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|Norpramin

Norpramin

Norpramin is used for:

Treating depression. It may be also be used for other conditions as determined by your doctor.

Norpramin is a tricyclic antidepressant. Exactly how it works is not fully understood. It is thought to increase the activity of certain chemicals in the brain (norepinephrine, serotonin), which help elevate mood.

Do NOT use Norpramin if:

• you are allergic to any ingredient in Norpramin
• you are taking astemizole, cisapride, dofetilide, guanethidine, H₁ antagonists (eg, diphenhydramine), pimozide, quinolones (eg, ciprofloxacin), or terfenadine, or have taken a monoamine oxidase (MAO) inhibitor (eg, phenelzine) within the last 14 days
• you are recovering from a heart attack

Contact your doctor or health care provider right away if any of these apply to you.

Before using Norpramin :

Some medical conditions may interact with Norpramin . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have a history of glaucoma or increased pressure in the eye, an enlarged prostate, problems urinating, heart problems, alcoholism, a history of seizures (eg, epilepsy), an overactive thyroid, suicidal thoughts or tendencies, or porphyria (a blood disease)

Some MEDICINES MAY INTERACT with Norpramin . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Anticholinergics (eg, oxybutynin, scopolamine), benzodiazepines (eg, alprazolam), or cimetidine because the effectiveness of Norpramin may be decreased
• Arsenic, benzodiazepines (eg, alprazolam), bupropion, carbamazepine, cimetidine, cisapride, diltiazem, disulfiram, dofetilide, droperidol, erythromycin, fluconazole, H₁ antagonists (eg, diphenhydramine), HIV protease inhibitors (eg, ritonavir), labetalol, lithium, mibefradil,MAO inhibitors (eg, phenelzine), phenothiazine (eg, thioridazine), pimozide, propafenone, quinine derivatives, quinolones (eg, ciprofloxacin), serotonin norepinephrine reuptake inhibitors (eg, atomoxetine), selective serotonin reuptake inhibitors (eg, fluoxetine), terbinafine, thyroid hormones (eg, levothyroxine), or verapamil because side effects, such as sedation and low blood pressure, may occur
• Anticoagulants (eg, warfarin), arsenic, carbamazepine, cisapride, clonidine, dofetilide, droperidol, galantamine, H₁ antagonists (eg, diphenhydramine), levodopa, lithium, MAO inhibitors (eg, phenelzine), phenothiazine (eg, thioridazine), pimozide, quinolones (eg, ciprofloxacin), sympathomimetics (eg, albuterol, amphetamine, pseudoephedrine), terfenadine, thyroid hormones (eg, levothyroxine), or tramadol because the actions and side effects of these medicines may be increased
• Clonidine, guanethidine , guanfacine, levodopa, methyldopa, or sympathomimetics (eg, albuterol, amphetamine, pseudoephedrine) because the effectiveness of these medicines may be decreased
• Furazolidone because an effect (toxic psychosis) not expected from either medicine may occur

This may not be a complete list of all interactions that may occur. Ask your health care provider if Norpramin may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Norpramin :

Use Norpramin as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Norpramin comes with an additional patient information sheet called a Medication Guide. Read it carefully and reread it each time you get Norpramin refilled.
• Norpramin may be taken with or without food.
• Do not eat grapefruit or drink grapefruit juice while taking Norpramin .
• Diets high in fiber may decrease the effectiveness of Norpramin . Talk with your doctor about the proper amount of fiber to consume.
• Take Norpramin 1 hour before or 6 hours after cholestyramine if you are taking both medicines.
• If you are switching from fluoxetine to Norpramin , you may need to discontinue fluoxetine for up to 5 weeks before starting Norpramin . Ask your doctor if you have any questions.
• Taking Norpramin at bedtime may help reduce side effects such as daytime drowsiness. Discuss this possibility with your health care provider.
• Continue to take Norpramin even if you feel well. Do not miss any doses.
• If you miss a dose of Norpramin , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. If you take 1 dose daily at bedtime, do not take missed dose the next morning.

Ask your health care provider any questions you may have about how to use Norpramin .

Important safety information:

• Norpramin may cause drowsiness, dizziness, blurred vision, or lightheadedness. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Norpramin . Using Norpramin alone, with certain other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.
• Limit your alcohol consumption while you are taking Norpramin . Norpramin will add to the effects of alcohol and other depressants. Ask your pharmacist if you have questions about which medicines are depressants.
• Norpramin may cause dizziness, lightheadedness, or fainting. Alcohol, hot weather, exercise, and fever can increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Also, sit or lie down at the first sign of dizziness, lightheadedness, or weakness.
• Norpramin may cause increased sensitivity to the sun. Avoid exposure to the sun, sunlamps, or tanning booths until you know how you react to Norpramin . Use a sunscreen or protective clothing if you must be outside for a prolonged period.
• Do not become overheated in hot weather or during exercise or other activities because heatstroke may occur.
• After you start using Norpramin , several weeks may pass before you feel the full benefit.
• Antidepressants can increase suicidal thoughts and actions in some children and teenagers. This risk may be higher in individuals with bipolar illness (also called manic-depressive illness), a family history of bipolar illness, or a history of attempting suicide. Pay close attention to changes in moods or actions, especially if changes occur suddenly. Contact your health care provider right away if any of the following effects occur or worsen: depression, anxiety, restlessness or irritability, panic attacks, thoughts or attempts of suicide, or other unusual changes in behavior or mood.
• Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Norpramin .
• LAB TESTS, including liver function, kidney function, and complete blood cell count, may be performed to monitor your progress or to check for side effects. Be sure to keep all doctor and lab appointments.
• Use Norpramin with caution in the ELDERLY because they may be more sensitive to its effects, especially sleeplessness.
• Norpramin is not recommended for use in CHILDREN. Safety and effectiveness have not been confirmed.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, discuss with your doctor the benefits and risks of using Norpramin during pregnancy. Norpramin is excreted in breast milk. Do not breast feed while taking Norpramin .

If you are on long-term therapy, you may have WITHDRAWAL symptoms (eg, nausea, headache, fatigue) if you suddenly stop taking Norpramin . Do not suddenly stop taking Norpramin or change dosage without asking your pharmacist or doctor first.

Possible side effects of Norpramin :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Black tongue; changes in blood sugar levels; changes in sex drive; changes in taste; confusion; diarrhea; dilated pupils; disorientation; dizziness; drowsiness; dry mouth; enlarged breasts; flushing; headache; heartburn; high blood pressure; increased appetite, especially for sweets; increased eye pressure; nausea; nightmares; numbness; painful ejaculation; pounding in the chest; sensitivity to sunlight; sleeplessness; small red spots under the skin; spontaneous flow of breast milk; stomach cramps; stomach pain; sweating; swelling of the testicles; tingling; tiredness; unpleasant taste; urinary problems, including excessive urination at night; vomiting; weakness; weight gain.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision or other vision changes; chest pain; constipation; delusions; difficulty speaking or swallowing; eye pain; fainting; fast, slow, or irregular heartbeat; hair loss; hallucinations; heart problems;impotence; irritability; loss of balance; mood swings; muscle stiffness; nervousness; restlessness; ringing in the ears; seizures; shakiness; sore throat or fever; twitching of the face or tongue; uncontrolled movements of arms or legs; unusual bleeding or bruising; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include agitation; confusion; drowsiness; dry mouth; enlarged pupils; fast or irregular heartbeat; flushing; loss of consciousness; seizures.

Store Norpramin at room temperature, between 59 and 86 degrees F (15 and 30 degrees C) in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Norpramin out of the reach of children and away from pets.

General information:

• If you have any questions about Norpramin , please talk with your doctor, pharmacist, or other health care provider.
• Norpramin is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Norpramin . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.