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QuickView for Nortriptyline (compound)


PubChem
Name: Nortriptyline
PubChem Compound ID: 13468
Description: A metabolite of AMITRIPTYLINE that is also used as an antidepressive agent. Nortriptyline is used in major depression, dysthymia, and atypical depressions.
Molecular formula: C19H22ClN
Molecular weight: 299.837 g/mol
Synonyms:
Nortriptyline hydrochloride [USAN:JAN]; 5H-Dibenzo(a,d)cycloheptene-delta(sup 5),gamma-propylamine, 10-11-dihydro-N-methyl-, hydrochloride; Vividyl; Ateben hydrochloride; Altilev; Nortab hydrochloride; Noritren; Desmethylamitriptyline hydrochloride; 5-(3-(Methylamino)propylidene)dibenzo(a,e)cyclohepta(1,5)diene hydrochloride; HSDB 3371.
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DrugBank
Identification
Name: Nortriptyline
Name (isomeric): DB00540
Drug Type: small molecule
Description: A metabolite of AMITRIPTYLINE that is also used as an antidepressive agent. Nortriptyline is used in major depression, dysthymia, and atypical depressions.
Brand: Sesaval, Allegron, Avantyl, Sensaval, Desmethylamitriptyline, Sensival Ventyl, Noramitriptyline, Nortriptyline Hcl, Noritren, Acetexa, Amitryptyline, Demethyl-, Altilev, Nortrilen, Norzepine, Demethylamitryptyline, Demethylamitriptylene, Ateben, Desitriptilina, Nortryptiline, Demethylamitriptyline, Psychostyl, Lumbeck, Vividyl, AVENTYL HCL, PAMELOR
Category: Norepinephrine-Reuptake Inhibitors, Antidepressants, Adrenergic Uptake Inhibitors, Antidepressive Agents, Tricyclic
CAS number: 72-69-5
Pharmacology
Indication: For the treatment of depression, chronic pain, irritable bowel syndrome, sleep disorders, diabetic neuropathy, agitation and insomnia, and migraine prophylaxis.
Pharmacology: Similar to protriptyline, nortriptyline is a tricyclic antidepressant of the dibenzocycloheptene type and is the active metabolite of amitriptyline.
Mechanism of Action: It is believed that nortriptyline either inhibits the reuptake of the neurotransmitter serotonin at the neuronal membrane or acts at beta-adrenergic receptors. Tricyclic antidepressants do not inhibit monoamine oxidase nor do they affect dopamine reuptake.
Absorption: Well absorbed from the GI tract. Peak plasma concentrations occur 7-8.5 hours following oral administration.
Protein binding: Highly protein-bound in plasma and tissues.
Biotransformation: Undergoes hepatic metabolism via the same pathway as other TCAs.
Route of elimination: Approximately one-third of a single orally administered dose is excreted in urine within 24 hours. Small amounts are excreted in feces via biliary elimination.
Half Life: 16 to 90+ hours
Toxicity: Symptoms of overdose include cardiac dysrhythmias, severe hypotension, shock, congestive heart failure, pulmonary edema, convulsions, and CNS depression, including coma. Changes in the electrocardiogram, particularly in QRS axis or width, are clinically significant indicators of tricyclic antidepressant toxicity. Side effects include: sedation, hypotension, blurred vision, dry mouth, constipation, urinary retention, postural hypotension, tachycardia, hypertension, ECG changes, heart failure, impaired memory and delirium, and precipitation of hypomanic or manic episodes in bipolar depression. Withdrawal symptoms include gastrointestinal disturbances, anxiety, and insomnia.
Affected organisms: Humans and other mammals
Interactions
Food interaction:
Avoid alcohol.
Take with food to reduce irritation.
Avoid excessive quantities of coffee or tea (caffeine).
Drug interaction:
GrepafloxacinIncreased risk of cardiotoxicity and arrhythmias
DuloxetinePossible increase in the levels of this agent when used with duloxetine
SparfloxacinIncreased risk of cardiotoxicity and arrhythmias
AtazanavirAtazanavir may increase the effect and toxicity of the tricyclic antidepressant, nortriptyline, by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of nortriptyline if atazanavir if initiated, discontinued or dose changed.
FluconazoleFluconazole may increase the effect and toxicity of the tricyclic antidepressant, nortriptyline, by decreasing its metabolism. Additive QTc-prolonging effects may also occur. Monitor for changes in the therapeutic and adverse effects of nortriptyline if fluconazole is initiated, discontinued or dose changed. Monitor for the development of torsades de pointes during concomitant therapy.
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