Select therapeutic use:
Indications for NORPRAMIN:
100–200mg daily in single or divided doses; max 300mg/day. Hospitalize initially if dose is 300mg/day; monitor ECG. Elderly and adolescents: 25–100mg daily in single or divided doses; max 150mg/day.
During or within 14 days of MAOIs. Concomitant linezolid or IV methylene blue. Acute post-MI.
Suicidality and antidepressant drugs.
Increased risk of suicidal thinking and behavior in children, adolescents and young adults; monitor for clinical worsening and unusual changes. Monitor for emergence of serotonin syndrome; discontinue if occurs. Screen for bipolar disorder. Psychosis. Mania/hypomania. Cardiovascular disease. Family history of sudden death, cardiac dysrhythmias or conduction disturbances. Urinary retention. Angle-closure glaucoma. Epilepsy. ECT. Hyperthyroidism. Diabetes. Hepatic or renal dysfunction. Perform leukocyte and differential counts if fever and sore throat develop; discontinue if neutrophil depression occurs. Discontinue before surgery. Write ℞ for smallest practical amount. Elderly. Pregnancy. Nursing mothers.
See Contraindications. Increased risk of serotonin syndrome with other serotonergic drugs (eg, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, St. John's Wort) or with drugs that impair serotonin metabolism (eg, MAOIs, linezolid, IV methylene blue). Potentiates alcohol, anticholinergics, sympathomimetics, benzodiazepines, other CNS depressants. Potentiated by CYP2D6 inhibitors; monitor plasma levels with cimetidine, SSRIs, phenothiazines, type 1C antiarrhythmics (eg, quinidine, propafenone, flecainide). Antagonized by barbiturates, carbamazepine. Paralytic ileus, hyperpyrexia with anticholinergics. Blocks guanethidine. Possible cardiotoxicity with concomitant thyroid medications.
Drowsiness, anticholinergic effects, arrhythmias, extrapyramidal symptoms, hypo- or hypertension, nausea, fatigue, rash, hyperhidrosis, headache, changes in blood sugar, photosensitivity, edema, blood dyscrasias, jaundice.
Tabs 10mg, 25mg, 50mg, 75mg, 100mg—100; 150mg—50