nortriptyline 🐶 Veterinary Use | Indications/Contra | FAERs-F | FAERs-M | Orange Bk | BioActivity |

Stem definition	Drug id	CAS RN
antidepressants, dibenzo[a,d]cycloheptane or cyclopheptene derivatives	1971	72-69-5

Description:

Molecule	Description
Molfile Inchi Smiles Synonyms: nortryptyline nortriptyline demethylamitriptylin desitriptilina desmethylamitriptyline noramitriptyline nortriptyline hydrochloride nortriptyline HCl	A metabolite of AMITRIPTYLINE that is also used as an antidepressive agent. Nortriptyline is used in major depression, dysthymia, and atypical depressions. Molecular weight: 263.38 Formula: C19H21N CLOGP: 4.32 LIPINSKI: 0 HAC: 1 HDO: 1 TPSA: 12.03 ALOGS: -5.48 ROTB: 3 Status: OFP Legend: OFP - off patent OFM - off market ONP - on patent

Molecule

Description

Molfile Inchi Smiles

Synonyms:

nortryptyline
nortriptyline
demethylamitriptylin
desitriptilina
desmethylamitriptyline
noramitriptyline
nortriptyline hydrochloride
nortriptyline HCl

A metabolite of AMITRIPTYLINE that is also used as an antidepressive agent. Nortriptyline is used in major depression, dysthymia, and atypical depressions.

Molecular weight: 263.38
Formula: C19H21N
CLOGP: 4.32
LIPINSKI: 0
HAC: 1
HDO: 1
TPSA: 12.03
ALOGS: -5.48
ROTB: 3

Status: OFP

Legend:
OFP - off patent
OFM - off market
ONP - on patent

Drug dosage:

Dose	Unit	Route
75	mg	O
30	mg	P

ADMET properties:

Property	Value	Reference
BDDCS (Biopharmaceutical Drug Disposition Classification System)	1	Benet LZ, Broccatelli F, Oprea TI
EoM (Fraction excreted unchanged in urine)	2 %	Benet LZ, Broccatelli F, Oprea TI
MRTD (Maximum Recommended Therapeutic Daily Dose)	6.34 µM/kg/day	Contrera JF, Matthews EJ, Kruhlak NL, Benz RD
BA (Bioavailability)	51 %	Kim MT, Sedykh A, Chakravarti SK, Saiakhov RD, Zhu H
Vd (Volume of distribution)	22 L/kg	Lombardo F, Berellini G, Obach RS
CL (Clearance)	10 mL/min/kg	Lombardo F, Berellini G, Obach RS
fu (Fraction unbound in plasma)	0.12 %	Lombardo F, Berellini G, Obach RS
t_half (Half-life)	30 hours	Lombardo F, Berellini G, Obach RS

Approvals:

Date	Agency	Company	Orphan
Nov. 6, 1964	FDA

FDA Adverse Event Reporting System (Female)

MedDRA adverse event term	Likelihood ratio	Likelihood ratio threshold	Patients taking drug having adverse event	Patients taking drug not having adverse event	Patients not taking drug having adverse event	Patients not taking drug not having adverse event
Temperature regulation disorder	511.43	13.70	168	30943	5964	63451947
Food allergy	416.64	13.70	170	30941	11231	63446680
Coeliac disease	394.38	13.70	169	30942	12628	63445283
Immunodeficiency	346.22	13.70	178	30933	20076	63437835
Pneumonia aspiration	328.82	13.70	207	30904	34333	63423578
Completed suicide	321.62	13.70	376	30735	145297	63312614
Bursitis	249.24	13.70	179	30932	36862	63421049
Rash erythematous	227.25	13.70	179	30932	42331	63415580
Coma	212.62	13.70	206	30905	64158	63393753
Fluid retention	189.59	13.70	187	30924	59499	63398412
Gastrooesophageal reflux disease	170.66	13.70	222	30889	95417	63362494
Toxicity to various agents	167.49	13.70	372	30739	246878	63211033
Drug hypersensitivity	163.72	13.70	424	30687	310263	63147648
Asthma	162.41	13.70	252	30859	127309	63330602
Upper respiratory tract infection	159.88	13.70	199	30912	81848	63376063
Presbyacusis	151.87	13.70	56	31055	2809	63455102
Hyperhidrosis	148.52	13.70	221	30890	107615	63350296
Pleural fibrosis	144.91	13.70	57	31054	3415	63454496
Pleural thickening	144.20	13.70	54	31057	2829	63455082
Blood magnesium increased	137.87	13.70	53	31058	2985	63454926
Osteopenia	136.22	13.70	97	31014	19688	63438223
Deafness neurosensory	136.09	13.70	60	31051	4795	63453116
Somnolence	135.99	13.70	282	30829	178403	63279508
Neovascularisation	114.39	13.70	36	31075	1109	63456802
Brugada syndrome	111.99	13.70	28	31083	360	63457551
Back pain	110.83	13.70	332	30779	263813	63194098
Epigastric discomfort	102.73	13.70	55	31056	6725	63451186
Overdose	99.92	13.70	192	30919	114886	63343025
Rubber sensitivity	96.34	13.70	38	31073	2293	63455618
Bone cyst	90.55	13.70	36	31075	2218	63455693
Constipation	85.25	13.70	273	30838	224670	63233241
Electrocardiogram QRS complex prolonged	83.93	13.70	46	31065	5892	63452019
Sensitivity to weather change	78.04	13.70	47	31064	7190	63450721
Erythema	77.51	13.70	225	30886	175526	63282385
Paradoxical drug reaction	75.29	13.70	38	31073	4114	63453797
Cyst	74.49	13.70	59	31052	14040	63443871
Rheumatoid arthritis	70.36	13.70	278	30833	253541	63204370
Glossodynia	68.44	13.70	5	31106	178871	63279040
Migraine	68.09	13.70	154	30957	103192	63354719
Forced expiratory volume decreased	66.14	13.70	37	31074	4931	63452980
Osteosclerosis	65.90	13.70	34	31077	3854	63454057
Poor venous access	65.81	13.70	56	31055	14729	63443182
Drug ineffective for unapproved indication	62.13	13.70	80	31031	33983	63423928
Blood potassium increased	59.26	13.70	58	31053	18251	63439660
Systemic lupus erythematosus	56.80	13.70	16	31095	208902	63249009
Somatic delusion	52.50	13.70	17	31094	575	63457336
Traumatic coma	52.20	13.70	11	31100	61	63457850
Hepatic enzyme increased	51.56	13.70	216	30895	202112	63255799
Wound	51.42	13.70	9	31102	163254	63294657
Swelling	50.22	13.70	37	31074	275341	63182570
Pericarditis	49.42	13.70	4	31107	131575	63326336
Hypersensitivity	49.04	13.70	277	30834	292408	63165503
Skin lesion	48.13	13.70	67	31044	30654	63427257
Headache	46.09	13.70	493	30618	632748	62825163
Neutropenia	41.32	13.70	17	31094	174988	63282923
Dry eye	40.34	13.70	72	31039	40689	63417222
Cardiac arrest	40.28	13.70	118	30993	92427	63365484
Suspected suicide	40.20	13.70	30	31081	6538	63451373
Lower respiratory tract infection	40.15	13.70	8	31103	132299	63325612
Mastoiditis	39.44	13.70	16	31095	1039	63456872
Unresponsive to stimuli	39.09	13.70	64	31047	33752	63424159
Maternal exposure during pregnancy	38.29	13.70	31	31080	220031	63237880
Vascular malformation	38.18	13.70	12	31099	368	63457543
Foetal death	37.82	13.70	36	31075	10944	63446967
Paranasal cyst	37.37	13.70	12	31099	395	63457516
Extrapyramidal disorder	37.35	13.70	39	31072	13245	63444666
Unmasking of previously unidentified disease	37.17	13.70	15	31096	961	63456950
Alopecia	37.11	13.70	68	31043	337468	63120443
Polymyositis	37.02	13.70	18	31093	1798	63456113
Deformity	35.93	13.70	36	31075	11648	63446263
Prescribed overdose	34.66	13.70	61	31050	34092	63423819
Bone density abnormal	33.90	13.70	21	31090	3377	63454534
Anuria	33.78	13.70	36	31075	12515	63445396
Pancytopenia	33.63	13.70	4	31107	96929	63360982
Anaemia	33.25	13.70	58	31053	293372	63164539
Alanine aminotransferase abnormal	33.12	13.70	23	31088	4481	63453430
Fatigue	32.03	13.70	611	30500	887417	62570494
Spinal stenosis	31.95	13.70	38	31073	14887	63443024
Osteoarthritis	31.84	13.70	111	31000	95232	63362679
Sleep disorder	31.73	13.70	100	31011	81466	63376445
Febrile neutropenia	30.49	13.70	10	31101	118439	63339472
Occult blood	29.89	13.70	14	31097	1287	63456624
Hypoventilation	29.73	13.70	22	31089	4732	63453179
Femoral neck fracture	29.46	13.70	28	31083	8495	63449416
Abdominal discomfort	28.34	13.70	73	31038	320812	63137099
Helicobacter infection	27.34	13.70	6	31105	92779	63365132
Systolic dysfunction	27.15	13.70	14	31097	1585	63456326
Blister	26.98	13.70	15	31096	129799	63328112
Vomiting	26.63	13.70	163	30948	559454	62898457
Suicidal ideation	25.64	13.70	78	31033	62343	63395568
Acute kidney injury	25.57	13.70	57	31054	263358	63194553
Exostosis	25.10	13.70	37	31074	17825	63440086
Blood pressure abnormal	25.09	13.70	34	31077	15164	63442747
Treatment failure	24.93	13.70	175	30936	198868	63259043
Ventricular tachyarrhythmia	24.92	13.70	7	31104	144	63457767
Leukopenia	24.90	13.70	4	31107	77286	63380625
Stomatitis	24.80	13.70	19	31092	138706	63319205
Accidental death	24.37	13.70	14	31097	1962	63455949
Disease progression	24.35	13.70	15	31096	122743	63335168
Electrocardiogram ST segment elevation	24.17	13.70	18	31093	3909	63454002
Electrocardiogram repolarisation abnormality	23.72	13.70	12	31099	1305	63456606
Carpal tunnel syndrome	23.52	13.70	39	31072	20778	63437133
Immune thrombocytopenia	22.80	13.70	27	31084	10529	63447382
Failed induction of labour	22.69	13.70	8	31103	352	63457559
Ill-defined disorder	22.69	13.70	6	31105	81749	63376162
Malignant neoplasm progression	21.02	13.70	7	31104	82114	63375797
Psoriasis	20.70	13.70	91	31020	86866	63371045
Pleural rub	20.16	13.70	5	31106	62	63457849
Gastrointestinal motility disorder	19.99	13.70	18	31093	5101	63452810
Impaired healing	19.69	13.70	13	31098	102529	63355382
Respiratory arrest	19.67	13.70	47	31064	32598	63425313
Heart rate increased	19.03	13.70	94	31017	94144	63363767
Oral discomfort	18.99	13.70	23	31088	9178	63448733
Abnormal faeces	18.94	13.70	18	31093	5462	63452449
Hyperaesthesia	18.68	13.70	23	31088	9335	63448576
Postmortem blood drug level increased	18.67	13.70	8	31103	596	63457315
Neuropathy peripheral	17.95	13.70	106	31005	113561	63344350
Long QT syndrome	17.92	13.70	14	31097	3265	63454646
Bone hypertrophy	17.83	13.70	7	31104	417	63457494
Antidepressant drug level above therapeutic	17.62	13.70	7	31104	430	63457481
Renal failure	17.59	13.70	19	31092	117633	63340278
Sepsis	17.56	13.70	30	31081	153093	63304818
Cardiac failure	17.53	13.70	11	31100	89131	63368780
Adverse reaction	17.11	13.70	23	31088	10180	63447731
Underdose	17.05	13.70	40	31071	27416	63430495
Essential tremor	16.97	13.70	9	31102	1079	63456832
General physical health deterioration	16.87	13.70	47	31064	201355	63256556
Urine odour abnormal	16.62	13.70	18	31093	6371	63451540
Decreased appetite	16.61	13.70	65	31046	250987	63206924
Asthenia	16.55	13.70	115	30996	383489	63074422
Iodine allergy	16.48	13.70	8	31103	796	63457115
Allodynia	16.34	13.70	8	31103	811	63457100
Intentional product misuse	16.24	13.70	66	31045	60851	63397060
Pain	16.24	13.70	476	30635	740152	62717759
Threatened labour	16.02	13.70	8	31103	846	63457065
Alanine aminotransferase increased	15.24	13.70	17	31094	103753	63354158
Blood pressure increased	15.05	13.70	133	30978	161929	63295982
Hyperkalaemia	15.00	13.70	4	31107	54199	63403712
Serotonin syndrome	14.87	13.70	39	31072	28643	63429268
Noninfectious myelitis	14.85	13.70	3	31108	13	63457898
Pneumonia	14.70	13.70	148	30963	456619	63001292
Delirium	14.47	13.70	56	31055	50485	63407426
Dyspnoea	14.33	13.70	233	30878	661080	62796831
Acute lung injury	13.90	13.70	9	31102	1562	63456349
Type 2 diabetes mellitus	13.82	13.70	7	31104	63861	63394050

FDA Adverse Event Reporting System (Male)

MedDRA adverse event term	Likelihood ratio	Likelihood ratio threshold	Patients taking drug having adverse event	Patients taking drug not having adverse event	Patients not taking drug having adverse event	Patients not taking drug not having adverse event
Toxicity to various agents	326.43	18.08	323	8639	200039	34747930
Sedation	271.11	18.08	124	8838	20882	34927087
Completed suicide	164.00	18.08	161	8801	98007	34849962
Nightmare	160.94	18.08	77	8885	14314	34933655
Nephrolithiasis	124.00	18.08	84	8878	30249	34917720
Product used for unknown indication	94.84	18.08	26	8936	957	34947012
Reversible airways obstruction	91.84	18.08	22	8940	467	34947502
Myokymia	88.35	18.08	16	8946	76	34947893
Suicidal ideation	84.09	18.08	75	8887	40313	34907656
Hyperhidrosis	80.46	18.08	98	8864	75594	34872375
Drug abuse	72.63	18.08	107	8855	98989	34848980
Drug ineffective	47.29	18.08	236	8726	456515	34491454
Overdose	44.56	18.08	82	8880	90977	34856992
Serotonin syndrome	43.41	18.08	38	8924	19895	34928074
Feelings of worthlessness	43.01	18.08	11	8951	308	34947661
Electrocardiogram QRS complex prolonged	42.29	18.08	22	8940	4872	34943097
Nausea	41.95	18.08	185	8777	339723	34608246
Brugada syndrome	37.03	18.08	12	8950	789	34947180
Abulia	36.13	18.08	11	8951	589	34947380
Cardio-respiratory arrest	35.22	18.08	56	8906	55217	34892752
Obsessive-compulsive disorder	34.26	18.08	20	8942	5544	34942425
Impaired quality of life	33.43	18.08	20	8942	5798	34942171
Decreased interest	30.60	18.08	14	8948	2346	34945623
Poisoning	30.07	18.08	25	8937	12201	34935768
Suicide attempt	29.69	18.08	43	8919	39073	34908896
Drug hypersensitivity	28.03	18.08	63	8899	80466	34867503
Vertigo	25.36	18.08	32	8930	25504	34922465
Depression	25.33	18.08	68	8894	97030	34850939
Antidepressant discontinuation syndrome	24.37	18.08	4	8958	9	34947960
Anaemia	24.18	18.08	15	8947	233320	34714649
Binocular eye movement disorder	23.03	18.08	5	8957	67	34947902
Fall	22.37	18.08	107	8855	202778	34745191
Respiratory depression	22.22	18.08	24	8938	16221	34931748
Pyrexia	22.13	18.08	32	8930	332981	34614988
Emotional distress	21.97	18.08	23	8939	15003	34932966
Thrombocytopenia	20.91	18.08	7	8955	156240	34791729
Cerebral hypoperfusion	20.81	18.08	7	8955	517	34947452
Drug dependence	20.41	18.08	28	8934	24189	34923780
Restless legs syndrome	20.37	18.08	17	8945	8337	34939632
Product use in unapproved indication	20.09	18.08	71	8891	117428	34830541
Substance abuse	19.57	18.08	16	8946	7625	34940344
Major depression	19.46	18.08	13	8949	4559	34943410
Suspected suicide	19.01	18.08	13	8949	4735	34943234
Depressed level of consciousness	18.96	18.08	37	8925	42804	34905165
Benzodiazepine drug level therapeutic	18.83	18.08	4	8958	48	34947921
Febrile neutropenia	18.54	18.08	6	8956	136843	34811126
Phonophobia	18.26	18.08	5	8957	183	34947786

FDA Adverse Event Reporting System (Geriatric)

MedDRA adverse event term	Likelihood ratio	Likelihood ratio threshold	Patients taking drug having adverse event	Patients taking drug not having adverse event	Patients not taking drug having adverse event	Patients not taking drug not having adverse event
Temperature regulation disorder	507.68	13.35	161	34940	5692	79703595
Completed suicide	471.83	13.35	560	34541	245207	79464080
Food allergy	417.93	13.35	163	34938	10661	79698626
Toxicity to various agents	414.77	13.35	697	34404	420843	79288444
Coeliac disease	399.97	13.35	160	34941	11191	79698096
Immunodeficiency	331.75	13.35	171	34930	21597	79687690
Bursitis	255.02	13.35	172	34929	35672	79673615
Pneumonia aspiration	214.76	13.35	201	34900	66766	79642521
Drug hypersensitivity	196.76	13.35	417	34684	298499	79410788
Hyperhidrosis	189.09	13.35	280	34821	151212	79558075
Rash erythematous	186.38	13.35	174	34927	57595	79651692
Fluid retention	165.72	13.35	178	34923	69631	79639656
Coma	147.62	13.35	201	34900	100448	79608839
Upper respiratory tract infection	147.45	13.35	191	34910	90977	79618310
Presbyacusis	146.47	13.35	52	35049	2608	79706679
Asthma	146.47	13.35	234	34867	134861	79574426
Gastrooesophageal reflux disease	142.14	13.35	201	34900	104045	79605242
Brugada syndrome	132.41	13.35	40	35061	1198	79708089
Overdose	131.59	13.35	266	34835	183940	79525347
Pleural thickening	129.72	13.35	49	35052	2933	79706354
Pleural fibrosis	123.79	13.35	52	35049	4115	79705172
Osteopenia	123.16	13.35	85	35016	18279	79691008
Blood magnesium increased	118.57	13.35	48	35053	3458	79705829
Somnolence	116.99	13.35	297	34804	238684	79470603
Sedation	115.60	13.35	128	34973	51767	79657520
Neovascularisation	115.23	13.35	36	35065	1209	79708078
Electrocardiogram QRS complex prolonged	112.25	13.35	66	35035	10767	79698520
Rubber sensitivity	110.96	13.35	38	35063	1711	79707576
Deafness neurosensory	110.30	13.35	56	35045	6842	79702445
Back pain	103.95	13.35	332	34769	303848	79405439
Rheumatoid arthritis	101.91	13.35	259	34842	208211	79501076
Epigastric discomfort	84.16	13.35	49	35052	7847	79701440
Bone cyst	79.67	13.35	36	35065	3397	79705890
Migraine	78.06	13.35	139	34962	87354	79621933
Sensitivity to weather change	75.51	13.35	46	35055	8001	79701286
Myokymia	74.82	13.35	16	35085	109	79709178
Nightmare	72.24	13.35	72	35029	25789	79683498
Constipation	70.86	13.35	279	34822	282771	79426516
Osteosclerosis	68.67	13.35	34	35067	3937	79705350
Hepatic enzyme increased	68.48	13.35	206	34895	182404	79526883
Cyst	67.78	13.35	53	35048	13787	79695500
Hypersensitivity	67.67	13.35	261	34840	261978	79447309
Anaemia	66.35	13.35	59	35042	444956	79264331
Product used for unknown indication	65.82	13.35	25	35076	1519	79707768
Drug ineffective for unapproved indication	64.24	13.35	95	35006	51143	79658144
Febrile neutropenia	62.05	13.35	13	35088	230986	79478301
Poor venous access	61.07	13.35	56	35045	18093	79691194
Neutropenia	58.05	13.35	27	35074	287683	79421604
Forced expiratory volume decreased	56.74	13.35	38	35063	7776	79701511
Paradoxical drug reaction	54.73	13.35	36	35065	7149	79702138
Erythema	54.15	13.35	218	34883	223072	79486215
Nephrolithiasis	53.20	13.35	89	35012	53202	79656085
Reversible airways obstruction	51.07	13.35	23	35078	2153	79707134
Somatic delusion	51.07	13.35	17	35084	701	79708586
Traumatic coma	49.39	13.35	10	35091	50	79709237
Headache	47.83	13.35	468	34633	653304	79055983
Treatment failure	47.52	13.35	174	34927	170312	79538975
Acute kidney injury	47.01	13.35	99	35002	519305	79189982
Drug abuse	45.30	13.35	166	34935	162525	79546762
Pancytopenia	45.18	13.35	9	35092	165736	79543551
Suspected suicide	44.37	13.35	37	35064	10539	79698748
Deformity	43.22	13.35	35	35066	9570	79699717
Prescribed overdose	41.51	13.35	66	35035	37817	79671470
Foetal death	39.81	13.35	31	35070	8013	79701274
Leukopenia	39.80	13.35	3	35098	116510	79592777
Blood potassium increased	39.19	13.35	56	35045	29219	79680068
Vascular malformation	38.90	13.35	12	35089	386	79708901
Sleep disorder	38.26	13.35	103	34998	85574	79623713
Fatigue	38.19	13.35	597	34504	929130	78780157
Serotonin syndrome	38.18	13.35	70	35031	44957	79664330
Interstitial lung disease	38.18	13.35	3	35098	112597	79596690
Pain	37.78	13.35	474	34627	703328	79005959
Cardio-respiratory arrest	37.47	13.35	119	34982	108391	79600896
Paranasal cyst	37.32	13.35	12	35089	443	79708844
Suicidal ideation	36.35	13.35	94	35007	76246	79633041
General physical health deterioration	35.82	13.35	41	35060	275197	79434090
Bone density abnormal	35.31	13.35	20	35081	3040	79706247
Dry eye	34.64	13.35	60	35041	36871	79672416
Mastoiditis	33.72	13.35	16	35085	1688	79707599
Skin lesion	32.92	13.35	63	35038	41781	79667506
Respiratory depression	32.87	13.35	50	35051	27580	79681707
Drug ineffective	32.61	13.35	661	34440	1080252	78629035
Unresponsive to stimuli	32.22	13.35	74	35027	55714	79653573
Pericarditis	32.15	13.35	4	35097	104232	79605055
Obsessive-compulsive disorder	31.88	13.35	24	35077	5903	79703384
Osteoarthritis	31.29	13.35	97	35004	87212	79622075
Feelings of worthlessness	31.18	13.35	11	35090	541	79708746
Polymyositis	30.15	13.35	18	35083	3018	79706269
Exostosis	29.88	13.35	37	35064	16821	79692466
Extrapyramidal disorder	29.79	13.35	43	35058	22636	79686651
Major depression	28.84	13.35	27	35074	8953	79700334
Spinal stenosis	28.54	13.35	35	35066	15756	79693531
Systemic lupus erythematosus	28.34	13.35	9	35092	121140	79588147
Renal failure	28.30	13.35	28	35073	200940	79508347
Unmasking of previously unidentified disease	28.02	13.35	15	35086	2042	79707245
Lower respiratory tract infection	27.84	13.35	11	35090	129209	79580078
Pyrexia	27.75	13.35	180	34921	678529	79030758
Occult blood	27.58	13.35	14	35087	1709	79707578
Pneumonia	26.54	13.35	176	34925	660070	79049217
Femoral neck fracture	26.42	13.35	27	35074	9957	79699330
Cardiac failure	26.23	13.35	18	35083	154824	79554463
Hyperkalaemia	25.88	13.35	9	35092	114389	79594898
Hypoventilation	25.70	13.35	23	35078	7201	79702086
Carpal tunnel syndrome	25.62	13.35	37	35064	19491	79689796
Vomiting	25.51	13.35	180	34921	665648	79043639
Sepsis	25.48	13.35	50	35051	269378	79439909
Glossodynia	25.41	13.35	7	35094	103330	79605957
Swelling	25.35	13.35	35	35066	216676	79492611
Contraindicated product administered	25.01	13.35	136	34965	157402	79551885
Wound	24.84	13.35	10	35091	116169	79593118
Abnormal faeces	24.77	13.35	23	35078	7548	79701739
Multiple organ dysfunction syndrome	24.67	13.35	11	35090	120235	79589052
Abulia	24.64	13.35	11	35090	1009	79708278
Atrial fibrillation	24.12	13.35	31	35070	197855	79511432
Alanine aminotransferase increased	23.65	13.35	22	35079	162548	79546739
Aspartate aminotransferase increased	23.64	13.35	16	35085	138625	79570662
Stomatitis	23.63	13.35	18	35083	146739	79562548
Respiratory arrest	23.52	13.35	67	35034	57483	79651804
Cervicogenic headache	23.14	13.35	5	35096	36	79709251
Ascites	23.06	13.35	3	35098	75559	79633728
Cardiac arrest	23.04	13.35	142	34959	171954	79537333
Malignant neoplasm progression	22.78	13.35	16	35085	135974	79573313
Decreased appetite	22.76	13.35	76	35025	342342	79366945
Disease progression	22.35	13.35	29	35072	184333	79524954
Accidental death	22.25	13.35	17	35084	4274	79705013
Anuria	22.25	13.35	36	35065	20927	79688360
Psoriasis	22.11	13.35	88	35013	89499	79619788
Hyperaesthesia	21.94	13.35	27	35074	12195	79697092
Liver disorder	21.80	13.35	3	35098	72414	79636873
Substance abuse	21.78	13.35	25	35076	10501	79698786
Heart rate increased	21.78	13.35	108	34993	120616	79588671
Impaired quality of life	21.47	13.35	29	35072	14357	79694930
Failed induction of labour	21.28	13.35	7	35094	278	79709009
Adverse reaction	20.77	13.35	23	35078	9291	79699996
Drug intolerance	20.66	13.35	192	34909	263927	79445360
Pleural rub	20.48	13.35	5	35096	65	79709222
Postmortem blood drug level increased	20.43	13.35	9	35092	800	79708487
Oedema peripheral	20.42	13.35	51	35050	252237	79457050
International normalised ratio increased	20.34	13.35	6	35095	84715	79624572
Blood pressure abnormal	20.32	13.35	31	35070	17138	79692149
Alanine aminotransferase abnormal	19.95	13.35	22	35079	8845	79700442
Dyspnoea	19.92	13.35	262	34839	856763	78852524
Oral discomfort	19.89	13.35	23	35078	9737	79699550
Septic shock	19.85	13.35	15	35086	122786	79586501
Pleural effusion	19.58	13.35	21	35080	145241	79564046
Delirium	19.20	13.35	81	35020	84546	79624741
Underdose	19.17	13.35	44	35057	33107	79676180
Gastrointestinal motility disorder	18.88	13.35	18	35083	6104	79703183
Electrocardiogram repolarisation abnormality	18.84	13.35	12	35089	2255	79707032
Mucosal inflammation	18.80	13.35	5	35096	75575	79633712
Blister	18.79	13.35	15	35086	119461	79589826
Lactic acidosis	18.79	13.35	4	35097	70355	79638932
Ventricular tachyarrhythmia	18.79	13.35	7	35094	403	79708884
Urine odour abnormal	18.51	13.35	18	35083	6255	79703032
Platelet count decreased	17.65	13.35	37	35064	194627	79514660
Electrocardiogram ST segment elevation	17.47	13.35	20	35081	8377	79700910
Hepatic failure	17.37	13.35	3	35098	61209	79648078
Binocular eye movement disorder	17.26	13.35	5	35096	129	79709158
Melaena	17.24	13.35	3	35098	60887	79648400
Intentional overdose	17.17	13.35	92	35009	105868	79603419
Antidepressant discontinuation syndrome	17.16	13.35	4	35097	42	79709245
Maternal exposure during pregnancy	17.04	13.35	21	35080	136517	79572770
Multiple sclerosis relapse	16.94	13.35	52	35049	46481	79662806
Rheumatoid factor positive	16.83	13.35	3	35098	59836	79649451
Benzodiazepine drug level therapeutic	16.68	13.35	4	35097	48	79709239
Bone hypertrophy	16.47	13.35	7	35094	570	79708717
Threatened labour	15.94	13.35	7	35094	617	79708670
Blood creatine phosphokinase increased	15.29	13.35	5	35096	66085	79643202
Gastrointestinal haemorrhage	15.21	13.35	26	35075	147693	79561594
Helicobacter infection	14.90	13.35	6	35095	69698	79639589
Essential tremor	14.87	13.35	9	35092	1546	79707741
Hypokalaemia	14.25	13.35	26	35075	144014	79565273
Immune thrombocytopenia	14.24	13.35	27	35074	17778	79691509
Blood glucose increased	14.02	13.35	18	35083	114957	79594330
Anxiety	13.95	13.35	169	34932	248343	79460944
C-reactive protein increased	13.95	13.35	22	35079	129005	79580282
Phonophobia	13.87	13.35	6	35095	510	79708777
Intentional product misuse	13.67	13.35	80	35021	95085	79614202
May-Thurner syndrome	13.50	13.35	3	35098	25	79709262
Dyspepsia	13.50	13.35	88	35013	108599	79600688
Ventricular arrhythmia	13.46	13.35	18	35083	8822	79700465
Musculoskeletal discomfort	13.37	13.35	28	35073	19807	79689480

FDA Adverse Event Reporting System (Pediatric)

MedDRA adverse event term	Likelihood ratio	Likelihood ratio threshold	Patients taking drug having adverse event	Patients taking drug not having adverse event	Patients not taking drug having adverse event	Patients not taking drug not having adverse event
Trismus	58.08	53.75	16	89	130	89557

Pharmacologic Action:

Source	Code	Description
ATC	N06AA10	NERVOUS SYSTEM PSYCHOANALEPTICS ANTIDEPRESSANTS Non-selective monoamine reuptake inhibitors
MeSH PA	D018663	Adrenergic Agents
MeSH PA	D018759	Adrenergic Uptake Inhibitors
MeSH PA	D000928	Antidepressive Agents
MeSH PA	D000929	Antidepressive Agents, Tricyclic
MeSH PA	D002491	Central Nervous System Agents
MeSH PA	D049990	Membrane Transport Modulators
MeSH PA	D018377	Neurotransmitter Agents
MeSH PA	D014179	Neurotransmitter Uptake Inhibitors
MeSH PA	D011619	Psychotropic Drugs
CHEBI has role	CHEBI:35469	antidepressants
CHEBI has role	CHEBI:35610	antineoplastic agents
CHEBI has role	CHEBI:35640	adrenergic uptake inhibitors
CHEBI has role	CHEBI:49103	drug metabolites
CHEBI has role	CHEBI:68495	Type I cell-death inducers
CHEBI has role	CHEBI:176497	geroprotectors
FDA EPC	N0000175752	Tricyclic Antidepressant

Drug Use | Suggest Off label Use Form| |View source of the data|

Disease	Relation	SNOMED_ID	DOID
Depressive disorder	indication	35489007
Neuropathic pain	off-label use	247398009
Smoking cessation assistance	off-label use	384742004
Attention deficit hyperactivity disorder	off-label use	406506008
Suicidal thoughts	contraindication	6471006
Alcoholism	contraindication	7200002
Sinus tachycardia	contraindication	11092001
Lowered convulsive threshold	contraindication	19260006
Myocardial infarction	contraindication	22298006	DOID:5844
Glaucoma	contraindication	23986001	DOID:1686
Torsades de pointes	contraindication	31722008
Hyperthyroidism	contraindication	34486009	DOID:7998
Renal failure syndrome	contraindication	42399005	DOID:1074
Conduction disorder of the heart	contraindication	44808001
Hepatic failure	contraindication	59927004
Open-angle glaucoma	contraindication	84494001	DOID:1067
Epilepsy	contraindication	84757009	DOID:1826
Prolonged QT interval	contraindication	111975006
Seizure disorder	contraindication	128613002
Bipolar affective disorder, current episode manic	contraindication	191618007
Cerebrovascular accident	contraindication	230690007
Benign prostatic hyperplasia	contraindication	266569009
Retention of urine	contraindication	267064002
Non-Q wave myocardial infarction	contraindication	314207007
Breastfeeding (mother)	contraindication	413712001
Myocardial infarction in recovery phase	contraindication	418044006
Congenital long QT syndrome	contraindication	442917000

🐶 Veterinary Drug Use

None

🐶 Veterinary products

None

Acid dissociation constants calculated using MoKa v3.0.0

Dissociation level	Dissociation constant	Type (acidic/basic)
pKa1	9.5	Basic

Orange Book patent data (new drug applications)

None

Orange Book exclusivity data (new drug applications)

None

Bioactivity Summary:

Target	Class	Pharos	UniProt	Action	Type	Activity value (-log[M])	Bioact source	MoA source
Sodium-dependent noradrenaline transporter	Transporter	P23975	SC6A2_HUMAN	INHIBITOR	Kd	8.36	WOMBAT-PK	CHEMBL
Sodium-dependent serotonin transporter	Transporter	P31645	SC6A4_HUMAN	INHIBITOR	Ki	7.34	WOMBAT-PK	CHEMBL
D(1A) dopamine receptor	GPCR	P21728	DRD1_HUMAN		Ki	6.57	DRUG MATRIX
D(2) dopamine receptor	GPCR	P14416	DRD2_HUMAN		Ki	5.59	PDSP
Alpha-2A adrenergic receptor	GPCR	P08913	ADA2A_HUMAN		Ki	6.56	DRUG MATRIX
5-hydroxytryptamine receptor 1A	GPCR	P08908	5HT1A_HUMAN		Ki	6.51	WOMBAT-PK
5-hydroxytryptamine receptor 2A	GPCR	P28223	5HT2A_HUMAN		Ki	7.36	WOMBAT-PK
5-hydroxytryptamine receptor 2B	GPCR	P41595	5HT2B_HUMAN		Ki	7.07	DRUG MATRIX
5-hydroxytryptamine receptor 2C	GPCR	P28335	5HT2C_HUMAN		Ki	8	WOMBAT-PK
5-hydroxytryptamine receptor 6	GPCR	P50406	5HT6R_HUMAN		Ki	6.67	CHEMBL
D(3) dopamine receptor	GPCR	P35462	DRD3_HUMAN		Ki	7.22	DRUG MATRIX
Histamine H1 receptor	GPCR	P35367	HRH1_HUMAN		Kd	8.03	WOMBAT-PK
Histamine H2 receptor	GPCR	P25021	HRH2_HUMAN		Ki	5.64	DRUG MATRIX
Muscarinic acetylcholine receptor M1	GPCR	P11229	ACM1_HUMAN		Ki	7.40	WOMBAT-PK
Muscarinic acetylcholine receptor M2	GPCR	P08172	ACM2_HUMAN		Ki	6.96	WOMBAT-PK
Muscarinic acetylcholine receptor M3	GPCR	P20309	ACM3_HUMAN		Ki	7.30	WOMBAT-PK
Muscarinic acetylcholine receptor M4	GPCR	P08173	ACM4_HUMAN		Ki	7.08	WOMBAT-PK
Muscarinic acetylcholine receptor M5	GPCR	P08912	ACM5_HUMAN		Ki	7.01	WOMBAT-PK
Aldehyde oxidase	Enzyme	Q06278	AOXA_HUMAN		IC50	6.07	WOMBAT-PK
Alpha-2C adrenergic receptor	GPCR	P18825	ADA2C_HUMAN		Ki	7.52	DRUG MATRIX
Sodium-dependent dopamine transporter	Transporter	Q01959	SC6A3_HUMAN		Ki	5.92	PDSP
Cytochrome P450 2D6	Enzyme	P10635	CP2D6_HUMAN		Km	6.23	WOMBAT-PK
Alpha-1D adrenergic receptor	GPCR	P25100	ADA1D_HUMAN		Ki	6.91	DRUG MATRIX
Cytochrome P450 2C19	Enzyme	P33261	CP2CJ_HUMAN		IC50	5.52	DRUG MATRIX
Proto-oncogene tyrosine-protein kinase receptor Ret	Kinase	P07949	RET_HUMAN		IC50	5.82	CHEMBL
Voltage-dependent N-type calcium channel subunit alpha-1B	Ion channel	Q00975	CAC1B_HUMAN		IC50	5	CHEMBL
Alpha-1A adrenergic receptor	GPCR	P35348	ADA1A_HUMAN		Ki	7.26	WOMBAT-PK
ATP-sensitive inward rectifier potassium channel 10	Ion channel	P78508	KCJ10_HUMAN	BLOCKER	IC50	4.80	SCIENTIFIC LITERATURE
Alpha-2B adrenergic receptor	GPCR	P18089	ADA2B_HUMAN		Ki	7	WOMBAT-PK
Alpha-1B adrenergic receptor	GPCR		ADA1B_RAT		Ki	6.94	DRUG MATRIX
5-hydroxytryptamine receptor 1B	GPCR		5HT1B_RAT		Ki	5.84	DRUG MATRIX
Alpha-1A adrenergic receptor	GPCR		ADA1A_RAT		IC50	10.40	CHEMBL
5-hydroxytryptamine receptor 1A	GPCR		5HT1A_RAT		IC50	5.73	CHEMBL
Histamine H1 receptor	GPCR		HRH1_RAT		IC50	10.30	CHEMBL

External reference:

ID	Source
4019860	VUID
N0000147946	NUI
D00816	KEGG_DRUG
894-71-3	SECONDARY_CAS_RN
4017520	VANDF
4019860	VANDF
C0028420	UMLSCUI
CHEBI:7640	CHEBI
21B	PDB_CHEM_ID
CHEMBL445	ChEMBL_ID
DB00540	DRUGBANK_ID
CHEMBL1201156	ChEMBL_ID
D009661	MESH_DESCRIPTOR_UI
4543	PUBCHEM_CID
2404	IUPHAR_LIGAND_ID
1328	INN_ID
BL03SY4LXB	UNII
203130	RXNORM
2733	MMSL
2740	MMSL
5192	MMSL
d00144	MMSL
001502	NDDF
004601	NDDF
13432000	SNOMEDCT_US
29666006	SNOMEDCT_US
372652004	SNOMEDCT_US

Pharmaceutical products:

Product	Category	Ingredients	NDC	Form	Quantity	Route	Marketing	Label
Nortriptyline Hydrochloride	HUMAN PRESCRIPTION DRUG LABEL	1	0093-0810	CAPSULE	10 mg	ORAL	ANDA	13 sections
Nortriptyline Hydrochloride	HUMAN PRESCRIPTION DRUG LABEL	1	0093-0811	CAPSULE	25 mg	ORAL	ANDA	13 sections
Nortriptyline Hydrochloride	HUMAN PRESCRIPTION DRUG LABEL	1	0093-0812	CAPSULE	50 mg	ORAL	ANDA	13 sections
Nortriptyline Hydrochloride	HUMAN PRESCRIPTION DRUG LABEL	1	0093-0813	CAPSULE	75 mg	ORAL	ANDA	13 sections
Nortriptyline Hydrochloride	HUMAN PRESCRIPTION DRUG LABEL	1	0121-0678	SOLUTION	10 mg	ORAL	ANDA	19 sections
Nortriptyline Hydrochloride	HUMAN PRESCRIPTION DRUG LABEL	1	0121-0678	SOLUTION	10 mg	ORAL	ANDA	19 sections
Nortriptyline Hydrochloride	HUMAN PRESCRIPTION DRUG LABEL	1	0121-0678	SOLUTION	10 mg	ORAL	ANDA	19 sections
PAMELOR	HUMAN PRESCRIPTION DRUG LABEL	1	0406-9910	CAPSULE	10 mg	ORAL	NDA	19 sections
PAMELOR	HUMAN PRESCRIPTION DRUG LABEL	1	0406-9911	CAPSULE	25 mg	ORAL	NDA	19 sections
PAMELOR	HUMAN PRESCRIPTION DRUG LABEL	1	0406-9912	CAPSULE	50 mg	ORAL	NDA	19 sections
PAMELOR	HUMAN PRESCRIPTION DRUG LABEL	1	0406-9913	CAPSULE	75 mg	ORAL	NDA	19 sections
Nortriptyline Hydrochloride	HUMAN PRESCRIPTION DRUG LABEL	1	10544-567	CAPSULE	10 mg	ORAL	ANDA	18 sections
NORTRIPTYLINE HYDROCHLORIDE	HUMAN PRESCRIPTION DRUG LABEL	1	16590-171	CAPSULE	25 mg	ORAL	ANDA	16 sections
Nortriptyline Hydrochloride	HUMAN PRESCRIPTION DRUG LABEL	1	21695-093	CAPSULE	10 mg	ORAL	ANDA	13 sections
Nortriptyline Hydrochloride	HUMAN PRESCRIPTION DRUG LABEL	1	21695-094	CAPSULE	25 mg	ORAL	ANDA	13 sections
Nortriptyline Hydrochloride	HUMAN PRESCRIPTION DRUG LABEL	1	21695-599	CAPSULE	50 mg	ORAL	ANDA	13 sections
Nortriptyline Hydrochloride	HUMAN PRESCRIPTION DRUG LABEL	1	21695-600	CAPSULE	75 mg	ORAL	ANDA	13 sections
Nortriptyline Hydrochloride	HUMAN PRESCRIPTION DRUG LABEL	1	33261-348	CAPSULE	25 mg	ORAL	ANDA	18 sections
Nortriptyline Hydrochloride	HUMAN PRESCRIPTION DRUG LABEL	1	33261-532	CAPSULE	10 mg	ORAL	ANDA	18 sections
Nortriptyline Hydrochloride	HUMAN PRESCRIPTION DRUG LABEL	1	33261-692	CAPSULE	50 mg	ORAL	ANDA	18 sections
Nortriptyline Hydrochloride	HUMAN PRESCRIPTION DRUG LABEL	1	33261-804	CAPSULE	75 mg	ORAL	ANDA	18 sections
Nortriptyline Hydrochloride	HUMAN PRESCRIPTION DRUG LABEL	1	43063-722	CAPSULE	25 mg	ORAL	ANDA	18 sections
Nortriptyline Hydrochloride	HUMAN PRESCRIPTION DRUG LABEL	1	43063-722	CAPSULE	25 mg	ORAL	ANDA	18 sections
Nortriptyline Hydrochloride	HUMAN PRESCRIPTION DRUG LABEL	1	43063-897	CAPSULE	25 mg	ORAL	ANDA	19 sections
Nortriptyline Hydrochloride	HUMAN PRESCRIPTION DRUG LABEL	1	43063-897	CAPSULE	25 mg	ORAL	ANDA	19 sections
Nortriptyline Hydrochloride	HUMAN PRESCRIPTION DRUG LABEL	1	45865-371	CAPSULE	10 mg	ORAL	ANDA	18 sections
Nortriptyline Hydrochloride	HUMAN PRESCRIPTION DRUG LABEL	1	50090-0507	CAPSULE	25 mg	ORAL	ANDA	18 sections
Nortriptyline Hydrochloride	HUMAN PRESCRIPTION DRUG LABEL	1	50090-0507	CAPSULE	25 mg	ORAL	ANDA	18 sections
Nortriptyline Hydrochloride	HUMAN PRESCRIPTION DRUG LABEL	1	50090-0537	CAPSULE	10 mg	ORAL	ANDA	18 sections
Nortriptyline Hydrochloride	HUMAN PRESCRIPTION DRUG LABEL	1	50090-0537	CAPSULE	10 mg	ORAL	ANDA	18 sections