Do not take this medicine with any of the following medications:

-arsenic trioxide
-certain medicines used to regulate abnormal heartbeat or to treat other heart conditions
-cisapride
-halofantrine
-linezolid
-MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
-methylene blue
-other medicines for mental depression
-phenothiazines like perphenazine, thioridazine and chlorpromazine
-pimozide
-probucol
-procarbazine
-sparfloxacin
-St. John''s Wort

This medicine may also interact with the following medications:

-atropine and related drugs like hyoscyamine, scopolamine, tolterodine and others
-barbiturate medicines for inducing sleep or treating seizures, like phenobarbital
-cimetidine
-ephedrine
-local anesthetics
-tramadol
-ziprasidone

They need to know if you have any of these conditions:
-an alcohol problem
-bipolar disorder or schizophrenia
-difficulty passing urine, prostate trouble
-glaucoma
-heart disease or previous heart attack
-liver disease
-lung or breathing disease, like asthma
-over active thyroid
-seizures
-thoughts or plans of suicide, a previous suicide attempt, or family history of suicide attempt
-an unusual or allergic reaction to protriptyline, other medicines, foods, dyes, or preservatives
-pregnant or trying to get pregnant
-breast-feeding

Tell your doctor if your symptoms do not get better or if they get worse. Visit your doctor or health care professional for regular checks on your progress. Because it may take several weeks to see the full effects of this medicine, it is important to continue your treatment as prescribed by your doctor.

Patients and their families should watch out for new or worsening thoughts of suicide or depression. Also watch out for sudden changes in feelings such as feeling anxious, agitated, panicky, irritable, hostile, aggressive, impulsive, severely restless, overly excited and hyperactive, or not being able to sleep. If this happens, especially at the beginning of treatment or after a change in dose, call your health care professional.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medicine. Avoid alcoholic drinks.

Do not treat yourself for coughs, colds, or allergies without asking your doctor or health care professional for advice. Some ingredients can increase possible side effects.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your doctor if the problem does not go away or is severe.

This medicine may cause dry eyes and blurred vision. If you wear contact lenses you may feel some discomfort. Lubricating drops may help. See your eye doctor if the problem does not go away or is severe.

This medicine can cause constipation. Try to have a bowel movement at least every 2 to 3 days. If you do not have a bowel movement for 3 days, call your doctor or health care professional.

This medicine can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and use sunscreen. Do not use sun lamps or tanning beds/booths.

Keep out of the reach of children.

Store between 20 and 25 degrees C (68 and 77 degrees F). Keep container tightly closed. Throw away any unused medicine after the expiration date.