Nortrilen Dosage/Direction for Use

Dosage should be initiated at a low level and increased gradually, noting carefully the clinical response and any evidence of intolerability. Dosages exceeding 150 mg/day should preferably be restricted to hospitalised patients (up to 200-250 mg).
Adults: Initially 50 mg once a day administered in the morning or 25 mg 2-3 times daily gradually increased, if necessary, by 25 mg every other day up to 100-150 mg once a day or 50 mg 2-3 times daily (rarely 200 mg daily in hospitalised patients). The additional doses are primarily administered in the morning.
The maintenance dose is the same as the optimal therapeutic dose.
Elderly patients: Patients over 60 years of age: Initially 10 mg 2-3 times daily or 25 mg once a day, gradually increased, if necessary, every other day up to 150 mg daily. The additional doses are primarily administered in the morning.
The maintenance dose is the same as the optimal therapeutic dose.
Children and adolescents (<18 years): Nortrilen is not recommended for use in children and adolescents due to lack of data on safety and efficacy.
Reduced renal function: Nortriptyline can be given in usual doses to patients with renal failure.
Reduced liver function: Careful dosing and, if possible, a serum level determination is advisable.
Duration of treatment: The antidepressant effect usually sets in after 2 to 4 weeks. Treatment with antidepressants is symptomatic and must therefore be continued for an appropriate length of time usually up to 6 months after recovery in order to prevent relapse. In patients with recurrent depression (unipolar) maintenance therapy may need to be continued for a number of years to prevent new episodes.
Discontinuation: When stopping therapy the drug should be gradually withdrawn during several weeks.
Method of administration: Dose increases are made preferably in the morning.
The tablets are swallowed with water.