• It may take a week or two after starting these tablets before you begin to feel the benefit. Do not stop taking nortriptyline, thinking it is not helping.
  • This medicine may make you sleepy. If this happens, do not drive or use tools or machines. Do not drink alcohol.
  • Tell your doctor if you feel that you are getting worse or if you experience any troublesome side-effects.
  • Your doctor will ask you to carry on taking nortriptyline for several months even after you feel better - this is to stop your symptoms from returning.
Type of medicine Tricyclic antidepressant
Used for Treatment of depression
Available as Tablets

The exact cause of depression is not known. Anyone can develop depression. It can develop for no apparent reason or it may be triggered by a life event such as a relationship problem, bereavement, or illness.

Before taking nortriptyline make sure your doctor or pharmacist knows:

  • If you are pregnant, trying for a baby or breast-feeding.
  • If you have thyroid problems.
  • If you have liver problems.
  • If you have epilepsy.
  • If you have diabetes.
  • If you have been constipated for several days.
  • If you have any difficulties passing urine, or have had prostate trouble.
  • If you have recently had a heart attack, or have any other heart problems.
  • If you have ever had a mental health problem (such as bipolar disorder or psychosis).
  • If you have glaucoma (increased pressure in the eye).
  • If you have phaeochromocytoma (a tumour on your adrenal gland).
  • If you have porphyria (a rare inherited blood disorder).
  • If you are taking other medicines, including those available to buy without a prescription, herbal and complementary medicines. This is especially important if you have taken a treatment for depression, known as a monoamine-oxidase inhibitor (MAOI), recently.
  • If you have ever had an allergic reaction to this or to any other medicine.
  • Before starting this treatment, read the manufacturer's printed information leaflet from inside the pack.
  • Take nortriptyline exactly as your doctor has told you.
  • Nortriptyline can cause drowsiness so your doctor may advise you to take a small dose when you first start taking nortriptyline and then to increase it gradually as your body gets used to it.
  • Nortriptyline is usually given as a once-a-day dose at bedtime, although it may also be taken in smaller doses two or three times a day. Your doctor will have told you which is right for you and these directions will be on the label of the pack for you too.
  • It is not important whether you take nortriptyline before or after food.
  • Try to take nortriptyline at the same time(s) each day to avoid missing any doses.
  • If you do forget to take a dose, take it as soon as you remember unless it is nearly time for your next dose, in which case leave out the missed dose. Do not take two doses together to make up for a forgotten dose.
  • You may feel that nortriptyline is not working for you straightaway. It can take a week or two after starting these tablets before the effect begins to build up, and 4-6 weeks before you feel the full benefit. Do not stop taking nortriptyline after a week or so, thinking it is not helping.
  • Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.
  • Do not drink alcohol while you are being treated with nortriptyline. Taking nortriptyline and alcohol will increase the chance that you experience side-effects.
  • If you buy any medicines, check with a pharmacist that they are safe to take with nortriptyline.
  • There are several types of antidepressants and they differ in their possible side-effects. If you find that nortriptyline does not suit you then let your doctor know, as another may be found that will.
  • While you feel depressed or are taking nortriptyline, you may have thoughts about harming yourself or ending your life. It is very important that you tell your doctor about this if it happens.
  • Your doctor will ask you to carry on taking nortriptyline after you feel better. You should expect that a normal course of treatment will last for around six months after your symptoms have eased.
  • Nortriptyline may cause your skin to become more sensitive to sunlight than usual. Avoid strong sunlight and sunbeds until you know how your skin reacts.
  • If you have diabetes you may need to check your blood glucose more frequently, as nortriptyline may affect the levels of sugar in your blood. Your doctor will be able to advise you about this.
  • Do not stop taking nortriptyline unless your doctor tells you to do so. Stopping treatment suddenly can sometimes cause problems and your doctor may want you to reduce your dose gradually if this is necessary.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

Common nortriptyline side-effects What can I do if I experience this?
Dry mouth Try chewing sugar-free gum or sweets
Constipation Try to eat a well-balanced diet containing plenty of fibre and drink plenty of water
Feeling sleepy, blurred vision If this happens, do not drive or use tools or machines. Do not drink alcohol
Feeling or being sick, diarrhoea Stick to simple foods. Try eating smaller meals but more regularly. If you are sick or have diarrhoea, drink plenty of water to replace the lost fluids
Headache Ask your pharmacist to recommend a suitable painkiller
Feeling dizzy, faint or light-headed when getting up Getting up more slowly may help. If you begin to feel faint, sit down until the feeling passes
Feeling anxious or confused, difficulties sleeping, tingling feelings, breast tenderness, difficulties with sexual function, changes in appetite and weight, changes in taste, ringing in the ears, itchy skin rash, loss of hair, increased sweating If any of these become troublesome, speak with your doctor for advice

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.
  • If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
  • Never take more than the prescribed dose. If you suspect that someone has taken an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.
  • This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
  • Never keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
  • If you have any questions about this medicine ask your pharmacist.

Further reading & references

  • British National Formulary; 62nd Edition (Sep 2011) British Medical Association and Royal Pharmaceutical Society of Great Britain, London

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.

Original Author:
Helen Allen
Current Version:
Peer Reviewer:
Dr Hannah Gronow
Last Checked:
Document ID:
3515 (v23)
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