Medicine Information

Aventy

Name: Aventy
Brand: Aventy
Rating: 4.5 (117 reviews)

Tablet50 mgTricyclic Antidepressants (TCAs)ATC: N06AA10

Generic Name

Nortriptyline Hydrochloride

Manufacturer

Square Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
aventy 50 mg tablet	৳ 60.00	৳ 240.00

Description

Overview of the medicine

Aventy 50 mg Tablet contains Nortriptyline, a tricyclic antidepressant primarily used to treat symptoms of depression. It works by affecting certain chemicals in the brain that are out of balance in people with depression. It can also be used for neuropathic pain and chronic pain conditions.

Uses & Indications

Major depressive disorder

Neuropathic pain (e.g., diabetic neuropathy, postherpetic neuralgia)

Chronic pain syndromes

Migraine prophylaxis (off-label)

Dosage

Adults

Initially 25 mg three or four times daily, or 50-150 mg once daily at bedtime. Dosage should be adjusted based on patient response and tolerability, up to a maximum of 150 mg/day.

Elderly

Lower doses are recommended, typically starting at 10-25 mg daily, with gradual titration. Monitor for adverse effects.

Renal_impairment

No specific dose adjustment is generally required, but use with caution in severe renal impairment.

How to Take

Take orally with or without food. It can be taken as a single daily dose, preferably at bedtime, or in divided doses.

Mechanism of Action

Nortriptyline inhibits the reuptake of norepinephrine and, to a lesser extent, serotonin in the central nervous system. This increases the concentration of these neurotransmitters in the synaptic cleft, leading to antidepressant effects. It also has anticholinergic, antihistaminic, and alpha-adrenergic blocking properties.

Pharmacokinetics

Onset

Antidepressant effects may take 2-4 weeks to become noticeable. Pain relief may be quicker.

Excretion

Mainly excreted in the urine as metabolites, with a small amount excreted in feces.

Half life

18-56 hours (average 28 hours), with considerable inter-individual variability.

Absorption

Well absorbed orally; peak plasma levels usually occur within 7-8.5 hours.

Metabolism

Extensively metabolized in the liver by cytochrome P450 enzymes (primarily CYP2D6) into active and inactive metabolites.

Side Effects

Contraindications

Hypersensitivity to Nortriptyline or any excipients
Concurrent use or within 14 days of discontinuing Monoamine Oxidase Inhibitors (MAOIs)
Acute recovery period after myocardial infarction

Drug Interactions

MAOIs

Contraindicated due to risk of serotonin syndrome and hypertensive crisis.

Cimetidine

May increase plasma concentrations of Nortriptyline.

SSRIs and SNRIs

Increased risk of serotonin syndrome; may increase Nortriptyline levels.

Thyroid hormones

Increased risk of cardiac arrhythmias.

Anticholinergic drugs

Increased anticholinergic side effects (e.g., dry mouth, urinary retention).

Antiarrhythmics (e.g., quinidine)

May increase Nortriptyline levels and cardiac effects.

CNS Depressants (e.g., alcohol, benzodiazepines)

Potentiation of CNS depressant effects.

Storage

Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.

Overdose

Symptoms of overdose include severe drowsiness, confusion, agitation, hallucinations, seizures, cardiac arrhythmias (tachycardia, QT prolongation), hypotension, shock, coma. Management involves supportive care, gastric lavage, activated charcoal, and symptomatic treatment of complications (e.g., anticonvulsants for seizures, antiarrhythmics for cardiac issues).

Pregnancy & Lactation

Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Nortriptyline is excreted in breast milk; therefore, caution should be exercised when administered to a nursing woman.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 x 10 tablets (100 tablets in a box)

Shelf Life

Typically 2-3 years from the date of manufacture.

Availability

Available in pharmacies nationwide

Approval Status

Approved by regulatory authorities (e.g., DGDA in Bangladesh)

Patent Status

Off-patent

WHO Essential Medicine

Yes

Clinical Trials

Nortriptyline has been extensively studied in numerous clinical trials for its efficacy in depression and neuropathic pain, demonstrating significant benefits compared to placebo in many studies. Ongoing research explores its role in other conditions.

Lab Monitoring

Plasma drug levels (therapeutic drug monitoring) to optimize dose and minimize toxicity
ECG (electrocardiogram) for cardiac abnormalities, especially in elderly patients or those with pre-existing heart conditions
Liver function tests (LFTs) periodically
Blood pressure and heart rate monitoring

Doctor Notes

Initiate therapy with low doses and titrate gradually to minimize side effects and optimize therapeutic response.
Monitor for suicidal ideation, especially at the initiation of treatment and after dose changes.
Consider therapeutic drug monitoring (TDM) for patients not responding or experiencing significant side effects.
Caution in patients with cardiac disease, glaucoma, urinary retention, or seizure disorders.

Patient Guidelines

Take the medicine exactly as prescribed by your doctor.
Do not stop taking the medicine suddenly without consulting your doctor, as it can lead to withdrawal symptoms.
Be aware that antidepressant effects may take several weeks to manifest.
Report any new or worsening symptoms of depression, suicidal thoughts, or unusual behavior changes to your doctor immediately.

Missed Dose Advice

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.

Driving Precautions

Nortriptyline may cause drowsiness, dizziness, or blurred vision. Avoid driving or operating machinery until you know how this medicine affects you.

Lifestyle Advice

Avoid alcohol consumption while taking this medication.
Maintain good oral hygiene to manage dry mouth.
Stay hydrated to alleviate constipation and dry mouth.
Rise slowly from a sitting or lying position to minimize dizziness due to orthostatic hypotension.