{"id":4593,"date":"2025-03-31T18:12:13","date_gmt":"2025-03-31T18:12:13","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/nortriptyline-txt\/"},"modified":"2025-03-31T18:12:13","modified_gmt":"2025-03-31T18:12:13","slug":"nortriptyline-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/nortriptyline-txt\/","title":{"rendered":"nortriptyline.txt"},"content":{"rendered":"

CLINICAL USE <\/H3>
\nTricyclic antidepressant

DOSE IN NORMAL RENAL FUNCTION <\/H3>30\u2013150 mg daily in single or divided doses

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :263.4 (299.8 as hydrochloride)<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :95<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : <5<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :15\u201323<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :25\u201338\/15\u201366

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>
  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function. Start with small dose

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR <10 mL\/min <\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in GFR <10 mL\/min
  • HDF\/high flux &nbsp :Unknown dialysability. Dose as in GFR <10 mL\/min
  • CAV\/VVHD &nbsp &nbsp &nbsp:Not dialysed. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugs\n
  • Alcohol: increased sedative effect\n
  • Analgesics: increased risk of CNS toxicity with tramadol; possibly increased risk of side effects with nefopam; possibly increased sedative effects with opioids\n
  • Anti-arrhythmics: increased risk of ventricular arrhythmias with amiodarone \u2013 avoid concomitant use; increased risk of ventricular arrhythmias with drugs that prolong the QT interval; increased risk of arrhythmias with propafenone\n
  • Antibacterials: increased risk of ventricular arrhythmias with moxifloxacin \u2013 avoid concomitant use; concentration reduced by rifampicin\n
  • Anticoagulants: may alter anticoagulant effect of coumarins\n
  • Antidepressants: enhanced CNS excitation and hypertension with MAOIs and moclobemide \u2013 avoid concomitant use; concentration possibly increased with SSRIs\n
  • Anti-epileptics: convulsive threshold lowered; concentration reduced by carbamazepine, primidone, barbiturates and possibly phenytoin\n
  • Antimalarials: avoid concomitant use with artemether\/lumefantrine\n
  • Antipsychotics: increased risk of ventricular arrhythmias especially with pimozide; increased antimuscarinic effects with clozapine and phenothiazines; concentration increased by antipsychotics\n
  • Antivirals: increased TAD side effects with amprenavir; concentration possibly increased with ritonavir\n
  • Atomoxetine: increased risk of ventricular arrhythmias and possibly convulsions\n
  • Beta-blockers: increased risk of ventricular arrhythmias with sotalol\n
  • Clonidine: tricyclics antagonise hypotensive effect; increased risk of hypertension on clonidine withdrawal\n
  • Dopaminergics: avoid use with entacapone; CNS toxicity reported with selegiline and rasagiline\n
  • Pentamidine: increased risk of ventricular arrhythmias\n
  • Sibutramine: increased risk of CNS toxicity \u2013 avoid concomitant use\n
  • Sympathomimetics: increased risk of hypertension and arrhythmias with adrenaline and noradrenaline; metabolism possibly inhibited by methylphenidate

    ADMINISTRATION <\/H3>

    Reconstition<\/H4>\u2013

    Route <\/H4>Oral

    Rate of Administration <\/H4>\u2013

    Comments<\/H4>\u2013

    OTHER INFORMATION <\/H4>All metabolites are highly lipophilic .
    \n","protected":false},"excerpt":{"rendered":"

    CLINICAL USE Tricyclic antidepressant DOSE IN NORMAL RENAL FUNCTION 30\u2013150<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-4593","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4593","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=4593"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4593\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=4593"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=4593"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=4593"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}