Protriptyline is a tricyclic antidepressant that is used to treat symptoms of depression.

Protriptyline may also be used for purposes not listed in this medication guide.

Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Your symptoms may not improve for up to a few weeks.

Tell your doctor if you have a planned surgery.

You may have withdrawal symptoms if you stop using protriptyline suddenly. Ask your doctor before stopping the medicine.

Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

Usual Adult Dose for Depression:

15 to 40 mg orally per day divided into three or four doses
-Maximum dose: 60 mg/day

Comments:
-Dosage increments should be made in the morning dose.
-After a satisfactory improvement is reached, the dose should be reduced to the lowest effective amount to relieve symptoms.

Use: Treatment of symptoms of mental depression in patients who are under close medical supervision

Usual Geriatric Dose for Depression:

5 mg orally 3 times a day, increasing gradually if necessary

Comments:
-Cardiovascular status should be monitored closely if daily dosage exceeds 20 mg.
-After a satisfactory improvement is reached, the dose should be reduced to the lowest effective amount to relieve symptoms.

Use: Treatment of symptoms of mental depression in patients who are under close medical supervision

You should not use protriptyline if you are allergic to it, or if:

• you have recently had a heart attack.

Do not use protriptyline if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, tranylcypromine, and others.

Tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone.

Tell your doctor if you have ever had:

• heart disease;

• a heart attack or stroke;

• a seizure;

• bipolar disorder (manic-depression);

• schizophrenia or other mental illness;

• a thyroid disorder;

• narrow-angle glaucoma;

• problems with urination;

• if you are receiving electroshock therapy.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Tell your doctor if you are pregnant or breastfeeding.

Protriptyline is not approved for use by anyone younger than 18 years old.

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of protriptyline can be fatal.

Overdose symptoms may include irregular heartbeats, feeling like you might pass out, seizures, coma.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

Unless your doctor tells you otherwise, continue your normal diet.

Do not drink alcohol. Dangerous side effects or death could occur.

Avoid driving or hazardous activity until you know how protriptyline will affect you. Your reactions could be impaired.

Protriptyline could make you sunburn more easily. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Get emergency medical help if you have signs of an allergic reaction: hives, rash, red or purple spots; fever; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Protriptyline may cause serious side effects. Call your doctor at once if you have:

• fever, chills, sore throat, mouth sores, feeling light-headed;

• blurred vision, eye pain or redness, seeing halos around lights;

• restless muscle movements in your eyes, tongue, jaw, or neck;

• seizure (convulsions);

• new or worsening chest pain, pounding heartbeats or fluttering in your chest;

• sudden numbness or weakness, problems with vision, or speech;

• easy bruising, unusual bleeding;

• painful or difficult urination; or

• jaundice (yellowing of the skin or eyes).

Common side effects of protriptyline may include:

• fast heartbeats;

• problems with balance or muscle movement;

• constipation;

• nausea, vomiting, loss of appetite;

• breast swelling (in men or women); or

• decreased sex drive, impotence.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Using protriptyline with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Many drugs can affect protriptyline. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all other medicines you use.

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.