When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to protriptyline, or you had a recent heart attack.

How to Use This Medicine:
Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you. You may need to take this medicine for a few weeks before you begin to feel better.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine together with cisapride. Do not use this medicine and an MAO inhibitor (MAOI) within 14 days of each other.
• Some foods and medicines can affect protriptyline works. Tell your doctor if you are also using any of the following:
  
  • Cimetidine, guanethidine, quinidine, tramadol
  • Thyroid medicine, a phenothiazine medicine (such as chlorpromazine, perphenazine, promethazine, prochlorperazine, thioridazine), medicine for heart rhythm problems (propafenone, flecainide)
• Tell your doctor if you are also using other medicine to treat depression, such as fluoxetine, paroxetine, or sertraline. You may need to wait at least 5 weeks before you begin using protriptyline.
• Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have heart or blood vessel disease, glaucoma, problems with urination, seizures, or thyroid disease.
• For some children, teenagers, and young adults, this medicine may increase mental or emotional problems. This may lead to thoughts of suicide and violence. Talk with your doctor right away if you have any thoughts or behavior changes that concern you. Tell your doctor if you or anyone in your family has a history of bipolar disorder or suicide attempts.
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• This medicine may make you dizzy or drowsy. Do not drive or do anything that could be dangerous until you know how this medicine affects you.
• This medicine may raise or lower your blood sugar level.
• Tell any doctor or dentist who treats you that you are using this medicine. You may need to stop using this medicine several days before you have surgery or medical tests.
• Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Change in how much or how often you urinate, problems urinating
• Chest pain or fast, pounding, or uneven heartbeat
• Eye pain, vision changes, seeing halos around lights
• Feeling anxious, agitated, confused, restless, or irritable
• Lightheadedness, dizziness, or fainting
• Thoughts of hurting yourself or others, unusual behavior

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088