-23T07:20:27Z

parser-claude: Nortriptyline MedTemplate refill, Top 300 stub upgrade

← Older revision		Revision as of 07:20, 23 May 2026
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	{{MedTemplate		{{MedTemplate
	\| generic = Nortriptyline		\| generic = Nortriptyline (hydrochloride)
	\| brand = Pamelor		\| brand = Pamelor (US brand discontinued; generic widely available), Aventyl
	\| structure =		\| structure =
	\| classes = TCA, Antidepressant		\| classes = [[:Category:Tricyclic antidepressants\|Tricyclic antidepressant (TCA, secondary amine)]], [[:Category:Antidepressants\|Antidepressant]], [[:Category:Neuropathic pain medicines\|Neuropathic pain medicine]], [[:Category:Migraine prophylactics\|Migraine prophylactic]]
	\| ~~mechanism = Norepinephrine reuptake inhibitor~~		\| uses = <vote slug="major-depressive-disorder-use">Major depressive disorder (FDA)</vote>, <vote slug="neuropathic-pain-broad-use">Neuropathic pain, often first-line (off-label; diabetic peripheral neuropathy, postherpetic neuralgia)</vote>, <vote slug="migraine-prophylaxis-use">Migraine prophylaxis (off-label)</vote>, <vote slug="chronic-pain-syndromes-use">Chronic pain syndromes (off-label)</vote>, <vote slug="smoking-cessation-adjunct-use">Smoking cessation adjunct (off-label, modest evidence)</vote>
	\| uses =		\| starting_dose = Depression: 25 mg PO TID-QID or 75 mg at bedtime, titrate to 75-150 mg/day. Neuropathic pain: 10-25 mg at bedtime, titrate to 50-100 mg/day. Elderly: 10 mg at bedtime (Beers-list cautions, though less than amitriptyline)
	\| starting_dose =		\| preparations = Capsules 10, 25, 50, 75 mg; oral solution 10 mg/5 mL
	\| preparations =		\| fda_max = 150 mg/day; therapeutic plasma-level monitoring recommended (target 50-150 ng/mL window)
	\| fda_max =		\| pill_id =
	\| routes =		\| routes = Oral
	\| onset =		\| onset = Pain and migraine prophylaxis effect 1-4 weeks; antidepressant effect 4-6 weeks
	\| duration =		\| duration = 24 hours (HS dosing)
	\| halflife =		\| halflife = 18-44 hours<ref name="pamelor-label">FDA Prescribing Information, Pamelor (nortriptyline hydrochloride), Mallinckrodt/various, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/018012s029,018013s059lbl.pdf</ref>
	~~\| bioavailability =~~		\| bioavailability = ~50% (oral)<ref name="pamelor-label" />
	~~\| pregnancy~~ =		\| pregnancy = TCA class signal; limited human data specific to nortriptyline.{{citation needed}}
	~~\| legal~~ =		\| legal = [[USLegal:Prescription only\|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults<ref name="pamelor-label" />
	\| ~~intro =~~		\| mechanism = <vote slug="nortriptyline-mech-claim">'''Secondary amine TCA''', the active metabolite of amitriptyline, with substantially less anticholinergic, antihistaminergic, and α1-adrenergic activity than the parent compound. This makes nortriptyline the "cleaner" TCA, generally preferred over amitriptyline in elderly patients and in chronic pain where the tertiary-amine side-effect burden is undesirable. Selective norepinephrine reuptake inhibition predominates over serotonin reuptake inhibition.</vote> Therapeutic plasma-level monitoring is standard practice for TCAs given the narrow therapeutic index and the established plasma-level-efficacy correlation. CYP2D6 substrate; CPIC PGx guidance applies for dose individualization<ref name="cpic-tca">CPIC Guideline for CYP2D6 and CYP2C19 Genotypes and Dosing of Tricyclic Antidepressants, 2016. https://cpicpgx.org/guidelines/guideline-for-tricyclic-antidepressants-and-cyp2d6-and-cyp2c19/</ref>.
	~~\| pharmacokinetics~~ =
	~~\| pharmacodynamics~~ =
	\| ~~indications~~ =
	\| ~~dosing~~ =
	\| ~~effects~~ =
	\| ~~interactions~~ = <~~pharmaInteractions~~/>
	~~\| pregnancy_details =~~
	\| monitoring =
	~~\| counseling =~~
	~~\| anecdotes =~~
	~~\| seealso =~~
	~~\| references~~ =
	}}		}}

			== References ==
			<references />

	[[Category:Tricyclic ~~Antidepressants (TCAs)~~]]		[[Category:Tricyclic antidepressants]]
	[[Category:Antidepressants]]		[[Category:Antidepressants]]
			[[Category:Neuropathic pain medicines]]
			[[Category:Migraine prophylactics]]

MediaWiki default: Assign pharmacological categories from List_of_CNS-active_medicines

2026-05-14T15:06:49Z

Assign pharmacological categories from List_of_CNS-active_medicines

← Older revision		Revision as of 15:06, 14 May 2026
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	}}		}}


			[[Category:Tricyclic Antidepressants (TCAs)]]
	[[Category:Antidepressants]]		[[Category:Antidepressants]]

MDElliottMD: Pharmacopedia: add

2026-05-14T03:31:03Z

Pharmacopedia: add <pharmaInteractions/>

← Older revision		Revision as of 03:31, 14 May 2026
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	\| dosing =		\| dosing =
	\| effects =		\| effects =
	\| interactions =		\| interactions = <pharmaInteractions/>
	\| pregnancy_details =		\| pregnancy_details =
	\| monitoring =		\| monitoring =

MDElliottMD: Pharmacopedia: remove contraindications parameter

2026-05-14T02:40:44Z

Pharmacopedia: remove contraindications parameter

← Older revision		Revision as of 02:40, 14 May 2026
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	\| dosing =		\| dosing =
	\| effects =		\| effects =
	~~\| contraindications =~~
	\| interactions =		\| interactions =
	\| pregnancy_details =		\| pregnancy_details =

MDElliottMD: Added empty fda_max parameter to MedTemplate call

2026-05-13T02:32:37Z

Added empty fda_max parameter to MedTemplate call

← Older revision		Revision as of 02:32, 13 May 2026
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	\| starting_dose =		\| starting_dose =
	\| preparations =		\| preparations =
			\| fda_max =
	\| routes =		\| routes =
	\| onset =		\| onset =
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	[[Category:Antidepressants]]		[[Category:Antidepressants]]

MDElliottMD: Expand stub to full MedTemplate parameter set

2026-05-13T01:00:00Z

Expand stub to full MedTemplate parameter set

@@ Line 1: / Line 1: @@
 {{MedTemplate
-| generic           = Nortriptyline
+| generic            = Nortriptyline
-| brand             = Pamelor
+| brand              = Pamelor
-| classes           = TCA, Antidepressant
+| structure          =
-| mechanism         = Norepinephrine reuptake inhibitor
+| classes            = TCA, Antidepressant
 }}
 [[Category:Antidepressants]]

MDElliottMD: Auto-created stub

2026-05-13T00:00:00Z

Auto-created stub

New page

{{MedTemplate
| generic = Nortriptyline
| brand = Pamelor
| classes = TCA, Antidepressant
| mechanism = Norepinephrine reuptake inhibitor
}}
[[Category:Antidepressants]]