This medication is a tricyclic antidepressant, prescribed for depression. It is also prescribed for migraine and nerve pain.  It corrects the imbalance of chemical substances acting on the nervous system.

Contraindicated in patients who are taking antihistamines, or who have taken MAOIs within the last 14days and hypersensitivity.

Adult: PO- Depression- Initial:50-75 mg/day; up to 150 mg/day if needed. Max: 300 mg/day in severe cases.
Neuropathic pain- Initial: 10-25 mg/day at night, up to 75 mg/day if needed.
Migraine prophylaxis- Initial: 10 mg/day at night. Maintenance: 50-75 mg/day at night.

It comes as a tablet, to take by mouth, with or without food.

• Caution should be exercised in patients with history of irregular heartbeat, heart disease, chest pain, liver disease, prostate problems, overactive thyroid, urinary retention, suicidal thoughts, alcohol addiction, any allergy, who are taking other medications, elderly, during pregnancy and breastfeeding.

• It may cause dizziness, drowsiness or blurred vision, do not drive a car or operate machinery, get up slowly from bed while taking this medication.

• Avoid alcohol consumption.

• Patient may develop with involuntary muscle movements; if it so consult with your doctor immediately.

• Avoid prolonged exposure to sunlight.

• It may cause heatstroke, protect from hot weather.

•   Body as a Whole: Lupus-like syndrome.
•  Liver: Liver failure.
•   Heart : Heart attack, stroke, nonspecific ECG changes, heart block, irregular heartbeat, low/high blood pressure, fainting, fast heart rate and palpitations.
•   Central Nervous System : Coma, seizures, hallucinations, delusions, confusion, disorientation, in coordination, unsteadiness, tremors, nerve disease, numbness, tingling, involuntary movements, poor concentration, excitement, anxiety, sleeplessness, restlessness, abnormal dreams, drowsiness, dizziness, weakness, fatigue and headache.
•   Allergic : Skin rash, hives, photosensitivity, swelling of the face and tongue.
•   Blood : Bone marrow depression including decreased blood cell counts and bruising.
•   Gastrointestinal : Nausea, vomiting, loss of appetite, mouth ulcer, peculiar taste and diarrhea.
•   Eye and ENT : Blurred vision, dim vision, increased eye pressure, dilatation of pupil and dry mouth.
•   Genitourinary : Testicular swelling and breast enlargement in males, spontaneous flow of milk from the nipple in females, increased or decreased sexual drive, impotence, urinary retention and lowered blood sugar levels.
•   Miscellaneous : Hair loss, weight gain or loss, urinary frequency and increased sweating.

This medication may develop with increased risk of suicidal thoughts in children and teenagers; watch them carefully.
Monitor blood sugar level regularly while taking this medication.

Store it at room temperature, and in an airtight container. Keep away from children.