1 What is Vivactil?

Brand: Vivactil

Generic: Protriptyline

Vivactil tablet is a prescription-only antidepressant that increases the levels of the brain chemical, serotonin, in the brain.

2 What to Know Before Using

Before using Vivactil, you must know all about the risks and complications associated with it. Together with your doctor, you can decide whether the medication will provide you more goods than the harms.

Here are some factors to be considered before deciding to use this medicine:

Allergies: Inform your doctor about the allergies you have, such as to this medication, other medications, or to foods, dyes, or preservatives.

Pediatric: It’s not clear if using this medicine in children is safe or effective.

Geriatric: It may be used in elderly after adjusting doses.

Breastfeeding: It may be used in a nursing mother after assessing the risks and benefits.

Drug Interactions: Taking two medicines together can be harmful due to possible interactions. In other cases, even if there is a possible interaction between two medicines your doctor may advise you to take them together after adjusting the dose or issuing precautions. Here is a list of the medicines which in general are not recommended to be used with protriptyline.

Inform your doctor if you are using any of these medicines:

  • Cisapride
  • Clorgyline
  • Isocarboxazid
  • Linezolid
  • Mesoridazine
  • Metoclopramide
  • Moclobemide
  • Phenelzine
  • Pimozide
  • Selegiline
  • Sparfloxacin
  • Thioridazine
  • Tranylcypromine
  • Ziprasidone

Though usually not recommended, your doctor may decide, after adjusting dose or frequency of one or both medicines, to use this medicine with any of the following medicines:

  • Aceclofenac
  • Amiodarone
  • Amisulpride
  • Amitriptyline
  • Aspirin
  • Azithromycin
  • Bupropion
  • Chloroquine
  • Chlorpromazine
  • Citalopram
  • Clomipramine
  • Clozapine
  • Desipramine
  • Desvenlafaxine
  • Dextromethorphan
  • Diclofenac
  • Domperidone
  • Donepezil
  • Droperidol
  • Epinephrine
  • Escitalopram
  • Flecainide
  • Fluconazole
  • Fluoxetine
  • Gemifloxacin
  • Halofantrine
  • Haloperidol
  • Imipramine
  • Ketorolac
  • Levothyroxine
  • Mefenamic Acid
  • Mefloquine
  • Methadone
  • Metronidazole
  • Mirtazapine
  • Naproxen
  • Norepinephrine
  • Nortriptyline
  • Ondansetron
  • Pargyline
  • Phenylephrine
  • Procainamide
  • Prochlorperazine
  • Quinidine
  • Risperidone
  • Sertraline
  • Sotalol
  • Tramadol
  • Trazodone
  • Trifluoperazine
  • Trimipramine
  • Vardenafil
  • Venlafaxine
  • Vortioxetine
  • Zolmitriptan

Rarely and only when absolutely needed, protriptyline may be used with the following medicines even if using them together may put you at risk of certain side effects. In such cases, you may have to take the adjusted dose or change the frequency of intake.

  • Atomoxetine
  • Cannabis
  • Carbamazepine
  • Dicumarol
  • Paroxetine
  • Phenprocoumon

Other Interactions: Taking your medicine together with certain foods or items such as alcohol or tobacco may cause undesirable interactions. Talk to your doctor to know if using this medicine with food, alcohol, or tobacco is safe.

Medical Problems: Certain medical conditions might influence the effects (both positive and adverse) and action of protriptyline.

DO NOT forget to inform your doctor about the following conditions:

3 Proper Usage

To use Vivactil properly, you must follow all instructions given by your doctor.

Here are some points to watch for:

  • Use only as directed. Do not take more, more frequently or for a longer time than recommended.
  • Read the patient information leaflet carefully and follow accordingly. For any query, consult your doctor.

Dosing: For best results, follow your doctor to know what amount of medicine you should take in a single dose. The doses of a medicine can differ according to the conditions for which it is being prescribed. Remember your doses can differ. Consult your doctor if you have anything to ask. The doses for oral tablets are:

For depression:

  • Adults: Start with 15 to 40 milligrams (mg) per day in 3 0r 4 divided doses. Then the doses may be increased but do not take more than 60 mg per day.
  • Teenagers and Older Adults: Start with 5 mg three times a day. Then the doses may be increased if required.
  • Children: Your doctor will decide the use and dose.

Missed Dose: Take your missed dose once you remember but avoid it if it’s time to take your next dose, and follow your normal dosing schedule. Avoid taking double doses to make up for the missed dose.


  • Store in a closed container at room temperature.
  • Keep away from heat, moisture, and direct light.
  • Do not freeze.
  • Keep away from children.
  • Discard any unused or expired medicines.

4 Precautions to Take

Before using Vivactil, there are some precautions you must take. Your progress should be regularly monitored to determine if you are responding to the treatment. Remember:

Taking protriptyline with a monoamine oxidase inhibitor (MAOI- phenelzine, selegiline, and isocarboxazid) can cause dangerously high levels of serotonin in the brain. You may start protriptyline at least two weeks after discontinuing a MAOI or start a MAOI 5 days after discontinuing protriptyline.

Cisapride, when used with protriptyline, can cause serious side effects. Therefore, avoid using them together.

Some children, teenagers, and young adults may have increased suicidal thoughts during treatment with protriptyline. Consult your doctor immediately if such thoughts cross your mind.

Inform your doctor about your sleep habits, energy levels, and mood changes. Inform your doctor about the history of suicide in your family, if any.

Do not skip a dose or discontinue without consulting your doctor. For protriptyline, the doses are gradually tapered down.

Using protriptyline with alcohol and other CNS depressants such as allergy medicine, sleeping pills, cold medicine, prescription pain medicine or narcotics can cause marked sleepiness. So avoid using them together.

If you are having a surgery, inform your doctor about your intake of protriptyline. It may also interfere with your blood sugar levels. Consult your doctor if you are concerned.

Some people may feel drowsy while taking this medicine. So take precautions while driving or using machines.

Consult your doctor about using other prescription or nonprescription medicines and herbal or vitamin supplements while taking protriptyline.

5 Potential Side Effects

Make sure you meet with your doctor in using Vivactil to avoid unwanted potential side effects.

Consult your doctor immediately if you experience any of the following side effects:

Incidence not known:

  • Abdominal or stomach pain
  • Agitation or irritability
  • Vision problems such as blurry vision
  • Abnormal sensations such as numbness, crawling, numbness, pinprick
  • Urinary problems
  • Chest discomfort
  • Sweating
  • Disorientation
  • Hearing abnormal sounds
  • Seizures
  • Speech problems
  • Dizziness
  • Rapid irregular heart rhythms
  • Hallucinations
  • Impaired hearing
  • Rapid shallow breathing
  • Mood problems
  • Nightmares
  • Muscle contractions
  • Shaking
  • Seek emergency medical attention if you experience the symptoms of overdose that include:
  • Altered consciousness
  • Disorientation
  • Impaired concentration
  • Drowsiness
  • Dilated pupils
  • Breathing difficulties
  • Reduce pulse

Mild and non-serious side effects usually go away on their own without requiring medical intervention. You may also ask your doctor to learn more about how you may prevent or reduce the side effects.

Talk to your doctor if the side effects persist or worry you, including:

Incidence not known: 

  • Abdominal
  • Dilated pupils
  • Black tongue
  • Hives
  • Exaggerated sex drive
  • Increased light sensitivity
  • Taste alterations
  • Swollen lymph nodes

The side effects of the medicine are not limited to the ones listed above. Call your doctor immediately if you experience any side effects that are uncommon or worry you. To report side effects to the FDA, contact at 1-800-FDA-1088.

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