Primox Tablets by Sun (Generic Nortriptyline Hydrochloride Tablets)

1. Primox Tablets by Sun (Generic Nortriptyline Hydrochloride Tablets) © Clearsky Pharmacy ( www.clearskypharmacy.biz )

2. Primox Tablets by Sun (Generic Nortriptyline Hydrochloride Tablets) Primox (Generic Nortriptyline Hydrochloride Tablets) is used for the relief of symptoms of depression. It may also be used for the treatment of some cases of nocturnal enuresis. It may 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. It works by affecting the balance of certain natural chemicals in the brain. © Clearsky Pharmacy ( www.clearskypharmacy.biz )

3. Primox Tablets by Sun (Generic Nortriptyline Hydrochloride Tablets) Active Ingredient The active ingredient contained in Primox tablets is Nortriptyline Hydrochloride. Each film coated Primox tablet contains Nortriptyline Hydrochloride equivalent to 25 mg of Nortriptyline. © Clearsky Pharmacy ( www.clearskypharmacy.biz )

4. Primox Tablets by Sun (Generic Nortriptyline Hydrochloride Tablets) Chemical Structure The structure of Nortriptyline Hydrochloride is given below: © Clearsky Pharmacy ( www.clearskypharmacy.biz )

5. Primox Tablets by Sun (Generic Nortriptyline Hydrochloride Tablets) Primox Tablets are manufactured by Sun Pharmaceutical Industries Limited, India in strengths of 25 mg. (Website: www.sunpharma.com www.sunpharma.com) URL: URL: https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html © Clearsky Pharmacy ( www.clearskypharmacy.biz )

6. Primox Tablets by Sun (Generic Nortriptyline Hydrochloride Tablets) Nortriptyline Hydrochloride Tablets – Brand Names Nortriptyline Hydrochloride tablets are available as Sensoval, Aventyl, Pamelor, Norpress, Allegron, Noritren, Primox, Sensival, and Nortrilen. URL: URL: https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html © Clearsky Pharmacy ( www.clearskypharmacy.biz )

7. Primox Tablets by Sun (Generic Nortriptyline Hydrochloride Tablets) Uses of Primox Tablets Primox (Generic Nortriptyline Tablets) is used for the relief of symptoms of depression. Endogenous depressions are more likely to be alleviated than are other types of depressive states. Generic Nortriptyline Hydrochloride is also used for the treatment of nicotine dependence as an aid to smoking cessation. Controlled trials have shown that Nortriptyline is an efficacious aid to smoking cessation with a magnitude of effect similar to that for Bupropion and nicotine replacement therapies. (https://pubmed.ncbi.nlm.nih.gov/16085520/) Nortriptyline Hydrochloride is a tricyclic antidepressant that is also occasionally used for treating neuropathic pain. URL: URL: https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html © Clearsky Pharmacy ( www.clearskypharmacy.biz )

8. Primox Tablets by Sun (Generic Nortriptyline Hydrochloride Tablets) Primox Tablets Dosage The dosage of Primox tablets Hydrochloride Tablets) is given below: Usual Adult Dose For the Relief of Symptoms of Depression: Usual Adult Dose For the Relief of Symptoms of Depression: For the treatment of depression the usual adult dose is 25 mg of Generic Nortriptyline 3 or 4 times daily. The dosage should begin at a low level and be increased as required. As an alternate dosage regimen, the total daily dosage may be given once a day. Doses above 100 mg per day are not recommended. Primox tablets (Generic Nortriptyline URL: URL: https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html © Clearsky Pharmacy ( www.clearskypharmacy.biz )

9. Primox Tablets by Sun (Generic Nortriptyline Hydrochloride Tablets) Primox Tablets Dosage Primox tablets (Generic Nortriptyline Hydrochloride Tablets) is given below: As an Aid in Smoking Cessation: As an Aid in Smoking Cessation: Generic Nortriptyline Hydrochloride is administered orally in the form of tablets. The dosing has to be started prior to quit date at 25 mg/day and then increased to 75 mg to 100 mg when feasible over 10 days to 5 weeks. The recommended starting time is 10 days to 28 days prior to the quit date and gradually increase to achieve a maintenance dose of 75 mg to 100 mg/day when possible for a total of up to 12 weeks. The dosage of Primox tablets URL: URL: https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html © Clearsky Pharmacy ( www.clearskypharmacy.biz )

10. Primox Tablets by Sun (Generic Nortriptyline Hydrochloride Tablets) Contraindications Primox is contraindicated in patients hypersensitive to Nortriptyline Hydrochloride or to any other ingredient present in the medication. Use of Primox (Generic Nortriptyline Hydrochloride Tablets) or other tricyclic antidepressants concurrently with a monoamine oxidase (MAO) inhibitor is contraindicated. The MAO inhibitor has to be discontinued for at least two weeks before treatment with Primox tablets (Nortriptyline HCl) is started. Starting Nortriptyline Hydrochloride in a patient who is being treated with MAOIs such as linezolid or intravenous methylene blue is also contraindicated because of an increased risk of serotonin syndrome. URL: URL: https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html © Clearsky Pharmacy ( www.clearskypharmacy.biz )

11. Primox Tablets by Sun (Generic Nortriptyline Hydrochloride Tablets) Contraindications Primox is contraindicated is contraindicated for the treatment of nocturnal enuresis. Primox (Generic Nortriptyline Tablets) is contraindicated during the acute recovery period after myocardial infarction. URL: URL: https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html © Clearsky Pharmacy ( www.clearskypharmacy.biz )

12. Primox Tablets by Sun (Generic Nortriptyline Hydrochloride Tablets) Storage Instructions Primox (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.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html © Clearsky Pharmacy ( www.clearskypharmacy.biz )

13. Primox Tablets by Sun (Generic Nortriptyline Hydrochloride Tablets) Warnings Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of Nortriptyline Hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. 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. URL: URL: https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html © Clearsky Pharmacy ( www.clearskypharmacy.biz )

14. Primox Tablets by Sun (Generic Nortriptyline Hydrochloride Tablets) Warnings A major depressive episode may be the initial presentation of bipolar disorder. It is generally believed that treating such an episode with any antidepressant alone may increase the likelihood of a mixed/manic episode in patients at risk for bipolar disorder. Before starting treatment with an antidepressant, patients should be adequately screened to determine if they are at risk for bipolar disorder. It should be noted that Nortriptyline tablets are not approved for use in treating bipolar depression. Patients and their caregivers should be alerted to the need to monitor for the emergence of anxiety, agitation, panic attacks, insomnia, irritability, hostility, impulsivity, akathisia, hypomania, mania, worsening of depression, and suicidal ideation, especially early during antidepressant treatment. Such symptoms should be reported to the patient’s doctor, especially if they are severe, abrupt in onset, or were not part of the patient’s presenting symptoms. © Clearsky Pharmacy ( www.clearskypharmacy.biz )

15. Primox Tablets by Sun (Generic Nortriptyline Hydrochloride Tablets) Warnings In patients developing throat pain, fever and flu symptoms during the first 10 weeks of treatment, it is recommended that a full blood count is conducted to exclude agranulocytosis. Hyperpyrexia has been reported during treatment with tricyclic antidepressants together with anticholinergic or with neuroleptics, especially during hot weather. Nortriptyline (Primox tablets) should be used with caution in patients with cardiovascular disease, including heart failure, conduction disorders (e.g. AV block grades I to III), or arrhythmias. Cardiovascular and ECG monitoring should be undertaken in such patients. An ECG should be performed prior to starting treatment, at steady state, after an increase in dose or after starting any potentially interacting medicine. © Clearsky Pharmacy ( www.clearskypharmacy.biz )

16. Primox Tablets by Sun (Generic Nortriptyline Hydrochloride Tablets) Warnings If the medicine is given to overactive or agitated patients, increased anxiety and agitation may occur. Troublesome patient hostility may be aroused by the use of Nortriptyline Hydrochloride. Discontinue the medicine for several days, if possible, prior to elective surgery. Both elevation and lowering of blood sugar levels have been reported. A case of significant hypoglycaemia has been reported after the addition of nortriptyline (125 mg/day) in a type II diabetic patient maintained on chlorpropamide (250 mg/day). Adjustment of anti- diabetic therapy may, therefore, be necessary. URL: URL: https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html © Clearsky Pharmacy ( www.clearskypharmacy.biz )

17. Primox Tablets by Sun (Generic Nortriptyline Hydrochloride Tablets) Effects On Ability To Drive And Use Machines Nortriptyline Hydrochloride (Primox Tablets) has moderate influence on the ability to drive and use machines. 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.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html © Clearsky Pharmacy ( www.clearskypharmacy.biz )

18. Primox Tablets by Sun (Generic Nortriptyline Hydrochloride Tablets) Primox Tablets And Alcohol You can drink alcohol while taking Nortriptyline but it can alter the effects of Nortriptyline and cause increased side effects. 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 Additionally, alcohol can increase the sedative effects of Nortriptyline, which means it may make you feel drowsy, impair your motor skills, impair your ability to drive (not that you should be driving after drinking, anyhow) or operate heavy machinery, etc. And if you’re taking or have recently taken non-steroidal anti-inflammatory drugs (NSAIDs) are also at an increased risk of gastrointestinal bleeding when also taking Nortriptyline and consuming alcohol. It might be best to stop drinking alcohol until you see how the medicine makes you feel. URL: URL: https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html © Clearsky Pharmacy ( www.clearskypharmacy.biz )

19. Primox Tablets by Sun (Generic Nortriptyline Hydrochloride Tablets) Side Effects The common side effects of Nortriptyline Hydrochloride (Primox Tablets) are Stomach or bowel problems (e.g. nausea, diarrhoea, constipation), Dry mouth or taste change, Change in appetite, Shakiness or tremor, Trouble sleeping, Dizziness or light-headedness (especially on standing rapidly), Tingling or numbness of the hands or feet, Ringing or other persistent noise in the ears, and Difficulty in passing urine. URL: URL: https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html © Clearsky Pharmacy ( www.clearskypharmacy.biz )

20. Primox Tablets by Sun (Generic Nortriptyline Hydrochloride Tablets) Side Effects 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. © Clearsky Pharmacy ( www.clearskypharmacy.biz )

21. Primox Tablets by Sun (Generic Nortriptyline Hydrochloride Tablets) Side Effects Gastrointestinal: Nausea and vomiting, anorexia, epigastric distress, diarrhea, peculiar taste, stomatitis, abdominal cramps, blacktongue. 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: Abrupt cessation of treatment after prolonged therapy may produce nausea, headache, and malaise. URL: URL: https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html © Clearsky Pharmacy ( www.clearskypharmacy.biz )

22. Primox Tablets by Sun (Generic Nortriptyline Hydrochloride Tablets) Primox Tablets Overdose Deaths may occur from overdosage with Primox (Generic Nortriptyline Tablets). Multiple drug ingestion (including alcohol) is common in deliberate tricyclic antidepressant overdose. Signs and symptoms of toxicity develop rapidly after tricyclic antidepressant overdose; therefore, hospital monitoring is required as soon as possible. Symptoms of overdose include: cardiac dysrhythmias, severe hypotension, convulsions, and CNS depression, including coma. Changes in the electrocardiogram, particularly in QRS axis or width, are clinically significant indicators of tricyclic antidepressant toxicity. Other signs of Generic Nortriptyline overdose may include confusion, disturbed concentration, transient visual hallucinations, dilated pupils, agitation, hyperactive reflexes, stupor, drowsiness, muscle rigidity, vomiting, hypothermia, hyperpyrexia, or many of the symptoms listed under side effects. © Clearsky Pharmacy ( www.clearskypharmacy.biz )

23. Primox Tablets by Sun (Generic Nortriptyline Hydrochloride Tablets) Primox Tablets Overdose Obtain an ECG and immediately start cardiac monitoring. Protect the patient’s airway, establish an intravenous line and initiate gastric decontamination. A minimum of six hours of observation with cardiac monitoring and observation for signs of CNS or respiratory depression, hypotension, cardiac dysrhythmias and/or conduction blocks, and seizures is necessary. In case signs of toxicity occur at any time during this period, extended monitoring is required. URL: URL: https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html © Clearsky Pharmacy ( www.clearskypharmacy.biz )

24. Primox Tablets by Sun (Generic Nortriptyline Hydrochloride Tablets) Primox Tablets During Pregnancy Nortriptyline Hydrochloride (Primox tablets) has been classified by the US FDA as Pregnancy Category C. Nortriptyline Hydrochloride (Primox tablets) should only be used in pregnancy if considered necessary, taking into account the risks of untreated depression, and under the close supervision of a physician. Epidemiological studies have suggested an increased risk of congenital abnormalities associated with use of tricyclic antidepressants in pregnancy. There is evidence of interference with central monoamine neurotransmission in rats. Neonates should be observed if maternal use of Nortriptyline (Primox tablets) has continued into the later stages of pregnancy, particularly into the third trimester. Neonates exposed to tricyclic antidepressants, late in the third trimester have shown drug withdrawal symptoms such as dyspnoea, lethargy, colic irritability, hypotension or hypertension and tremor or spasms. URL: URL: https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html © Clearsky Pharmacy ( www.clearskypharmacy.biz )

25. Primox Tablets by Sun (Generic Nortriptyline Hydrochloride Tablets) Primox Tablets During Nursing Notriptyline (Primox Tablets) passes into breast milk in very small amounts so it's unlikely to cause any harm to your baby. If you are being treated for depression it's important to continue taking Notriptyline to keep you well. Breastfeeding will also benefit both you and your baby. Because of the low levels of Notriptyline in breast milk, amounts ingested by the infant are small and usually not been detected in the serum of the infant, although the less active metabolites are often detectable in low levels in infant serum. Immediate side effects have not been reported and a limited amount of follow-up has found no adverse effects on infant growth and development. A safety scoring system finds Notriptyline use to be possible with caution during breastfeeding. URL: URL: https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html © Clearsky Pharmacy ( www.clearskypharmacy.biz )

26. Primox Tablets by Sun (Generic Nortriptyline Hydrochloride Tablets) Primox Tablets Primox Tablets (Generic Nortriptyline Hydrochloride Tablets) by Sun Pharmaceutical Industries Limited, India. URL: URL: https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html https://www.clearskypharmacy.biz/generic-aventyl-primox-by-sun-pharma.html © Clearsky Pharmacy ( www.clearskypharmacy.biz )