Brand name:

Norpramin

Why is Norpramin prescribed?

Norpramin is used in the treatment of depression. It is one of a family of drugs called tricyclic antidepressants. Drugs in this class are thought to work by affecting the levels of the brain's natural chemical messengers (called neurotransmitters), and adjusting the brain's response to them.

Norpramin has also been used to treat bulimia and attention deficit disorders, and to help with cocaine withdrawal.

Most important fact about Norpramin

Serious, sometimes fatal, reactions have been known to occur when drugs such as Norpramin are taken with another type of antidepressant called an MAO inhibitor. Drugs in this category include Nardil and Parnate. Do not take Norpramin within two weeks of taking one of these drugs. Make sure your doctor and pharmacist know of all Norpramins you are taking.

How should you take Norpramin?

Norpramin should be taken exactly as prescribed.

Do not stop taking Norpramin if you feel no immediate effect. It can take up to 2 or 3 weeks for improvement to begin.

Norpramin can cause dry mouth. Sucking hard candy or chewing gum can help this problem.

--If you miss a dose...

If you take several doses per day, take the forgotten dose as soon as you remember, then take any remaining doses for the day at evenly spaced intervals. If you take Norpramin once a day at bedtime and don't remember until morning, skip the missed dose. Never try to "catch up" by doubling the dose.

--Storage instructions...

Norpramin can be stored at room temperature. Protect it from excessive heat.

Norpramin side effects

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Norpramin.

• Side effects may include:
  Anxiety, confusion, dizziness, dry mouth, frequent urination or problems urinating, high blood pressure, hallucinations, hives, impaired coordination, irregular heartbeat, low blood pressure, numbness, rapid heartbeat, sensitivity to sunlight, sex drive changes, tingling, tremors

Why should Norpramin not be prescribed?

Norpramin should not be used if you are known to be hypersensitive to it, or if you have had a recent heart attack.

People who take antidepressant drugs known as MAO inhibitors (including Nardil and Parnate) should not take Norpramin.

Special warnings about Norpramin

In clinical studies, antidepressants increased the risk of suicidal thinking and behavior in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of Norpramin or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Norpramin has not been studied in children.

Additionally, the progression of major depression is associated with a worsening of symptoms and/or the emergence of suicidal thinking or behavior in both adults and children, whether or not they are taking antidepressants. Individuals being treated with Norpramin and their caregivers should watch for any change in symptoms or any new symptoms that appear suddenly--especially agitation, anxiety, hostility, panic, restlessness, extreme hyperactivity, and suicidal thinking or behavior--and report them to the doctor immediately. Be especially observant at the beginning of treatment or whenever there is a change in dose.

Before using Norpramin, tell your doctor if you have heart or thyroid disease, a seizure disorder, a history of being unable to urinate, or glaucoma.

Nausea, headache, and uneasiness can result if you suddenly stop taking Norpramin. Consult your doctor and follow instructions closely when discontinuing Norpramin.

This drug may impair your ability to drive a car or operate potentially dangerous machinery. Do not participate in any activities that require full alertness if you are unsure about your ability.

Norpramin may increase your skin's sensitivity to sunlight. Overexposure could cause rash, itching, redness, or sunburn. Avoid direct sunlight or wear protective clothing.

If you are planning to have elective surgery, make sure that your doctor is aware that you are taking Norpramin. It should be discontinued as soon as possible prior to surgery.

Tell your doctor if you develop a fever and sore throat while you are taking Norpramin. He may want to do some blood tests.

Possible food and drug interactions when taking Norpramin

People who take antidepressant drugs known as MAO inhibitors (including Nardil and Parnate) should not take Norpramin.

If Norpramin is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Norpramin with the following:

Cimetidine (Tagamet)
Drugs that improve breathing, such as Proventil
Drugs that relax certain muscles, such as Bentyl
Fluoxetine (Prozac)
Guanethidine (Ismelin)
Paroxetine (Paxil)
Sedatives/hypnotics (Halcion, Valium)
Sertraline (Zoloft)
Thyroid medications (Synthroid)

Extreme drowsiness and other potentially serious effects can result if Norpramin is combined with alcohol or other depressants, including narcotic painkillers such as Percocet and Demerol, sleeping medications such as Halcion and Nembutal, and tranquilizers such as Valium and Xanax.

Special information if you are pregnant or breastfeeding

Pregnant women or mothers who are nursing an infant should use Norpramin only when the potential benefits clearly outweigh the potential risks. If you are pregnant or planning to become pregnant, inform your doctor immediately.

Recommended dosage for Norpramin

Your doctor will tailor the dose to your individual needs.

ADULTS

Overdosage

Any medication taken in excess can have serious consequences. An overdosage of Norpramin can be fatal. If you suspect an overdose, seek medical help immediately.

• Symptoms of overdose may include:
  Agitation, coma, confusion, convulsions, dilated pupils, disturbed concentration, drowsiness, extremely low blood pressure, hallucinations, high fever, irregular heart rate, low body temperature, overactive reflexes, rigid muscles, stupor, vomiting