Patient/caregiver was instructed on precautions to be exercised while taking nortriptyline as follows:
- As the balance between the chemicals in the brain has to be finely regulated to help relieve the anxiety and depressive symptoms and experience feelings of well-being, the dose of nortriptyline also needs to be finely regulated, in order to accomplish this goal. Your physician could change the dose of nortriptyline, based on the response and side-effects developed. Maintain compliance with follow-up physician appointments and be accommodative to the plan of dose changes, until you show an optimum response.
- Notify your doctor of any unresolved and worsening anxiety and depressive symptoms or continuing unpleasant side-effects, so that, your dosage on the medication could be revised.
- Nortriptyline use in expectant mothers could increase risk for pregnancy complications, such as, miscarriage. Newborns can also present with harmful side-effects of the medication. Nortriptyline can cross the placenta and enter the baby. Newborns exposed to nortriptyline in the uterus can present with harmful side-effects of the medication, such as, respiratory depression, breathing difficulties, developmental delays, and other toxicity with the medication. After birth, newborns could also demonstrate symptoms of sudden withdrawal from the medication and present with listlessness, lack of energy, sleep disturbances, appetite changes, feeding difficulties, and seizures. So, nortriptyline is cautiously administered with careful monitoring or avoided for an alternative drug during pregnancy and in women planning for pregnancy. Women in the child-bearing age group taking nortriptyline must employ effective contraceptive measures in order to avoid getting pregnant.
- Blood work, labs for liver and kidney function could be periodically ordered while taking nortriptyline. Observe compliance with all physician visits and periodical lab draws ordered, for an update on improvement/deterioration with symptoms of mood disorder and side-effects developed. This will also allow your physician to make appropriate changes in your plan of care, as needed.
