Vivactil

• Antidepressants that boost serotonin, including Paxil, Prozac, and Zoloft
• Antipsychotic medications such as Mellaril and chlopromazine
• Barbiturates such as Nembutal and Seconal
• Certain blood pressure medications such as guanethidine
• Cimetidine (Tagamet)
• Decongestants such as Sudafed
• Drugs that quell spasms, such as Donnatal and Levsin
• Epinephrine (EpiPen)
• Flecainide (Tambocor)
• Narcotic painkillers such as Percodan and Vicodin
• Norepinephrine
• Other antidepressants such as Elavil and Tofranil
• Propafenone (Rythmol)
• Quinidine
• Tramadol (Ultram)
• Tranquilizers and sleep aids such as Halcion, Valium, and Xanax

Special information if you are pregnant or breastfeeding

The effects of Vivactil during pregnancy have not been adequately studied. It should be used during pregnancy only if its benefits outweigh the potential risk. If you are pregnant or planning to become pregnant, inform your doctor immediately.

It is not known whether Vivactil makes its way into breast milk. Consult with your doctor before deciding to breastfeed.

Recommended dosage for Vivactil

The doctor will start with a low dose and increase it gradually, watching for side effects and a positive response

ADULTS

The usual adult dosage is 15 to 40 milligrams in 3 or 4 doses per day. The maximum dosage is 60 milligrams daily. Increases are made in the morning dose.

CHILDREN

The safety and effectiveness of Vivactil have not been studied in children.

OLDER ADULTS AND ADOLESCENTS

Lower dosages are recommended for adolescents and older adults. Five milligrams 3 times a day may be given initially, followed by a gradual increase if necessary. Heart function must be monitored in older adults who are taking 20 or more milligrams per day.

Overdosage

An overdose of Vivactil can be fatal. If you suspect an overdose, seek medical help immediately.

• Critical signs of Vivactil overdose may include:
  Convulsions, irregular heartbeat, severely low blood pressure, reduced level of consciousness or even coma.

• Other signs of Vivactil overdose may include:
  Agitation, confusion, dilated pupils, disturbed concentration, drowsiness, fever, hyperactive reflexes, low body temperature, muscle rigidity, sporadic hallucinations, stupor, vomiting, or any of the other symptoms listed in "What side effects may occur?"