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protriptyline

Pronunciation: proe TRIP ti leen

Brand: Vivactil

What is the most important information I should know about protriptyline?

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You should not take this medication if you have recently had a heart attack, or if you are allergic to protriptyline or to similar antidepressants such as amitriptyline, amoxapine, clomipramine, desipramine, doxepin, imipramine, nortriptyline, or trimipramine.

Do not use protriptyline if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include furazolidone, isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

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Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

What is protriptyline?

Protriptyline is a tricyclic antidepressant. Protriptyline affects chemicals in the brain that may become unbalanced.

Protriptyline is used to treat symptoms of depression.

Protriptyline may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking protriptyline?

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You should not take this medication if you have recently had a heart attack, or if you are allergic to protriptyline or to similar antidepressants such as amitriptyline, amoxapine, clomipramine, desipramine, doxepin, imipramine, nortriptyline, or trimipramine.

Do not use protriptyline if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include furazolidone, isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

To make sure protriptyline is safe for you, tell your doctor if you have:

  • heart disease, or a history of heart attack, stroke, or seizures;
  • bipolar disorder (manic-depression);
  • schizophrenia or other mental illness;
  • liver disease;
  • a thyroid disorder;
  • diabetes (protriptyline may raise or lower blood sugar); or
  • problems with urination.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using protriptyline. Your family or other caregivers should also be alert to changes in your mood or symptoms.

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It is not known whether protriptyline will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

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It is not known whether protriptyline passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Older adults may be more likely to have side effects from this medication.

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Do not give this medicine to a child without medical advice.

How should I take protriptyline?

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

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If you need surgery, tell the surgeon ahead of time that you are using protriptyline. You may need to stop using the medicine for a short time.

Do not stop using protriptyline suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using protriptyline.

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It may take a few weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve during treatment.

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Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

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Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of protriptyline can be fatal.

What should I avoid while taking protriptyline?

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Do not drink alcohol. Protriptyline can increase the effects of alcohol, which could be dangerous.

Grapefruit and grapefruit juice may interact with protriptyline and lead to unwanted side effects. Discuss the use of grapefruit products with your doctor.

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This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

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Avoid exposure to sunlight or tanning beds. Protriptyline can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

What are the possible side effects of protriptyline?

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Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

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Call your doctor at once if you have:

  • a feeling that you might pass out;
  • new or worsening chest pain, pounding heartbeats or fluttering in your chest;
  • sudden numbness or weakness, problems with vision, speech, or balance;
  • fever;
  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;
  • confusion, hallucinations, unusual thoughts or behavior;
  • restless muscle movements in your eyes, tongue, jaw, or neck;
  • painful or difficult urination;
  • seizure (convulsions); or
  • jaundice (yellowing of the skin or eyes).

Common side effects may include:

  • tingly feeling, weakness, lack of coordination;
  • nausea, vomiting, loss of appetite, constipation, diarrhea;
  • dry mouth, blurred vision, ringing in your ears;
  • breast swelling (in men or women); or
  • decreased sex drive, impotence, or difficulty having an orgasm.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect protriptyline?

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Taking protriptyline with other drugs that make you sleepy or slow your breathing can increase these effects. Ask your doctor before taking protriptyline with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Before taking protriptyline, tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, or sertraline.

You must wait at least 5 weeks after stopping fluoxetine (Prozac) before you can take protriptyline.

Many drugs can interact with protriptyline. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with protriptyline, especially:

  • bupropion;
  • cimetidine;
  • quinidine;
  • St. John's wort;
  • terbinafine;
  • any other anti-depressant, or medication to treat mental illness;
  • bladder or urinary medicines such as darifenacin, fesoterodine, oxybutynin, tolterodine, solifenacin;
  • bronchodilators such as ipratropium or tiotropium;
  • cold or allergy medicine that contains an antihistamine;
  • medication for Parkinson's disease;
  • medication to treat excess stomach acid, stomach ulcer, motion sickness, or irritable bowel syndrome;
  • a decongestant (pseudoephedrine, phenylephrine), diet pills, stimulant medication; or
  • the heart rhythm medications flecainide, propafenone, or quinidine.

This list is not complete and many other drugs can interact with protriptyline. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

Where can I get more information?

Your pharmacist has information about protriptyline written for health professionals that you may read.


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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