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Nortriptyline to quit smoking
Sounds like nor-TRIP-ti-LEAN
Key points about nortriptyline for quitting smoking
- Nortriptyline is used to help adults stop smoking.
- Find out how to take it safely and possible side effects.
Nortriptyline is used to help adults stop smoking. It is usually used when nicotine replacement therapy (NRT) has not been effective. It can help to reduce the severity of nicotine withdrawal symptoms such as anxiety and stress. Nortriptyline is available on prescription from your doctor. Read more about treatments to quit smoking.
Taking nortriptyline increases your chances of quitting smoking. It approximately doubles the chances of giving up smoking long-term. It doesn't contain nicotine, which is important to some people.
Note: Nortriptyline is also used to treat chronic pain. This page focuses on its use for quitting smoking only.
Brand change
From 1 August 2025, the funded brand of nortriptyline tablets (10 mg and 25 mg) has changed from Norpress to Allegron. The supplier of Norpress tablets have discontinued their supply to New Zealand.
Allegron tablets have the same active ingredient, in the same amount as Norpress tablets, and is designed to work in the same way. However, the new tablets and packaging look different.
For more information about this change, including images of the tablets, see Norpress brand change(external link).
If you have any questions about this brand change, talk to your healthcare provider.
Remember, it’s important to keep taking nortriptyline because stopping suddenly can make you feel unwell.
In Aotearoa New Zealand nortriptyline is available as tablets (10 mg and 25 mg).
The effect of nortriptyline is not immediate. It's best to start nortriptyline 10 to 28 days before you plan to stop smoking (your quit date). This allows it to build up in your body before you stop smoking completely.
- The usual starting dose is 25 mg once a day before your quit date. Your doctor will increase this slowly over a 10 day to 5 week period.
- The usual maximum dose is 75 to 100 mg daily.
- Most people will take nortriptyline for 2 weeks. However, for some people, they may continue for up to 6 months.
- Swallow the tablets whole with a glass of water: Do not crush or chew the tablets.
- Timing: You can take nortriptyline with or without food. It is best to take nortriptyline in the evening. Start by taking it 1 hour before going to bed, if you find that you feel drowsy the next morning, try taking it earlier in the evening.
- Missed dose: If you forget to take your dose, take it as soon as you remember. But if it is nearly time for your next dose, just take the next dose at the right time. If you only take one dose at bedtime and you miss the dose, do not take the medicine in the morning. Wait until the next night and skip the missed dose.
- Don't stop taking nortriptyline suddenly. If you think nortriptyline is not working for you, speak to your doctor. Do not stop taking the tablets suddenly. It should be gradually reduced over a few weeks to avoid severe side effects.
Here are some things to know when you're taking nortriptyline. Other things may be important as well, so ask your healthcare provider what you should know about.
- Nortriptyline may affect your ability to drive: Nortriptyline can affect your concentration (how you focus or pay attention). It can slow your reaction times and cause sleepiness, blurred vision, dizziness, or make you feel anxious or jittery. Be careful when driving or using tools until you know how this medicine affects you.
- Avoid alcohol while you're taking nortriptyline. Drinking alcohol can increase side effects of feeling sleepy, putting you at risk of falls and other accidents.
- Taking other medicines: Nortriptyline interacts with many other medicines, herbal supplements (such as St. John's Wort) and rongoā Māori so check with your healthcare provider before starting nortriptyline or before starting any new medicines or products.
Like all medicines, nortriptyline can cause side effects, although not everyone gets them. If you're concerned about any symptoms you think might be related to your medicine, talk to your healthcare provider. The following information offers some guidance but doesn't include all possible side effects.
Common side effects
- Dry mouth
- Feeling sick (nausea)
- Headache
- Constipation
- Drowsiness
- Light-headed
- Blurred vision
- Weight changes
Tell your healthcare provider immediately or phone Healthline free on 0800 611 116 if these occur
- Fast beating heart (palpitations)
- Feeling anxious.
- Suicidal feelings or behaviour such as agitation, aggression, self-harm, worsening of low mood
Read more about medicines and side effects and reporting a reaction you think might be a side effect.
Norpress(external link) Medsafe Consumer Information, NZ
Allegron(external link) Medsafe Consumer Information, NZ
Resources
5 questions to ask about your medications(external link) Health Quality and Safety Commission, NZ, 2019 English(external link), te reo Māori(external link)
References
- Update on smoking cessation(external link) BPAC, NZ 2010
- Nortriptyline(external link) NZ Formulary, NZ 2022
Brochures
Medicines and side effects
Healthify He Puna Waiora, NZ, 2024
Health Quality and Safety Commission, NZ, 2019 English, te reo Māori
Free helplines
Credits: Sandra Ponen, Pharmacist, Healthify He Puna Waiora. Healthify is brought to you by Health Navigator Charitable Trust.
Reviewed by: Angela Lambie, Pharmacist, Auckland
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