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Lisa, MSN, FNP-BC, CCRN
Lisa, MSN, FNP-BC, CCRN, Nurse Practitioner
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how to taper off of Nortriptyline

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Hello;

 

Thank you for writing in today. Obviously, a Nortriptyline taper should only be done under the care of your medical provider; however, I can give you a general idea of how your provider may recommend a taper. In order to do so, I do have a few questions. I hope you understand.

 

Dose per day?

How long have you been taking the medication?

Why are you taking the medication? (This drug has several indications for use.)

Any other medical conditions?

What other medications are you taking?

 

Please let me know.

 

Ms. Lisa

Customer reply replied 7 years ago.
i am taking it for chronic pain. currently taking 20 mg at bedtime. I also take synthroid and fosamax. I have been taking Nortriptyline for 14 days. I just want to know for down the road should i need to stop it.

Hello;

 

Thank you for responding.

 

At this time, you're not on a very large dose and haven't been on it for very long. At this point, a taper would probably drop you to 10 mg and possibly 5. You would be off in about a week. However, the longer you are on the drug and if the dose is increased, your taper will be done more conservatively over a longer period of time. A nortriptyline taper can be done in a number of days to weeks, depending on the dose and length of time on the drug. Therefore, if you ever feel that you are experiencing bothersome side effects or just desire to get off of the medication, you should notify your provider right away, so that a taper can be prescribed, because it will take time to come off of the medication.

 

I hope this helps. If you have additional questions, concerns, or would like to discuss this further, please let me know.

 

Ms. Lisa

Customer reply replied 7 years ago.
I am wanting a formula to taper by please.

I can't provide a specific formula for taper to use in the future. This would entirely depend on the dose and length of time you are on the medication. If you taper in 1 year, this will be different from tapering in 5 years. Also, the speed of the taper will be dependent on your symptoms. If after a couple of days on the taper, you have some withdrawal symptoms or your pain in unbearable, your taper may be prolonged. If you tolerate your taper well, your provider may be more aggressive with a more rapid taper. Tapering will be dependent on cummulative dose, length of time on medication, and symptoms/tolerance of taper. Therefore it is impossible to give you a taper formula to use in the future. Tapering is individualized, based on patient needs and circumstances, which is why a provider is necessary to monitor Nortriptyline tapering.

 

I will provide you with an example of a taper; however, again, this can't be used a a prescribed taper specific to you for in the future, due to the other variables.

 

Example--

 

Nortriptyline 10 mg . Take one tab every night x 5 nights; Then, decrease to 1/2 tab every night x 5 nights; Then stop.

 

I hope this helps. If you have any additional questions or concerns, please let me know.

 

Ms. Lisa