155. Treatment Recommendations: Medications-Nortriptyline (Continued)

Treating Tobacco Use and Dependence: 2008 Update

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Nortriptyline HCl—Prescription only.

Prescribing instructions

Initiate—Therapy is initiated 10-28 days before the quit date to allow nortriptyline to reach steady state at the target dose.

Therapeutic monitoring—Although therapeutic blood levels for smoking cessation have not been determined, therapeutic monitoring of plasma nortriptyline levels should be considered under American Psychiatric Association Guidelines for treating patients with depression. Clinicians may choose to assess plasma nortriptyline levels as needed.

Dosing information—Users should not discontinue nortriptyline abruptly due to withdrawal effects.

Overdose may produce severe and life-threatening cardiovascular toxicity, as well as seizures and coma. Risk of overdose should be considered carefully before using nortriptyline.


25 mg box of 60 = $24.00 (daily dosage determines how long supply lasts

a. Cost data were established by averaging the retail price of the medication at national chain pharmacies in Atlanta, GA, Los Angeles, CA, Milwaukee, WI, Sunnyside, NY and listed on-line during January 2008 and may not reflect discounts available to health plans and others.

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Page last reviewed October 2014
Page originally created September 2012
Internet Citation: 155. Treatment Recommendations: Medications-Nortriptyline (Continued). Content last reviewed October 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/tobacco/clinicians/presentations/2008update-full/slide155.html