Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets)

Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets)
© The Swiss Pharmacy

Sensival (Generic Nortriptyline Hydrochloride
Tablets) are used to treat mental/mood
problems such as depression. It may help
improve mood and feelings of well-being,
relieve anxiety and tension, and increase your
energy level. Sensival may also be used for the
treatment of some cases of nocturnal enuresis.

Sensival Tablets are manufactured by Wallace Pharma Limited, India
in the strengths of 25 mg.

Chemical Structure

The active ingredient contained in Sensival tablets is
Nortriptyline Hydrochloride.
Each film-coated Sensival tablet contains Nortriptyline
Hydrochloride equivalent to 25 mg of Nortriptyline.

Uses of Sensival 25 mg Tablets:
Sensival Tablets (Generic Nortriptyline Hydrochloride
Tablets) is used to treat mental/mood problems such as
depression. It could help improve mood and feelings of
well-being, relieve anxiety and tension, and increase your
energy level.
This medication belongs to a class of medications called
tricyclic antidepressants. Nortriptyline works on your
central nervous system to increase the level of certain
chemicals in your brain. This helps relieve your depression.
URL: https://www.theswisspharmacy.com/product_info.php?info=p9588_Sensival-Tablets.html

Recommended Adult Dosage
For most patients, the dose of Sensival Tablets (Generic
Nortriptyline Hydrochloride Tablets) is 25 mg three or four
times daily; dosage should begin at a low level and be
increased as required. As an alternate regimen, the total daily
dosage may be given once a day.
When doses above 100 mg daily are administered, plasma
levels of Nortriptyline should be monitored and maintained in
the optimum range of 50 to 150 ng/mL. Doses above 150
mg/day are not recommended.

Warnings
Great care is required if Nortriptyline is administered to hyperthyroid
patients or those receiving thyroid medication, because cardiac
arrhythmias may develop.
A major depressive episode may be the initial presentation of bipolar
disorder. It is generally believed (though not established in controlled
trials) that treating such an episode with an antidepressant alone may
increase the likelihood of precipitation of a mixed/manic episode in
patients at risk for bipolar disorder.
The development of a potentially life-threatening serotonin syndrome
has been reported with SNRIs and SSRIs, including Nortriptyline
Hydrochloride, alone but particularly with concomitant use of other
serotonergic drugs.

Recommended Dosage - Elderly and Adolescent Patients
For elderly and adolescent patients the dose of Sensival is 30
to 50 mg/day, in divided doses, or the total daily dosage may
be given once a day.
Nortriptyline Hydrochloride is not recommended for children.
Nortriptyline tablets are administered orally.
Lower than usual dosages are recommended for elderly
patients and adolescents. Lower dosages are also
recommended for outpatients than for hospitalized patients.

Contraindications
➔
Sensival is contraindicated in patients with a known
hypersensitivity to Nortriptyline Hydrochloride, Tricyclic
Antidepressants, or any component of the tablet.
➔
Cross-sensitivity between nortriptyline hydrochloride and other
Dibenzazepines is a possibility.
➔
Myocardial Infarction
➔
Nortriptyline Hydrochloride is contraindicated during the acute
recovery period after myocardial infarction.

Contraindications
➔
The use of MAOIs intended to treat psychiatric disorders with
Nortriptyline Hydrochloride or within 14 days of stopping
treatment with Nortriptyline Hydrochloride is contraindicated
because of an increased risk of serotonin syndrome.
➔
The use of Nortriptyline Hydrochloride within 14 days of stopping
an MAOI intended to treat psychiatric disorders is also
contraindicated.

Storage Instructions
Sensival Tablets (Generic Nortriptyline Hydrochloride
Tablets) have to be stored at controlled room
temperature i.e. from 20°C to 25°C (68°F to 77°F) with
excursions permitted between 15° to 30°C (59° to
86°F).
Keep this as well as all other medicines away from
children and pets.

Warnings
Patients with major depressive disorder (MDD), both adult and
pediatric, may experience worsening of their depression and/or the
emergence of suicidal ideation and behavior (suicidality) or unusual
changes in behavior, whether or not they are taking antidepressant
medications, and this risk may persist until significant remission occurs.
Suicide is a known risk of depression and certain other psychiatric
disorders, and these disorders themselves are the strongest predictors
of suicide. There has been a long-standing concern, however, that
antidepressants may have a role in inducing worsening of depression
and the emergence of suicidality in certain patients during the early
phases of treatment.

Warnings
Patients with cardiovascular disease should be given Nortriptyline only
under close supervision because of the tendency of the drug to
produce sinus tachycardia and to prolong the conduction time.
Myocardial infarction, arrhythmia and strokes have occurred.
The antihypertensive action of guanethidine and similar agents may be
blocked. Because of its anticholinergic activity, use Sensival tablets
(Nortriptyline) with great caution in patients with glaucoma or a history
of urinary retention.
Patients with a history of seizures should be followed closely when
Sensival (Nortriptyline Hydrochloride Tablets) is administered because
this drug is known to lower the convulsive threshold.

Warnings
There have been postmarketing reports of an association between
treatment with Nortriptyline Hydrochloride tablets and the unmasking
of Brugada syndrome. Brugada syndrome is a disorder characterized
by syncope, abnormal electrocardiographic (ECG) findings, and a risk of
sudden death.
The pupillary dilation that occurs following use of many antidepressant
drugs including Nortriptyline Hydrochloride tablets may trigger an
angle-closure attack in a patient with anatomically narrow angles who
does not have a patent iridectomy.
Nortriptyline may impair the mental and/or physical abilities required
for the performance of hazardous tasks, such as operating machinery
or driving a car; therefore, the patient should be warned accordingly.

Sensival Tablets and Alcohol
Sensival tablets may make you dizzy or drowsy or blur your
vision. Alcohol can make you more dizzy or drowsy. Limit
alcoholic beverages.
Excessive consumption of alcohol in combination with
Nortriptyline therapy may have a potentiating effect, which may
lead to the danger of increased suicidal attempts or overdosage,
especially in patients with histories of emotional disturbances or
suicidal ideation.
The patient should be informed that the response to alcohol may
be exaggerated.

Driving or Operating Machinery
Some people feel sleepy while they're taking Sensival Tablets
(Generic Nortriptyline Hydrochloride Tablets). It's best to stop
driving, cycling or operating machinery for the first few days and
after each dose increase, until you know how this medicine makes
you feel.
Nortriptyline Hydrochloride tablets may cause some people to
become drowsy. If this occurs, do not drive, use machines, or do
anything else that could be dangerous if you are not alert.
Dizziness, lightheadedness, or fainting may occur, especially when
you get up from a lying or sitting position. Getting up slowly may
help. If this problem continues or gets worse, check with your
doctor.

Possible Side Effects
Side effects of Sensival (Nortriptyline Hydrochloride tablets) are given below:
Cardiovascular - Hypotension, hypertension, tachycardia, palpitation,
myocardial infarction, arrhythmias, heart block, stroke.
Psychiatric - Confusional states (especially in the elderly) with hallucinations,
disorientation, delusions; anxiety, restlessness, agitation; insomnia, panic,
nightmares; hypomania; exacerbation of psychosis.
Neurologic - Numbness, tingling, paresthesias of extremities; incoordination,
ataxia, tremors; peripheral neuropathy; extrapyramidal symptoms; seizures,
alteration in EEG patterns; tinnitus.
Anticholinergic - Dry mouth and, rarely, associated sublingual adenitis;
blurred vision, disturbance of accommodation, mydriasis; constipation,
paralytic ileus; urinary retention, delayed micturition, dilation of the urinary
tract.

Allergic - Skin rash, petechiae, urticaria, itching, photosensitization (avoid
excessive exposure to sunlight); edema (general or of face and tongue),
drug fever, cross-sensitivity with other tricyclic drugs.
Hematologic - Bone marrow depression, including agranulocytosis;
eosinophilia; purpura; thrombocytopenia.
Gastrointestinal - Nausea and vomiting, anorexia, epigastric distress,
diarrhea, peculiar taste, stomatitis, abdominal cramps, black tongue.
Endocrine - Gynecomastia in the male, breast enlargement and
galactorrhea in the female; increased or decreased libido, impotence;
testicular swelling; elevation or depression of blood sugar levels;
syndrome of inappropriate ADH (antidiuretic hormone) secretion.

Other - Jaundice (simulating obstructive), altered liver function;
weight gain or loss; perspiration; flushing; urinary frequency,
nocturia; drowsiness, dizziness, weakness, fatigue; headache;
parotid swelling; alopecia.
Withdrawal Symptoms - Though these are not indicative of
addiction, abrupt cessation of treatment after prolonged therapy
may produce nausea, headache, and malaise.
Postmarketing Experience:
Cardiac Disorders - Brugada syndrome
Eye Disorders – angle-closure glaucoma

Sensival Tablets Overdosage
50mg of a tricyclic antidepressant can be an overdose in a child. Of patients
who are alive at presentation, mortality of 0-15% has been reported.
Symptoms may begin within several hours and may include blurred vision,
confusion, restlessness, dizziness, hypothermia, hyperthermia, agitation,
vomiting, hyperactive reflexes, dilated pupils, fever, rapid heart rate,
decreased bowel sounds, dry mouth, inability to void, myoclonic jerks,
seizures, respiratory depression, myoglobinuric renal failure, nystagmus,
ataxia, dysarthria, choreoathetosis, coma, hypotension and cardiac
arrhythmias.
Cardiac conduction may be slowed, with prolongation of QRS complex and
QT intervals, right bundle branch and AV block, ventricular tachyarrhythmias
(including Torsade de pointes and fibrillation) and death.

Treatment of Sensival Tablets Overdosage
Symptomatic and supportive therapy is recommended. Activated
charcoal may be more effective than emesis or lavage to reduce
absorption.
Ventricular arrhythmias, especially when accompanied by lengthened
QRS intervals, may respond to alkalinisation by hyperventilation or
administration of sodium bicarbonate. Serum electrolytes should be
monitored and managed. Refractory arrhythmias may respond to
propranolol, bretylium or lignocaine. Quinidine and procainamide
usually should not be used because they may exacerbate arrhythmias
and conduction already slowed by the overdose.

Sensival Tablets During Pregnancy
Nortriptyline Hydrochloride (Sensival Tablets) has been classified by
the AU FDA as Pregnancy Category C.
The safety of Nortriptyline Hydrochloride (Sensival Tablets) for use
during pregnancy has not been established, nor is there evidence from
animal studies that it is free from hazard; therefore the drug should not
be administered to pregnant patients or women of childbearing age
unless the potential benefits clearly outweigh any potential risk.

Sensival Tablets (Generic Nortriptyline
Hydrochloride Tablets) are manufactured by Wallace
Pharma Limited, India.

Sensival Tablets (Generic Nortriptyline Hydrochloride Tablets)

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