This section gives an overview of the commonly used drugs (excluding opioids) to manage symptoms in patients with terminal illnesses. The information includes basic dosage information as well as indications for use and potential side effects. Please note that non-opioid drugs commonly used in palliative care in Singapore are shown here but the list is NOT exhaustive and neither are the side effects nor indications. Doses are for adults only. Please check with pharmacy colleagues for dose adjustments (if any) in renal or liver impairment. Unless otherwise indicated, use water for injection for dilution in continuous subcutaneous infusions.
*For information on opioids, please search and refer to the drugs with their given context.
Nortriptyline
Route, Dosage and Frequency
ROUTE
|
DOSAGE AND FREQUENCY
|
| PO |
10-25mg at bedtime. Increase by 25mg every 1-2 weeks as needed (max 100mg/day) |
Other Information
Indications
Neuropathic pain, Depression.
Side-Effects
Dry mouth, Urinary retention, Constipation, Blurred vision, Somnolence, Postural hypotension.
Remarks
Tricyclic antidepressant but better side effect profile than Amitriptyline. Depression needs higher doses (e.g. >75mg/day). Caution in elderly. Contraindicated in cardiac disease or concomitant use of monoamine oxidase inhibitors.
Reference
- Watson M. Oxford Handbook of Palliative Care. Oxford, NY: Oxford University Press; 2009.