Primox Tablets

Generic Nortriptyline Hydrochloride (Primox tablets) - Product Information

Nortriptyline Hydrochloride (Primox tablets) is used for the relief of symptoms of depression. Endogenous depressions are more likely to be alleviated than are other depressive states.
Nortriptyline hydrochloride is also indicated for the treatment of nicotine dependence as an aid to smoking cessation.
We also have in stock Generic Olanzapine Tablets (Oleanz) are used for the treatment of mental illness such as bipolar disorder, depression, and schizophrenia in adults and adolescents who are at least 13 years old.

Name of the Drug

Primox tablets.

Manufacturer of Primox Tablets

Sun Pharmaceutical Industries Limited, India  
Website: www.sunpharma.com

Active Pharmaceutical Ingredient

The active ingredient present in Primox tablets is Nortriptyline Hydrochloride.
Each Primox tablet, for oral administration, contains Nortriptyline Hydrochloride, USP equivalent to 25 mg of Nortriptyline.

Uses of Primox Tablets

Nortriptyline hydrochloride is indicated for the relief of symptoms of depression. Endogenous depressions are more likely to be alleviated than are other depressive states. Nortriptyline is also used for treating nerve pain and bedwetting in children (nocturnal enuresis). Nortriptyline hydrochloride is also indicated for the treatment of nicotine dependence as an aid to smoking cessation.

Generic Nortriptyline Hydrochloride (Primox tablets) - Dosage

Generic Nortriptyline Hydrochloride tablets should be administered exactly as suggested by your doctor. Your doctor may recommend a dosage of Primox tablets depending on your age, medical requirement, body weight, other medical conditions, and current medications.
The dose of this medicine will be different for different patients. The following dosing information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
Usual Adult Dose –
25 mg three or four times daily; dosage should begin at a low level and be increased as required. As an alternate regimen, the total daily dosage may be given once a day.
When doses above 100 mg daily are administered, plasma levels of nortriptyline should be monitored and maintained in the optimum range of 50 to 150 ng/mL. Doses above 150 mg/day are not recommended.
Elderly and Adolescent Patients
– 30 to 50 mg/day, in divided doses, or the total daily dosage may be given once a day.
Switching a Patient To or From a Monoamine Oxidase Inhibitor (MAOI) Intended to Treat Psychiatric Disorders
At least 14 days should elapse between discontinuation of an MAOI intended to treat psychiatric disorders and initiation of therapy with Pamelor. Conversely, at least 14 days should be allowed after stopping Pamelor before starting an MAOI intended to treat psychiatric disorders.
Primox tablets work effectively if the amount of Nortriptyline Hydrochloride is maintained at a constant level in the body. You should be systematic about the daily schedule for the medication such that you take tablets at about the same time every day, to get the maximum benefit of the medication. Continue taking tablets without missing any doses for the recommended treatment period and do not stop the treatment suddenly even if you feel better.

Please consult your doctor for exact dosing instructions. Primox tablets (Generic Nortriptyline Hydrochloride tablets) should be administered in the dose prescribed by the doctor and for the duration recommended by the doctor.

Missed Dose

If you forget to take your regular Primox tablet dose on time, take it whenever you remember.
If you remember the next day, skip the missed dose and take your scheduled dose. Do not take a double dose to compensate the missed dose.

Nortriptyline Hydrochloride Mechanism of Action – How do Primox Tablets Work?

The mechanism of mood elevation by tricyclic antidepressants such as Nortriptyline Hydrochloride is at present unknown. Nortriptyline hydrochloride is not a monoamine oxidase inhibitor. It inhibits the activity of such diverse agents as histamine, 5-hydroxytryptamine, and acetylcholine. It increases the pressor effect of norepinephrine but blocks the pressor response of phenethylamine.
Studies suggest that Nortriptyline Hydrochloride interferes with the transport, release, and storage of catecholamines. Operant conditioning techniques in rats and pigeons suggest that Nortriptyline Hydrochloride has a combination of stimulant and depressant properties.

Storage Instructions for Primox Tablets

Store Primox tablets at controlled room temperature (20°C to 25°C),protected from heat, moisture, and sunlight. Excursions are permitted from 15°C to 30°C.
Retain the original packing of the medication and do not consume past its expiration date printed on the blister pack. Keep the pack of generic Nortriptyline Hydrochloride tablets away from the reach of children and pets. Do not dispose along with domestic waste or sewage. Consult your doctor or pharmacist about the correct method of disposal.

Contraindications

Primox tablets are contraindicated in patients with a hypersensitivity to Nortriptyline Hydrochloride or any inactive ingredient present in tablets. Primox tablets are also contraindicated in the following cases:
The use of MAOIs intended to treat psychiatric disorders with Nortriptyline Hydrochloride or within 14 days of stopping treatment with Nortriptyline Hydrochloride is contraindicated because of an increased risk of serotonin syndrome. The use of nortriptyline hydrochloride within 14 days of stopping an MAOI intended to treat psychiatric disorders is also contraindicated
Cross-sensitivity between Nortriptyline hydrochloride and other dibenzazepines is a possibility.
Myocardial Infarction: Nortriptyline hydrochloride is contraindicated during the acute recovery period after myocardial infarction.

Overdose

Overdose of tricyclic antidepressants may manifest with doses as small as 50 mg in a child.
Symptoms of overdose of tricyclic antidepressants may begin within several hours of oral ingestion. Symptoms and signs may include blurred vision, confusion, restlessness, dizziness, hypothermia, hyperthermia, agitation, vomiting, hyperactive reflexes, dilated pupils, fever, rapid heart rate, decreased bowel sounds, dry mouth, inability to void, myoclonic jerks, seizures, respiratory depression, myoglobinuric renal failure, nystagmus, ataxia, dysarthria, choreoathetosis, coma, hypotension, and cardiac arrhythmias.
An effect on cardiac conduction, similar to that of quinidine, may be seen with slowing of conduction, prolongation of the QRS complex and QT intervals, right bundle branch and AV block, ventricular tachyarrhythmias (including Torsade de pointes and fibrillation), and death. In managing overdose, consider the possibility of multiple drug overdose, interactions among drugs, and unusual drug kinetics in your patients. Protect the patient's airway and support ventilation and perfusion. Meticulously monitor and maintain, within acceptable limits, the patient's vital signs, blood gases, serum electrolytes, etc.
Absorption of drugs from the gastrointestinal tract may be decreased by giving activated charcoal, which, in many cases, is more effective than emesis or lavage; consider charcoal instead of gastric emptying. Repeated doses of charcoal over time may hasten elimination of some drugs that have been absorbed. Safeguard the patient's airway when employing charcoal. Emesis is contraindicated.

Warnings and Precautions

Clinical Worsening and Suicide Risk
Patients with major depressive disorder (MDD), both adult and pediatric, may experience worsening of their depression and/or the emergence of suicidal ideation and behavior (suicidality) or unusual changes in behavior, whether or not they are taking antidepressant medications, and this risk may persist until significant remission occurs.
Serotonin Syndrome
The development of a potentially life-threatening serotonin syndrome has been reported with SNRIs and SSRIs, including nortriptyline hydrochloride, alone but particularly with concomitant use of other serotonergic drugs.
Unmasking of Brugada Syndrome
There have been postmarketing reports of an association between treatment with Nortriptyline Hydrochloride and the unmasking of Brugada syndrome. Brugada syndrome is a disorder characterized by syncope, abnormal electrocardiographic (ECG) findings, and a risk of sudden death.
Angle-Closure Glaucoma
The pupillary dilation that occurs following use of many antidepressant drugs including nortriptyline hydrochloride may trigger an angle-closure attack in a patient with anatomically narrow angles who does not have a patent iridectomy.
Use in Pregnancy
Safe use of Nortriptyline Hydrochloride during pregnancy and lactation has not been established; therefore, when the drug is administered to pregnant patients, nursing mothers, or women of childbearing potential, the potential benefits must be weighed against the possible hazards.

Side Effects of Primox Tablets

The side effects of Nortriptyline Hydrochloride (Primox tablets) are given below:

• Cardiovascular - Hypotension, hypertension, tachycardia, palpitation, myocardial infarction, arrhythmias, heart block, stroke.
• Psychiatric - Confusional states (especially in the elderly) with hallucinations, disorientation, delusions; anxiety, restlessness, agitation; insomnia, panic, nightmares; hypomania; exacerbation of psychosis.
• Neurologic - Numbness, tingling, paresthesias of extremities; incoordination, ataxia, tremors; peripheral neuropathy; extrapyramidal symptoms; seizures, alteration in EEG patterns; tinnitus.
• Anticholinergic - Dry mouth and, rarely, associated sublingual adenitis; blurred vision, disturbance of accommodation, mydriasis; constipation, paralytic ileus; urinary retention, delayed micturition, dilation of the urinary tract.
• Allergic - Skin rash, petechiae, urticaria, itching, photosensitization (avoid excessive exposure to sunlight); edema (general or of face and tongue), drug fever, cross-sensitivity with other tricyclic drugs.
• Hematologic - Bone marrow depression, including agranulocytosis; eosinophilia; purpura; thrombocytopenia.
• Gastrointestinal - Nausea and vomiting, anorexia, epigastric distress, diarrhea, peculiar taste, stomatitis, abdominal cramps, black tongue.
• Endocrine - Gynecomastia in the male, breast enlargement and galactorrhea in the female; increased or decreased libido, impotence; testicular swelling; elevation or depression of blood sugar levels; syndrome of inappropriate ADH (antidiuretic hormone) secretion.
• Other - Jaundice (simulating obstructive), altered liver function; weight gain or loss; perspiration; flushing; urinary frequency, nocturia; drowsiness, dizziness, weakness, fatigue; headache; parotid swelling; alopecia.
• Withdrawal Symptoms - Though these are not indicative of addiction, abrupt cessation of treatment after prolonged therapy may produce nausea, headache, and malaise.

Nortriptyline Hydrochloride During Pregnancy and Breastfeeding

Nortriptyline Hydrochloride has been classified by the US FDA as Pregnancy Category C.
Nortriptyline is known to cross the placenta barrier. Safe use of nortriptyline during pregnancy has not been established; therefore, when the drug is administered to pregnant patients, or women of childbearing age, the potential benefits must be weighed against the possible hazards.
Do not use this medicine without your doctor's consent in case you are pregnant. Stop using this medication and inform your doctor immediately if you become pregnant during treatment.
Nortriptyline is present in breast milk. Safe use of nortriptyline during lactation has not been established; therefore, when the drug is administered to nursing mothers, the potential benefits must be weighed against the possible hazards.
Do not use this medication without telling your doctor if you are breast-feeding a baby.

Buy Primox 25 mg (Generic Nortriptyline) Pills Online From Only $0.22 per Pill

You can buy Generic Nortriptyline Hydrochloride online from Everest Online Pharmacy at a cheap price. Primox 25 mg pills, manufactured by Sun Pharmaceutical Industries Ltd., India are supplied in a blister strip of 10 tablets. The 25 mg tablets cost only $0.22 per unit when you place an order for 300 tablets.

Disclaimer

The above information is provided to the best of our knowledge and in good faith. It is without a warrant of any kind, expressed or implied.

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