Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets)

1. Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets) © The Swiss Pharmacy

2. Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets) Sensival (Generic Nortriptyline Hydrochloride Tablets) are used to treat mental/mood problems such as depression. It may help improve mood and feelings of well-being, relieve anxiety and tension, and increase your energy level. Sensival may also be used for the treatment of some cases of nocturnal enuresis. © The Swiss Pharmacy

3. Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets) Sensival Tablets are manufactured by Wallace Pharma Limited, India in the strengths of 25 mg. © The Swiss Pharmacy

4. Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets) Chemical Structure © The Swiss Pharmacy

5. Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets) The active ingredient contained in Sensival tablets is Nortriptyline Hydrochloride. Each film-coated Sensival tablet contains Nortriptyline Hydrochloride equivalent to 25 mg of Nortriptyline. © The Swiss Pharmacy

6. Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets) Uses of Sensival 25 mg Tablets: Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets) is used to treat mental/mood problems such as depression. It could help improve mood and feelings of well-being, relieve anxiety and tension, and increase your energy level. This medication belongs to a class of medications called tricyclic antidepressants. Nortriptyline works on your central nervous system to increase the level of certain chemicals in your brain. This helps relieve your depression. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html © The Swiss Pharmacy

7. Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets) Recommended Adult Dosage For most patients, the dose of Sensival Tablets Nortriptyline Hydrochloride Tablets) is 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. Sensival Tablets (Generic URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html © The Swiss Pharmacy

8. Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets) Warnings Great care is required if Nortriptyline is administered to hyperthyroid patients or those receiving thyroid medication, because cardiac arrhythmias may develop. A major depressive episode may be the initial presentation of bipolar disorder. It is generally believed (though not established in controlled trials) that treating such an episode with an antidepressant alone may increase the likelihood of precipitation of a mixed/manic episode in patients at risk for bipolar disorder. 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. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html © The Swiss Pharmacy

9. Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets) Recommended Dosage - Elderly and Adolescent Patients For elderly and adolescent patients the dose of Sensival is 30 to 50 mg/day, in divided doses, or the total daily dosage may be given once a day. Nortriptyline Hydrochloride is not recommended for children. Nortriptyline tablets are administered orally. Lower than usual dosages are recommended for elderly patients and adolescents. Lower dosages are also recommended for outpatients than for hospitalized patients. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html © The Swiss Pharmacy

10. Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets) Contraindications ➔Sensival is contraindicated in patients with a known hypersensitivity to Nortriptyline Hydrochloride, Tricyclic Antidepressants, or any component of the tablet. ➔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. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html © The Swiss Pharmacy

11. Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets) Contraindications ➔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. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html © The Swiss Pharmacy

12. Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets) Storage Instructions Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets) have to be stored at controlled room temperature i.e. from 20°C to 25°C (68°F to 77°F) with excursions permitted between 15° to 30°C (59° to 86°F). Keep this as well as all other medicines away from children and pets. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html © The Swiss Pharmacy

13. Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets) Warnings 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. Suicide is a known risk of depression and certain other psychiatric disorders, and these disorders themselves are the strongest predictors of suicide. There has been a long-standing concern, however, that antidepressants may have a role in inducing worsening of depression and the emergence of suicidality in certain patients during the early phases of treatment. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html © The Swiss Pharmacy

14. Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets) Warnings Patients with cardiovascular disease should be given Nortriptyline only under close supervision because of the tendency of the drug to produce sinus tachycardia and to prolong the conduction time. Myocardial infarction, arrhythmia and strokes have occurred. The antihypertensive action of guanethidine and similar agents may be blocked. Because of its anticholinergic activity, use Sensival tablets (Nortriptyline) with great caution in patients with glaucoma or a history of urinary retention. Patients with a history of seizures should be followed closely when Sensival (Nortriptyline Hydrochloride Tablets) is administered because this drug is known to lower the convulsive threshold. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html © The Swiss Pharmacy

15. Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets) Warnings There have been postmarketing reports of an association between treatment with Nortriptyline Hydrochloride tablets and the unmasking of Brugada syndrome. Brugada syndrome is a disorder characterized by syncope, abnormal electrocardiographic (ECG) findings, and a risk of sudden death. The pupillary dilation that occurs following use of many antidepressant drugs including Nortriptyline Hydrochloride tablets may trigger an angle-closure attack in a patient with anatomically narrow angles who does not have a patent iridectomy. Nortriptyline may impair the mental and/or physical abilities required for the performance of hazardous tasks, such as operating machinery or driving a car; therefore, the patient should be warned accordingly. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html © The Swiss Pharmacy

16. Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets) Sensival Tablets and Alcohol Sensival tablets may make you dizzy or drowsy or blur your vision. Alcohol can make you more dizzy or drowsy. Limit alcoholic beverages. Excessive consumption of alcohol in combination with Nortriptyline therapy may have a potentiating effect, which may lead to the danger of increased suicidal attempts or overdosage, especially in patients with histories of emotional disturbances or suicidal ideation. The patient should be informed that the response to alcohol may be exaggerated. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html © The Swiss Pharmacy

17. Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets) Driving or Operating Machinery Some people feel sleepy while they're taking Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets). It's best to stop driving, cycling or operating machinery for the first few days and after each dose increase, until you know how this medicine makes you feel. Nortriptyline Hydrochloride tablets may cause some people to become drowsy. If this occurs, do not drive, use machines, or do anything else that could be dangerous if you are not alert. Dizziness, lightheadedness, or fainting may occur, especially when you get up from a lying or sitting position. Getting up slowly may help. If this problem continues or gets worse, check with your doctor. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html © The Swiss Pharmacy

18. Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets) Possible Side Effects Side effects of Sensival (Nortriptyline Hydrochloride 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. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html © The Swiss Pharmacy

19. Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets) Possible Side Effects 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. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html © The Swiss Pharmacy

20. Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets) Possible Side Effects 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. Postmarketing Experience: Cardiac Disorders - Brugada syndrome Eye Disorders – angle-closure glaucoma URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html © The Swiss Pharmacy

21. Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets) Sensival Tablets Overdosage 50mg of a tricyclic antidepressant can be an overdose in a child. Of patients who are alive at presentation, mortality of 0-15% has been reported. Symptoms may begin within several hours and 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. Cardiac conduction may be slowed, with prolongation of QRS complex and QT intervals, right bundle branch and AV block, ventricular tachyarrhythmias (including Torsade de pointes and fibrillation) and death. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html © The Swiss Pharmacy

22. Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets) Treatment of Sensival Tablets Overdosage Symptomatic and supportive therapy is recommended. Activated charcoal may be more effective than emesis or lavage to reduce absorption. Ventricular arrhythmias, especially when accompanied by lengthened QRS intervals, may respond to alkalinisation by hyperventilation or administration of sodium bicarbonate. Serum electrolytes should be monitored and managed. Refractory arrhythmias may respond to propranolol, bretylium or lignocaine. Quinidine and procainamide usually should not be used because they may exacerbate arrhythmias and conduction already slowed by the overdose. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html © The Swiss Pharmacy

23. Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets) Sensival Tablets During Pregnancy Nortriptyline Hydrochloride (Sensival Tablets) has been classified by the AU FDA as Pregnancy Category C. The safety of Nortriptyline Hydrochloride (Sensival Tablets) for use during pregnancy has not been established, nor is there evidence from animal studies that it is free from hazard; therefore the drug should not be administered to pregnant patients or women of childbearing age unless the potential benefits clearly outweigh any potential risk. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html © The Swiss Pharmacy

24. Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets) Sensival Tablets Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets) are manufactured by Wallace Pharma Limited, India. URL: URL: https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html © The Swiss Pharmacy