Like all medicines, nortriptyline can cause side effects in some people, but many people have no side effects or only minor ones.

Some of the common side effects of nortriptyline will gradually improve as your body gets used to the medicine.

Doses of nortriptyline for pain are lower than the doses for depression. This means your side effects are usually milder and go away within a few days if you're taking nortriptyline to treat pain.

Common side effects of nortriptyline

These side effects can sometimes happen if you take nortriptyline. There are things you can do to help cope with them:

Constipation

Get more fibre into your diet such as fresh fruit, vegetables and cereals. Try to drink several glasses of water or squash every day. If you can, it may also help to increase your level of exercise.

Feeling dizzy

This may be due to low blood pressure. Drink plenty of water or squash. Do not stand up too quickly after you've been sitting or lying down. Do not drive, cycle or use tools or machinery until this feeling passes. It's best not to drink alcohol until you see how the medicine affects you.

Dry mouth

Chew sugar-free gum or have some sugar-free sweets.

Feeling sleepy

Take nortriptyline in the evening. It's best not to drink alcohol until you see how the medicine affects you. Do not drive, cycle or use tools or machinery while you're feeling sleepy.

Difficulty peeing

Try to relax when you pee. Do not try to force the flow of pee. If you cannot pee, try again a short time later.

Call 111 or talk to your doctor GP urgently if you cannot pee at all.

Headaches

Make sure you rest and drink plenty of fluids. It's best not to drink alcohol until you see how the medicine affects you. Try taking paracetamol or ibuprofen if you need pain relief. Talk to your doctor if the headaches do not go away or are severe.

Keep taking the medicine but talk to your doctor or pharmacist if the advice on how to cope does not help and these side effects bother you or do not go away.

Serious side effects

It happens rarely, but some people have a serious side effect after taking nortriptyline.

Call a doctor or call 111 now if:

your heartbeat becomes fast or irregular
the whites of your eyes turn yellow, or your skin turns yellow (although this may be less obvious on brown or black skin) – these can be signs of a liver problem
you have a headache that does not get better, you feel sick (nauseas) and weak and you have muscle cramps – together these can be signs of low sodium levels in your blood
you have eye pain, a change in your eyesight, or swelling or redness in or around the eye
you have constipation that lasts a long time, a swollen stomach, high temperature and you’re being sick (vomiting) – this can be a sign of intestinal problems
you have problems peeing which are causing stomach ache, or you cannot pee at all – you have a high temperature, shivering or chills and a sore throat, or you’re bleeding or bruising more easily than usual – these can be signs of blood or bone problems

Urgent advice: Call 999 if:

you have weakness or numbness on one side of your face or body, trouble speaking or swallowing, confusion, loss of balance or blurred eyesight – these can be signs of a stroke
you pass out
you have a seizure or fit
you get severe chest pain which may spread to your neck or arm, shortness of breath and a clammy feeling – these can be signs of a heart attack

Immediate action required: Call 999 or go to A&E if:

you have thoughts about harming yourself or ending your life

Serious allergic reaction

It’s possible to have a serious allergic reaction (anaphylaxis) to nortriptyline.

Immediate action required: Call 999 now if:

your lips, mouth, throat or tongue suddenly become swollen
you're breathing very fast or struggling to breathe (you may become very wheezy or feel like you're choking or gasping for air)
your throat feels tight or you're struggling to swallow
your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
you suddenly become very confused, drowsy or dizzy
someone faints and cannot be woken up
a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)

You or the person who's unwell may also have a rash that's swollen, raised, itchy, blistered or peeling.

These can be signs of a serious allergic reaction and may need immediate treatment in hospital.

Do not drive yourself to A&E.

The person you speak to at 999 will give you advice about what to do.

Other side effects

These are not all the side effects of nortriptyline. For a full list see the leaflet inside your medicines packet.

You can report any suspected side effect using the Yellow Card safety scheme.

Reporting side effects