Vivactil Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Vivactil Tablet (protriptyline) is a tricyclic antidepressant (TCA) used to treat symptoms of mental depression in patients under close medical supervision. It is especially suited for patients who feel withdrawn or have low energy. It is taken by mouth, usually several times a day, with the dose started low and increased gradually under a doctor's guidance.

What is Vivactil Tablet

Vivactil (protriptyline hydrochloride) is a tricyclic antidepressant used to treat symptoms of depression. It is given by mouth as tablets and is meant for patients who are under close medical supervision.

Vivactil Tablet uses

• Treatment of symptoms of mental depression in patients under close medical supervision
• Particularly suitable for withdrawn and low-energy (anergic) patients

Benefits of Vivactil Tablet

• May improve mood and feelings of well-being
• May increase energy levels
• Has a more activating effect, which can help patients who feel withdrawn or low in energy
• May start working faster than some other tricyclic antidepressants, with initial effects possibly seen within about a week to two weeks

How Vivactil Tablet works

Protriptyline is thought to work by helping the brain keep more of its natural chemicals, norepinephrine and serotonin, which helps relieve symptoms of depression. The exact way it works to relieve depression is not fully known, but it is not a monoamine oxidase inhibitor and does not work mainly by stimulating the central nervous system.

Vivactil Tablet dosage

Vivactil can be taken with or without food, by mouth. It needs to be taken multiple times a day (3 to 4 times daily). Dosage is started low and increased gradually based on response and tolerance, with increases usually made to the morning dose. Lower doses are generally used in adolescents and elderly patients.

Do not stop taking this medicine suddenly without checking with your doctor first; your doctor may want you to lower the dose gradually. Keep all follow-up visits with your doctor so they can check your progress and adjust your dose if needed. Tell your doctor about all other medicines, supplements, and herbal products you take.

Available forms and strengths

Film-coated tablets (5 mg and 10 mg)

Side effects of Vivactil Tablet

Common

• Nausea and vomiting
• Diarrhea
• Loss of appetite
• Stomach pain or cramps
• Dry mouth
• Unpleasant or peculiar taste
• Weakness and fatigue
• Tingling, numbness, or prickly feelings in the limbs
• Anxiety and restlessness
• Dizziness
• Drowsiness
• Insomnia and nightmares
• Blurred vision
• Headache
• Ringing in the ears
• Breast swelling (in men or women)
• Decreased sex drive
• Trouble getting or keeping an erection
• Difficulty having an orgasm
• Constipation
• Weight gain or loss
• Increased sweating
• Hair thinning or loss

Serious

• Sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights
• Fast, irregular, or pounding heartbeats, fluttering in the chest, shortness of breath, or sudden dizziness, lightheadedness, or passing out
• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, heavy sweating, or tremors
• Worsening depression or new or worsening thoughts of suicide
• Seizures or convulsions
• Signs of a severe allergic or skin reaction, such as rash, hives, or swelling of the face, ankles, or hands
• Unusual bleeding or bruising
• Yellowing of the eyes or skin (possible liver problem)
• Hallucinations, confusion about identity, place, or time, or false beliefs
• Fever with or without chills, sore throat, or swollen glands (possible blood problem)

Warnings and precautions

• Antidepressants can increase the risk of suicidal thoughts and behavior in children, teenagers, and young adults, especially when starting the medicine or changing the dose. This risk is lower in adults over 24, and the risk is actually reduced in adults 65 and older. Patients of all ages should be watched closely for worsening depression or unusual changes in behavior.
• This medicine is not approved for use in children.
• Vivactil should not be used alone to treat bipolar disorder, since treating a depressive episode with an antidepressant alone may increase the chance of triggering a manic or mixed episode in people at risk for bipolar disorder.
• This medicine carries a risk of heart problems, including abnormal heart rhythms, heart attack, and stroke, so it should be used carefully, especially in older adults or people with heart disease.
• This drug can cause the pupils of the eyes to widen slightly, which can trigger an attack of angle-closure glaucoma in people who are prone to it.
• Do not take this medicine with a monoamine oxidase inhibitor (MAOI) or within 14 days of stopping one, since this combination can cause severe fever, high blood pressure, and seizures, and can be fatal.
• This medicine should not be combined with cisapride, because the combination can cause dangerous heart rhythm problems.
• This drug should not be used right after a heart attack, during the early recovery period.
• Taking this medicine with certain other drugs, such as cimetidine or tramadol, can increase side effects or seizure risk; tell your doctor about all medicines and supplements you use.
• Stopping this medicine suddenly after long-term use can cause withdrawal symptoms like nausea, headache, and a general feeling of being unwell, so the dose should be lowered gradually under a doctor's guidance.
• Vivactil should only be used during pregnancy if your doctor prescribes it, because it may harm an unborn baby. Tell your doctor if you are pregnant or planning to become pregnant.
• It isn't known if this medicine passes into breast milk or if it could harm a nursing baby, so check with your doctor before breastfeeding.
• Vivactil may affect liver function, and dose selection should be cautious in patients with decreased liver function, especially in older adults.
• This medicine can add to the effects of alcohol and may increase the danger of an overdose or suicide attempt in people who drink heavily, so avoid or limit alcohol while taking it.
• This medicine can cause drowsiness or affect your mental and physical abilities, so be careful when driving or doing other tasks that require alertness until you know how it affects you.

Storage

• Store at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature]
• Dispense in a tight, light-resistant container as defined in the USP, with a child-resistant closure (as required)
• Keep container tightly closed
• Keep this and all medications out of the reach of children

When to see a doctor

• Get emergency help right away if you have sudden vision loss, severe eye pain or swelling, or see halos around lights.
• Get emergency help right away for fast, irregular, or pounding heartbeats, fluttering in the chest, shortness of breath, or sudden dizziness or fainting.
• Get emergency help right away for a severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, heavy sweating, or tremors.
• Call your doctor right away if you notice new or worsening depression, thoughts of hurting yourself, or sudden changes in mood or behavior, such as increased agitation, irritability, anger, or recklessness.
• Get emergency medical help right away if you have symptoms of overdose, such as severe drowsiness leading to coma, confusion, trouble breathing, muscle weakness or tightness, a weak pulse, seizures, or very low body temperature.

Alternatives

• Imipramine
• Amitriptyline
• Nortriptyline