Protriptyline Hydrochloride
Pronunciation: (proe-TRIP-ti-leen).
- Generic name
- Protriptyline hydrochloride
- Brand names
- Protyline, Triptil, Vivactil, Prothiaden
- Drug class
- Mental Health & Psychiatry
Availability and supply rules vary by country
Trade names by country:
Australia: · Full directory
What Protriptyline hydrochloride is and how it works
Uses, formulations, monitoring, and supply rules can differ by patient, product, and country. Follow the exact local product information and professional advice.
Mechanism of action: how Protriptyline hydrochloride works
Protriptyline is a tricyclic antidepressant that inhibits the reuptake of norepinephrine and, to a lesser extent, serotonin at the presynaptic neuronal membrane. This increases the concentration of these neurotransmitters in the synaptic cleft, enhancing neurotransmission and improving mood. It also has anticholinergic and sedative properties. (2) (3)
What Protriptyline hydrochloride is used for
Depression
Narcolepsy
Attention-deficit/hyperactivity disorder (ADHD)
Chronic fatigue syndrome
Before taking Protriptyline hydrochloride
Do not take / not appropriate for
- Contraindicated in patients with recent myocardial infarction, current or recent (within 14 days) MAOI use, and known hypersensitivity to protriptyline or other TCAs. (Contraindication) (2)
Tell your clinician about
(2) (3)How to take Protriptyline hydrochloride
- General Instructions: Take protriptyline exactly as prescribed by your doctor. Do not take more or less than directed. It is usually taken 1 to 3 times daily, with or without food.. Adult Dosing: Typical starting dose for depression is 15 to 40 mg per day in divided doses. The maximum recommended dose is 60 mg per day.. Pediatric Dosing: Safety and efficacy in children have not been established. Use in pediatric patients is not routinely recommended.. Administration: Swallow tablets whole with a glass of water. Take at the same times each day to maintain steady levels in your body.. When To Stop: Do not stop taking protriptyline suddenly. Your doctor will guide you on how to taper the dose to avoid withdrawal symptoms.. Storage: Store at room temperature (20–25°C/68–77°F), away from moisture, heat, and light. Keep out of reach of children.
- This page does not provide a dose calculator. Dosing must follow the prescriber, pharmacist, or product label.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (2) (3)
Missed dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular schedule. Do not take an extra dose to catch up.
Overdose
Overdose of protriptyline can be life-threatening. Symptoms may include severe drowsiness, confusion, hallucinations, rapid or irregular heartbeat, seizures, or loss of consciousness. Seek emergency medical help or call your local poison control center immediately. (2) (3)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms to a healthcare professional.
Dry mouth
Incidence: Reported in the clinician-authored database; frequency not established
Constipation
Incidence: Reported in the clinician-authored database; frequency not established
Blurred vision
Incidence: Reported in the clinician-authored database; frequency not established
Drowsiness
Incidence: Reported in the clinician-authored database; frequency not established
Urinary retention
Incidence: Reported in the clinician-authored database; frequency not established
Orthostatic hypotension
Incidence: Reported in the clinician-authored database; frequency not established
Tachycardia
Incidence: Reported in the clinician-authored database; frequency not established
Seizures
Incidence: Reported in the clinician-authored database; frequency not established
Serious warnings
FDA BOXED WARNING — Suicidality and Antidepressant Drugs — serious
Symptoms: FDA BOXED WARNING — Suicidality and Antidepressant Drugs: antidepressants increased the risk, compared with placebo, of suicidal thinking and behavior in children, adolescents, and young adults in short-term studies of major depressive disorder and other psychiatric disorders. Anyone considering protriptyline or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increased risk of suicidality with antidepressants versus placebo in adults beyond age 24, and showed a reduced risk in adults 65 and older; depression and certain other psychiatric disorders are themselves associated with an increased risk of suicide. Patients of all ages starting antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior, and families/caregivers should be advised of the need for close observation and communication with the prescriber. Protriptyline is not approved for use in pediatric patients.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2) (3)
May increase risk of suicidal thoughts or actions, especially in young adults and adolescents (see FDA boxed warning above) — serious
Symptoms: May increase risk of suicidal thoughts or actions, especially in young adults and adolescents (see FDA boxed warning above). Can cause heart rhythm disturbances; use with caution in patients with cardiac disease. May worsen glaucoma or urinary retention. Can interact with many other medications; inform your doctor of all medicines you take. Not recommended for use during pregnancy or breastfeeding unless clearly needed.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2) (3)
Contraindications recorded in the clinician database — serious
Symptoms: Contraindications recorded in the clinician database: Contraindicated in patients with recent myocardial infarction, current or recent (within 14 days) MAOI use, and known hypersensitivity to protriptyline or other TCAs. Use with caution in patients with cardiovascular disease, glaucoma, urinary retention, seizure disorders, hyperthyroidism, and elderly patients due to increased risk of adverse effects.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2) (3)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Recorded interactions | Protriptyline can interact with a wide range of medications, including MAO inhibitors, other antidepressants, anticholinergic drugs, antihistamines, and certain heart medications. Combining protriptyline with these drugs can increase the risk of serious side effects such as serotonin syndrome, heart rhythm disturbances, or excessive sedation. Always inform your healthcare provider of all prescription, over-the-counter, and herbal products you are taking. | (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
The FDA label states that safe use in pregnancy has not been established; use in pregnant women or women who may become pregnant requires that possible benefits be weighed against possible hazards to mother and child. In mice, rats, and rabbits, doses about ten times the recommended human dose showed no apparent adverse effects on reproduction. Discuss any pregnancy or plans for pregnancy with your prescriber. (2) (3)
Breastfeeding
The FDA label states that safe use during lactation has not been established; use in nursing mothers requires that possible benefits be weighed against possible hazards to mother and child. Discuss breastfeeding with your healthcare provider before use. (2) (3)
Children
Frequency: Not applicable. Weight Based: Not recommended for pediatric use. Max Daily Dose: Not applicable. Max Single Dose: Not applicable. Age Restrictions: Protriptyline is not approved for use in pediatric patients (see FDA boxed warning on antidepressants and suicidality in children, adolescents, and young adults). (2) (3)
Renal_impairment
The FDA label does not include a dedicated renal- or hepatic-impairment dosing section for protriptyline. It notes that dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function in that group. No specific dose-reduction table is given for renal or hepatic impairment at any age; renal and hepatic status should be assessed by the prescriber, who may choose a lower starting dose. (2) (3)
Hepatic_impairment
The FDA label does not include a dedicated renal- or hepatic-impairment dosing section for protriptyline. It notes that dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function in that group. No specific dose-reduction table is given for renal or hepatic impairment at any age; renal and hepatic status should be assessed by the prescriber, who may choose a lower starting dose. (2) (3)
Monitoring
(2) (3)Storage
Store at 20-25°C (68-77°F) (USP Controlled Room Temperature), dispensed in a tight, light-resistant container. Keep out of reach of children.
Study the drug class: Tricyclic antidepressants
Professional information
Clinician-facing context only. This section does not replace current product labeling.
General
Indication: Depression
Dose summary: Initial dose of 15 mg orally once daily, may be increased to 25 mg to 50 mg daily based on clinical response.
Renal context: The FDA label reviewed for this page does not include a dedicated renal-impairment dosing section for protriptyline. It notes only that dose selection for elderly patients should be cautious, starting at the low end of the dosing range, reflecting the greater frequency of decreased renal (as well as hepatic and cardiac) function in that group. No specific dose-reduction table is given; renal status should be assessed by the prescriber. (2) (3)
Hepatic guidance
The FDA label does not include a dedicated hepatic-impairment dosing section for protriptyline. It notes only that dose selection for elderly patients should be cautious, starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic (as well as renal and cardiac) function in that group; it also notes that cimetidine can reduce hepatic metabolism of tricyclic antidepressants, delaying elimination and raising steady-state levels. No specific hepatic dose-reduction table is given.
Frequently asked questions
How long does it take for protriptyline to work?
It may take 2 to 4 weeks to notice improvement in depressive symptoms. Continue taking the medication as prescribed, even if you do not feel better right away.
Can I drink alcohol while taking protriptyline?
It is best to avoid alcohol, as it can increase drowsiness and the risk of side effects such as dizziness and impaired judgment.
What should I do if I experience side effects?
Mild side effects may improve over time. If you experience severe or persistent side effects, or any warning signs such as chest pain or confusion, contact your doctor immediately.
Is protriptyline safe during pregnancy or breastfeeding?
Protriptyline should only be used during pregnancy or breastfeeding if clearly needed and prescribed by your doctor. Discuss risks and benefits with your healthcare provider.
Can protriptyline be used in children?
Protriptyline is not routinely recommended for use in children, as safety and efficacy have not been established.
What happens if I suddenly stop taking protriptyline?
Stopping protriptyline suddenly can cause withdrawal symptoms such as headache, nausea, and irritability. Always consult your doctor before discontinuing.
Are there any foods or activities I should avoid?
Avoid alcohol and activities requiring alertness until you know how the drug affects you. There are no specific food restrictions, but maintain a healthy diet and stay hydrated.
What happens if I take too much Protriptyline?
Taking too much Protriptyline can lead to serious and potentially life-threatening symptoms, including severe drowsiness, confusion, hallucinations, rapid heartbeat, seizures, and coma. If an overdose is suspected, it is crucial to seek immediate emergency medical attention. Do not attempt to induce vomiting or self-treat. Prompt professional intervention is essential for managing an overdose.
Is Protriptyline safe during pregnancy?
Protriptyline's safety during pregnancy is not definitively established, and it falls under a pregnancy category that requires careful consideration. It is crucial to consult with your healthcare provider if you are pregnant, planning to become pregnant, or breastfeeding. Your doctor will weigh the potential risks to the fetus against the benefits of treatment for the mother and discuss alternative options or necessary monitoring.
What is the mechanism of action of Protriptyline hydrochloride?
Protriptyline is a tricyclic antidepressant that inhibits the reuptake of norepinephrine and, to a lesser extent, serotonin at the presynaptic neuronal membrane. This increases the concentration of these neurotransmitters in the synaptic cleft, enhancing neurotransmission and improving mood. It also has anticholinergic and sedative properties. (2) (3)
What is the generic name of Protriptyline Hydrochloride?
The generic name is Protriptyline hydrochloride. It is sold under brand names including Protyline, Triptil, Vivactil, Prothiaden.
What class of drug is Protriptyline hydrochloride?
Protriptyline Hydrochloride is classed as: Mental Health & Psychiatry.
References
- Clinician-authored medicine record for ProtriptylineMedGuideGlobal · Global (internal) · accessed 2026-08-07 · source 1
- Protriptyline Hydrochloride tablets — FDA-approved prescribing informationU.S. FDA (via DailyMed) · United States · accessed 2026-08-03 · source 2
- Protriptyline Hydrochloride tablets, USP — FDA-approved prescribing information (Epic Pharma)U.S. FDA (via DailyMed) · United States · accessed 2026-08-07 · source 3
- Protriptyline — patient drug information (MedlinePlus)U.S. National Library of Medicine (MedlinePlus) · US · accessed 2026-08-14 · source 4
- Protriptyline Hydrochloride — FDA approval record (Drugs@FDA ANDA090462)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 5
- Protriptyline — RxNorm normalized drug concept (RXCUI 203199)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 6
Brand names by country
Single-ingredient Protriptyline hydrochloride names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.