Pamelor

What you should know before using

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to medicines in this group or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatrics

Children are especially sensitive to the effects of this medicine. This may increase the chance of side effects during treatment. However, side effects in children taking this medicine for bedwetting usually disappear upon continued use. The most common of these are nervousness, sleeping problems, tiredness, and mild stomach upset. If these side effects continue or are bothersome, check with your doctor.

Antidepressants must be used with caution in children with depression. Studies have shown occurrences of children thinking about suicide or attempting suicide in clinical trials for this medicine. More study is needed to be sure antidepressants are safe and effective in children

Geriatric

Drowsiness, dizziness, confusion, vision problems, dryness of mouth, constipation, and problems in urinating are more likely to occur in elderly patients, who are usually more sensitive than younger adults to the effects of tricyclic antidepressants.

Studies have not been done in pregnant women. However, there have been reports of newborns suffering from muscle spasms and heart, breathing, and urinary problems when their mothers had taken tricyclic antidepressants immediately before delivery. Also, studies in animals have shown that some tricyclic antidepressants may cause unwanted effects in the fetus.

Breast Feeding

Tricyclic antidepressants pass into the breast milk. Doxepin has been reported to cause drowsiness in the nursing baby.

Drug Interactions

Using medicines in this class with any of the following medicines is not recommended. Your doctor may decide not to treat you with a medication in this class or change some of the other medicines you take.

• Bepridil
• Cisapride
• Clorgyline
• Furazolidone
• Grepafloxacin
• Iproniazid
• Isocarboxazid
• Levomethadyl
• Mesoridazine
• Moclobemide
• Nialamide
• Pargyline
• Phenelzine
• Pimozide
• Procarbazine
• Selegiline
• Sparfloxacin
• Terfenadine
• Thioridazine
• Toloxatone
• Tranylcypromine
• Ziprasidone

Using medicines in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Acecainide
• Ajmaline
• Amiodarone
• Amisulpride
• Amprenavir
• Aprindine
• Arsenic Trioxide
• Astemizole
• Atazanavir
• Azimilide
• Bretylium
• Chloral Hydrate
• Chloroquine
• Clarithromycin
• Clonidine
• Clorgyline
• Darifenacin
• Disopyramide
• Dofetilide
• Dolasetron
• Droperidol
• Enflurane
• Entacapone
• Epinephrine
• Erythromycin
• Etilefrine
• Flecainide
• Fluconazole
• Fluoxetine
• Fosamprenavir
• Foscarnet
• Gatifloxacin
• Gemifloxacin
• Halofantrine
• Haloperidol
• Halothane
• Hydroquinidine
• Ibutilide
• Iproniazid
• Isoflurane
• Isradipine
• Lidoflazine
• Linezolid
• Lorcainide
• Methoxamine
• Midodrine
• Moxifloxacin
• Nefazodone
• Nefopam
• Nialamide
• Norepinephrine
• Octreotide
• Olanzapine
• Oxilofrine
• Pargyline
• Pentamidine
• Phenelzine
• Phenylephrine
• Pirmenol
• Prajmaline
• Procainamide
• Procarbazine
• Prochlorperazine
• Propafenone
• Quetiapine
• Quinidine
• Risperidone
• Selegiline
• Sematilide
• Sertindole
• Sertraline
• Sotalol
• Spiramycin
• Sulfamethoxazole
• Sultopride
• Tedisamil
• Telithromycin
• Toloxatone
• Tramadol
• Trifluoperazine
• Trimethoprim
• Vasopressin
• Venlafaxine
• Zolmitriptan
• Zotepine

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other Medical Problems

The presence of other medical problems may affect the use of medicines in this class. Make sure you tell your doctor if you have any other medical problems, especially:

• Alcohol abuse (or history of)—Drinking alcohol may cause increased CNS depressant effects.

• Asthma or
• Bipolar disorder (manic-depressive illness) or
• Blood disorders or
• Convulsions (seizures) or
• Difficult urination or
• Enlarged prostate or
• Glaucoma or increased eye pressure or
• Heart disease or
• High blood pressure (hypertension) or
• Schizophrenia—Tricyclic antidepressants may make the condition worse.

• Kidney disease or
• Liver disease—Higher blood levels of tricyclic antidepressants may result, increasing the chance of side effects.

• Overactive thyroid or
• Stomach or intestinal problems—Tricyclic antidepressants may cause an increased chance of serious side effects.