Indications for Protriptyline HCl:
15–40mg daily in 3–4 divided doses. Increase AM dose if needed; max 60mg daily. Elderly, adolescents: initially 5mg 3 times daily.
Protriptyline HCl Contraindications:
During or within 14 days of MAOIs. Concomitant cisapride. Acute post-MI.
Protriptyline HCl Warnings/Precautions:
Increased risk of suicidal thinking and behavior in children, adolescents, and young adults; monitor for clinical worsening or unusual changes. History of seizures. Urinary retention. Increased intraocular tension. Angle-closure glaucoma. Cardiovascular disorders. Bipolar disorder. Mania. Psychosis. ECT. Diabetes. Hyperthyroidism. Liver disorders. Discontinue prior to surgery. Poor metabolizers (CYP2D6). Avoid abrupt cessation. Avoid sun, UV light. Elderly (monitor cardiovascular effects over 20mg/day). Pregnancy. Nursing mothers.
Protriptyline HCl Classification:
Protriptyline HCl Interactions:
See Contraindications. Hyperpyretic crisis, convulsions, death with MAOIs. Avoid during or within 5 weeks of fluoxetine. Potentiates alcohol, CNS depressants. Blocks guanethidine. Paralytic ileus, hyperpyrexia with anticholinergics, neuroleptics. Potentiated by CYP2D6 inhibitors (eg, quinidine, phenothiazines, SSRIs, propafenone, flecainide); monitor with cimetidine. Adjust sympathomimetic, anticholinergic doses. Increased seizure risk with tramadol.
CNS, anticholinergic, or cardiovascular effects (eg, drowsiness, confusion, anxiety, tachycardia, hypotension), extrapyramidal symptoms, nausea, fatigue, rash, headache, changes in blood sugar, photosensitivity, edema, blood dyscrasias, sexual dysfunction, gynecomastia, liver dysfunction.
Formerly known under the brand name Vivactil.