Protriptyline (Oral)

Protriptyline is a tricyclic antidepressant that is used in the treatment of depression in patients.


Protriptyline is used to treat depression in patients. While it is not known exactly how this treatment works, it is thought that it has an effect by increasing the levels of serotonin in the brain. This medication forms a part of the group of medications known as tricyclic antidepressants.

This medication comes in the form of a Vivactil tablet that is available only with a prescription from a doctor.

Conditions Treated

Type of Medicine

  • Tricyclic antidepressant

Side Effects

In addition to the required effects that may occur from the use of this treatment, other side effects that are unwanted can also arise from use. In some cases these side effects will require that you seek medical attention, while others may simply abate over time.

The following side effects would necessitate that you contact a doctor immediately:

Incidence not known:

  • Abdominal pains
  • Agitation
  • Belief that others can hear what you are thinking
  • Blurring of vision
  • Changed in urination volume, appearance or frequency
  • Chest pains
  • Cold sweats
  • Confusion about location, time and identity
  • Convulsions or seizures
  • Difficulty in speaking
  • Discomfort across the
  • Double vision
  • Drooling or dribbling
  • Faintness or dizziness when rising from a sitting or lying position
  • Feeling of being watched or controlled by others
  • Feeling of warmth when cool
  • Feeling of weakness in the arms, hands, legs or feet
  • Feeling, seeing, or hearing things not experienced by others
  • Fever occurring with or without chills
  • Hearing loss or change
  • Holding of false beliefs even when disproven
  • Hostility towards others
  • Hyperventilation
  • Inability to move arms, legs or face
  • Irregularity of heartbeat or puls
  • Irritability
  • Lack of coordination or control of movements
  • Lower back pain
  • Mental changes
  • Mood changes
  • Muscle spasming or jerking of all limbs
  • Muscle trembling
  • Muscle twitching
  • Nightmares
  • Pain or discomfort occurring in the arms, jaw, back or neck
  • Paling of the skin
  • Panic
  • Pins and needles sensations on the skin
  • Pounding felt in the ears
  • Red or purple spots appearing on the skin
  • Reddening of the face, neck, arms and/or upper chest
  • Shakiness and unsteadiness when walking
  • Side pain
  • Slurring of speech
  • Soreness of throat
  • Sores and/or ulcers around mouth
  • Stiffness of the limbs
  • Stomach pain
  • Stools with a clay-like coloration
  • Stupor
  • Sweating
  • Swelling of the glands
  • Swollen face, ankles or hands
  • Troubled sleeping
  • Twisting movements of the body or limbs
  • Uncontrolled excitement
  • Unexplained noises that are not heard by others
  • Unusual behavior
  • Unusual bleeding
  • Unusual bruising
  • Unusual tiredness
  • Unusual weakness
  • Weight gain
  • White spots on lips or mouth
  • Weight loss
  • Yellowing of the eyes
  • Yellowing of the skin

Other side effects may occur that would not normally necessitate that you visit a doctor. The following side effects will usually abate over time as your body gets used to the treatment or they may be only mild. If they become bothersome or are ongoing, however, then you should seek advice from your doctor about how to alleviate the side effects:

  • Abdominal cramping
  • Blackening of the tongue
  • Difficulty in passing bowel movements
  • Enlarged or swollen breasts
  • Enlarged pupils
  • Hair loss
  • Heartburn
  • Hives
  • Increased sensitivity of eyes to light
  • Increased sensitivity of skin to sunlight
  • Increased sexual ability or performance
  • Increased sexual desire or interest
  • Pain across the upper stomach
  • Pain in the throat
  • Pain or discomfort across the chest
  • Red or purple spots developing on the skin
  • Severe sunburn
  • Stomach cramps
  • Swelling of testicles
  • Swelling or inflammation of the mouth
  • Swelling, pain, or tenderness of the lymph glands
  • Thinning of the hair
  • Unexpected or increased milk flow produced from the breasts
  • Unusual taste
  • Waking with the need to urinate during the night
  • Welts

It is also possible to overdose on this medication. If you suspect that you or someone else has overdosed on this treatment then you should contact emergency services immediately. The symptoms of overdose from this medication include the following:

  • Changed level of consciousness
  • Clumsiness or loss on control of body
  • Confusion or disorientation
  • Disturbed ability to concentrate
  • Drowsiness extending to profound coma
  • Enlargement of the pupils
  • Increased frequency or severity of unconscious or jerking movements
  • Lowered body temperature
  • Muscle aches
  • Muscle tightness
  • Muscle weakness
  • Severe tiredness or sleepiness
  • Shivering when warm
  • Troubled breathing
  • Weak or feeble pulse

Other side effects that have not been listed herein may also occur from the use of this medication. If you experience other side effects then inform your doctor. If you are worried about your immediate health, however, then you should contact the emergency services.


This medication should only ever be used as directed by your doctor. You should never take more of it, take it more frequently or take it longer than directed by your doctor. Doing so can increase the risk of serious side effects occurring.

This medication will come with a medication guide that you should read and ensure that you understand. If you have any questions after reading then you should discuss these with your doctor.

The dose of this medication will differ depending on the patient, their condition and on other factors. You should take this treatment only as directed by your doctor and should not make any changes without first discussing them with your physician. The following dosing information is for reference only:

For the treatment of depression:

  • Adults - 15-40mg daily taken across 3 doses. This may be increased up to a maximum of 60mg daily.
  • Teenagers and Elderly patients - 5mg taken 3 times daily. This may be increased as required by the doctor.
  • Children - Individual cases must be determined by a doctor.


Medications can interact with one another in the body and should not be used together in some cases. This medication reacts with a wide range of other medications. In some cases these medications should not be used together in conjunction with Protriptyline at all. In other cases both treatments may be administered, but the doctor may make changes to the dose of one or both of the treatments.

The following medications should not be used in conjunction with Protriptyline. Your doctor may decide not to treat you with Protriptyline or may change one of your other medications:

  • Ziprasidone
  • Tranylcypromine
  • Thioridazine
  • Terfenadine
  • Sparfloxacin
  • Selegiline
  • Ranolazine
  • Piperaquine
  • Pimozide
  • Phenelzine
  • Moclobemide
  • Metoclopramide
  • Methylene Blue
  • Mesoridazine
  • Linezolid
  • Levomethadyl
  • Isocarboxazid
  • Grepafloxacin
  • Dronedarone
  • Clorgyline
  • Cisapride
  • Bromopride
  • Bepridil
  • Amifampridine

The use of Protriptyline in conjunction with the following medications is not normally recommended. Where the use of both is still the best treatment for you, your doctor may still prescribe both. They may wish to make changes to the frequency of use or dose of either Protriptyline or of the following treatments:

  • Zuclopenthixol
  • Zotepine
  • Zolmitriptan
  • Vortioxetine
  • Voriconazole
  • Vinflunine
  • Vilazodone
  • Vilanterol
  • Venlafaxine
  • Vemurafenib
  • Vasopressin
  • Vardenafil
  • Vandetanib
  • Valdecoxib
  • Triptorelin
  • Trimipramine
  • Trifluoperazine
  • Trazodone
  • Tramadol
  • Toremifene
  • Tolmetin
  • Tolfenamic Acid
  • Tiotropium
  • Tiaprofenic Acid
  • Tetrabenazine
  • Tenoxicam
  • Telithromycin
  • Telavancin
  • Tapentadol
  • Tacrolimus
  • Sunitinib
  • Sumatriptan
  • Sultopride
  • Sulpiride
  • Sulindac
  • Sotalol
  • Sorafenib
  • Solifenacin
  • Sodium Salicylate
  • Sodium Phosphate, Monobasic
  • Sodium Phosphate, Dibasic
  • Sodium Phosphate
  • Sevoflurane
  • Sertraline
  • Sertindole
  • Salsalate
  • Salicylic Acid
  • Safinamide
  • Rofecoxib
  • Risperidone
  • Rasagiline
  • Quinine
  • Quinidine
  • Quetiapine
  • Proquazone
  • Propyphenazone
  • Propafenone
  • Promethazine
  • Proglumetacin
  • Prochlorperazine
  • Procarbazine
  • Procainamide
  • Pranoprofen
  • Posaconazole
  • Pitolisant
  • Piroxicam
  • Pimavanserin
  • Piketoprofen
  • Phenylephrine
  • Phenylbutazone
  • Perflutren Lipid Microsphere
  • Pentamidine
  • Pazopanib
  • Pasireotide
  • Pargyline
  • Parecoxib
  • Panobinostat
  • Palonosetron
  • Paliperidone
  • Oxyphenbutazone
  • Oxymorphone
  • Oxymetazoline
  • Oxycodone
  • Oxilofrine
  • Oxaprozin
  • Ondansetron
  • Ofloxacin
  • Octreotide
  • Nortriptyline
  • Norfloxacin
  • Norepinephrine
  • Nimesulide Beta Cyclodextrin
  • Nimesulide
  • Nilotinib
  • Niflumic Acid
  • Nepafenac
  • Nefopam
  • Naratriptan
  • Naproxen
  • Nafarelin
  • Nabumetone
  • Moxifloxacin
  • Morniflumate
  • Moricizine
  • Mirtazapine
  • Mifepristone
  • Midodrine
  • Metronidazole
  • Methoxamine
  • Methadone
  • Meperidine
  • Meloxicam
  • Mefloquine
  • Mefenamic Acid
  • Meclofenamate
  • Lumiracoxib
  • Lumefantrine
  • Loxoprofen
  • Lornoxicam
  • Lorcainide
  • Lopinavir
  • Levothyroxine
  • Levofloxacin
  • Levalbuterol
  • Leuprolide
  • Lapatinib
  • Ketorolac
  • Ketoprofen
  • Ketoconazole
  • Ivabradine
  • Isradipine
  • Isoflurane
  • Iproniazid
  • Iobenguane I 123
  • Indomethacin
  • Imipramine
  • Iloperidone
  • Ibutilide
  • Ibuprofen
  • Hydroxyzine
  • Hydroxychloroquine
  • Histrelin
  • Halothane
  • Haloperidol
  • Halofantrine
  • Granisetron
  • Goserelin
  • Gonadorelin
  • Gemifloxacin
  • Gatifloxacin
  • Frovatriptan
  • Foscarnet
  • Flurbiprofen
  • Fluoxetine
  • Flufenamic Acid
  • Fluconazole
  • Floctafenine
  • Flecainide
  • Fingolimod
  • Feprazone
  • Fepradinol
  • Fenoprofen
  • Felbinac
  • Etoricoxib
  • Etofenamate
  • Etodolac
  • Etilefrine
  • Escitalopram
  • Erythromycin
  • Epinephrine
  • Enflurane
  • Efavirenz
  • Droxicam
  • Droperidol
  • Donepezil
  • Domperidone
  • Dolasetron
  • Dofetilide
  • Disopyramide
  • Dipyrone
  • Diflunisal
  • Diclofenac
  • Dextromethorphan
  • Dexketoprofen
  • Dexibuprofen
  • Desvenlafaxine
  • Deslorelin
  • Desipramine
  • Delamanid
  • Degarelix
  • Dasatinib
  • Darunavir
  • Dabrafenib
  • Cyclobenzaprine
  • Crizotinib
  • Clozapine
  • Clonixin
  • Clonidine
  • Clomipramine
  • ¬†Clarithromycin
  • Citalopram
  • Ciprofloxacin
  • Choline Salicylate
  • Chlorpromazine
  • Chloroquine
  • Celecoxib
  • Buserelin
  • Bupropion
  • Buprenorphine
  • Bufexamac
  • Bromfenac
  • Azithromycin
  • Astemizole
  • Aspirin
  • Asenapine
  • Arsenic Trioxide
  • Aripiprazole
  • Aprindine
  • Apomorphine
  • Anagrelide
  • Amtolmetin Guacil
  • Amoxapine
  • Amitriptyline
  • Amisulpride
  • Amiodarone
  • Alfuzosin
  • Albuterol
  • Acemetacin
  • Aceclofenac

The use of the following treatments can increase the side effects of Protriptyline or vice versa. The use of these treatments in conjunction would not normally be recommended and your doctor may wish to change dose and frequency of use where both are prescribed:

  • S-Adenosylmethionine
  • Phenprocoumon
  • Paroxetine
  • Dicumarol
  • Carbamazepine
  • Cannabis
  • Atomoxetine
  • Arbutamine
  • Acenocoumarol

Interactions with other drugs may also occur. Ensure that you have informed your doctor of all treatments that you take before beginning treatment with this medication.

Other medical conditions from which you suffer can also have an impact on the use of this medication in the treatment of depression. You should inform your doctor of all conditions from which you suffer. This is particularly important if you suffer from any of the following medical conditions:

These conditions may be worsened by the use of Protriptyline:

Protriptyline should not be used in patients who have suffered the following:

  • Recent heart attack

Other medical conditions may also affect the use of this treatment in patients. Ensure that you have informed your doctor of all conditions from which you suffer before use.


Before beginning treatment with this medication you should assess the benefits in relation to the risks of use. This is a decision that you should make in conjunction with your doctor having considered all of the following:


If you have ever reacted badly to medications in the past then this may inhibit your ability to use this treatment. Inform your doctor of all allergies from which you have suffered including allergies to: foods, animals, preservatives, dyes and other substances.


The safety and efficiency of use in children is unknown. You should discuss this with your doctor. Other more appropriate medications may be available for use as an alternative.


Elderly patients are at increased risk of having other medical conditions that could inhibit safe use. You should be cautious of kidney, liver and heart problems that may impact on the safe end efficient use in the elderly. Elderly patients should be started on a lower dose initially to assess their reaction to the treatment.


It is not yet known what the effect of Protriptyline is on a fetus. If you are pregnant, planning to get pregnant or believe you may become pregnant during use then you should discuss this with your doctor. Before beginning treatment ensure that you understand the risks of use.


There are no known risks to the use of this treatment while breastfeeding. There is, however, a shortage of information on the use of this treatment while breastfeeding. You should consider this carefully with your doctor and other treatments that are known not to pose a risk to the infant may be preferable in this case.

When using this medication you will need to make regular visits to your doctor to check your progress. They will also check for unwanted side effects and may make changes to your dose to get the best possible effect from treatment.

This medication should not be used if the patient has taken a monoamine oxidase (MAO) inhibitor within the previous fortnight. Patients should also avoid these treatments until 5 days have passed after cessation of the use of protriptyline. The use of both treatments can cause confusion, agitation, disorientation, restlessness, intestinal problems, very high blood pressure and convulsions in the patient.

Protriptyline should never be taken in conjunction with cisapride. Doing so will expose the patient to severe side effects.

This medication may increase thoughts of suicide in some cases. This is most common when used in children, teenagers and young adults. If you start to consider or contemplate suicide more often then you should tell your doctor immediately. Any new, unusual or worrying thoughts or behaviors that you have should be reported to your doctor straight away. This is especially important if they are worsening rapidly. Patients may also act recklessly, get upset quickly and have sudden strong feelings develop.

If anyone in your family suffers from bipolar disorder or has attempted suicide then this treatment may not be suitable for you.

You should never stop treatment with this medication without discussing this with a doctor. This treatment will need to be stopped gradually to prevent an intensification of your condition occurring. You must avoid withdrawal symptoms from this treatment which can be severe.

This medication will intensify the effects of central nervous system depressants. Examples of these include:

  • Alcohol
  • Tranquilizers
  • Sleeping medications
  • Barbiturates
  • Muscle relaxants
  • Narcotics
  • Anesthetics
  • Antihistamines

You should not take any such CNS depressants without first discussing this with your doctor. Doing so will expose you to serious risks.

You should limit your consumption of alcohol during treatment. Excessive use of alcohol will have serious side effects when you are taking protriptyline. If this concerns you then you should discuss your alcohol use with your doctor before beginning treatment.

The use of this medication may affect blood sugar levels and may affect diabetic treatment. You should discuss this with your doctor and monitor blood sugar levels closely if you are diabetic.

This medication may make you drowsy. You should learn how this medication affects you and ensure that you are completely safe to do so before you drive or operate machinery when taking it.

Do not take any other medications without first discussing them with your doctor. Doing so can increase the risk of certain side effects.


This treatment should be kept out of the reach of children at all times.

Medication should be stored in a sealed container at room temperature. Keep it out of direct light, away from heat and away from moisture. Ensure that the treatment does not freeze.

Outdated medication should be disposed of properly and safely as directed by your physician.


Protriptyline is used in the treatment of depression in patients. It is a tricyclic antidepressant.

The exact method by which this treatment works is unknown, but it is believed that the treatment works by increasing the serotonin levels in the brain.

This treatment is available only with a prescription and will need to be taken regularly to have the desired effect. This medication should be taken in a habit-forming manner that enables you to ensure that it is taken at the same time every day. This treatment can be taken with or without food, but should be taken with food if it irritates your stomach when you take it.

It is possible to overdose on this medication and you should be aware of the symptoms of overdose. If they occur then you will need to seek emergency medical attention for treatment.

This medication may also cause a range of side effects that would require you to seek medical attention. You should make yourself aware of these potential side effects before beginning treatment so that you can recognize them and seek the correct medical attention.

In some patients the use of this treatment may cause or increase thoughts of suicide. If this does occur or if you experience mood changes then it is vital that you inform your doctor right away.

This treatment can be used in adults as well as in teenagers and elderly adults. In teenagers and elderly adults, however, the initial dose will be lower due to an increased possibility of unwanted side effects occurring.

This medication should not be taken in conjunction with central nervous system depressants and these treatments will see their effects intensified when you are taking protriptyline. This includes alcohol and the consumption of alcohol should be avoided or limited. If you believe that this may be a problem for you then you should talk with your doctor before you begin treatment. Patients with alcohol dependencies may not be prescribed with this treatment at all.


Last Reviewed:
February 01, 2018
Last Updated:
April 05, 2018
Content Source: