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Nortriptyline (Pamelor)

Antidepressantprescriptionoral · inferred

Secondary amine tricyclic antidepressant (TCA) and active metabolite of amitriptyline. More norepinephrine-selective than parent compound with less anticholinergic, sedative, and orthostatic effects, the best-tolerated TCA. Therapeutic drug monitoring recommended (target 50-150 ng/mL). Used for depression, neuropathic pain, migraine prophylaxis, and smoking cessation. CYP2D6 substrate, genotype affects dosing significantly.

Projected serum levels — 25 mg, once daily

Nortriptyline (Pamelor)
Nortriptyline (Pamelor) modeled serum levels, 25 mg once daily over 15 days Population-based pharmacokinetic estimate. Steady state reached after approximately 4 days. 0 0.50 1 1.5 2 Day 0 Day 4 Day 8 Day 11 Day 15 Time on a regular schedule ≈ steady state · day 4
Nortriptyline (Pamelor) modeled serum levels with a loading dose of 62.2 mg, then 25 mg once daily The first dose is larger so levels approach steady state faster. 0 0.50 1 1.5 2 Day 0 Day 4 Day 8 Day 11 Day 15 Time on a regular schedule

Maintenance schedule: 25 mg once daily (oral).

Loading schedule: 62.2 mg on day 1, then 25 mg once daily — reaching therapeutic levels sooner.

Modeled steady state after ~4 days: peak ≈ 2.0 mg, trough ≈ 1.4 mg body load. Population-based estimate over 15 days for a 25 mg dose at a 70 kg reference body mass — the interactive app scales curves to your doses, timing, and body mass.

Key facts

Category
Antidepressant
Route modeled
Oral
Model confidence
inferred
Half-life
30 h
Common dose
25 mg
Suggested maximum
150 mg/day
Reference dose range
12.5–150 mg (single dose)
Suggested cadence
once daily
Validated against
25 mg oral — Cmax 0.020 mg/L at 7.5 h

Documented interactions

  • danger
    1P-LSD (1-Propionyl-LSD) + Nortriptyline (Pamelor) Serotonin risk

    1P-LSD (1-Propionyl-LSD) and Nortriptyline (Pamelor) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental status).

  • danger
    25I-NBOMe + Nortriptyline (Pamelor) Serotonin risk

    25I-NBOMe and Nortriptyline (Pamelor) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental status).

  • danger
    2C-I (2,5-Dimethoxy-4-iodophenethylamine) + Nortriptyline (Pamelor) Serotonin risk

    2C-I (2,5-Dimethoxy-4-iodophenethylamine) and Nortriptyline (Pamelor) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental…

  • danger
    2C-B (4-Bromo-2,5-dimethoxyphenethylamine) + Nortriptyline (Pamelor) Serotonin risk

    2C-B (4-Bromo-2,5-dimethoxyphenethylamine) and Nortriptyline (Pamelor) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental…

  • danger
    4-AcO-DMT (Psilacetin) + Nortriptyline (Pamelor) Serotonin risk

    4-AcO-DMT (Psilacetin) and Nortriptyline (Pamelor) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental status).

  • danger
    5-MeO-DMT (5-Methoxy-N,N-dimethyltryptamine) + Nortriptyline (Pamelor) Serotonin risk

    5-MeO-DMT (5-Methoxy-N,N-dimethyltryptamine) and Nortriptyline (Pamelor) both have serotonergic activity. Risk of serotonin syndrome (hyperthermia, rigidity, autonomic instability, altered mental…

Serum checks 230 modeled interaction pairings for nortriptyline (pamelor) across your whole stack — absorption conflicts, enzyme inhibition, and nutrient depletion included.

Research behind this entry

  1. Amitriptyline versus nortriptyline: efficacy and tolerability in depressed outpatients Miller HL et al. · Journal of Affective Disorders, 1989 DOI

    Head-to-head RCT finding nortriptyline equally effective as amitriptyline for depression but with significantly fewer anticholinergic and sedative side effects, establishing it as the preferred TCA.

  2. Clinical pharmacokinetics of nortriptyline: pharmacogenomics and therapeutic drug monitoring Hicks JK et al. · Clinical Pharmacology & Therapeutics, 2017 DOI

    CPIC pharmacogenomic guideline establishing CYP2D6 genotype-based nortriptyline dosing: 50% dose reduction for poor metabolizers, standard dose for extensive metabolizers, and 25% increase for ultrarapid metabolizers.

2 published studies referenced in the app, each with a plain-language summary.