The latest toll includes a young boy killed by gunfire during clashes Tuesday in the city of Granada between anti-government protesters and riot police, the Nicaraguan Center for Human Rights said.
It said 1,300 people had been wounded in the violence.
A parish priest, Wilmer Perez, earlier told the 100% news channel that the boy was killed in a confrontation between demonstrators and pro-government supporters trying to clear a barricade in the city, 45 kilometers (28 miles) south of the capital Managua.
Ten people were killed in running battles over the weekend in the flashpoint city of Masaya, the center said.
Residents armed with homemade mortars and slingshots faced off in clashes with what they said were paramilitary forces and riot police loyal to Ortega, who has dominated the Central American country's politics for four decades.
The Catholic Church initially tried to mediate the conflict, but called off the talks after a crackdown on a march led by victims' mothers on Wednesday left another 16 people dead.
On Monday, Ortega's wife and vice president, Rosario Murillo -- a figure widely reviled by the protesters -- made an appeal to return to dialogue.
"We all want peace, we want dialogue, we want to work together and listen to each other, discuss all issues, because there's a solution for everything," she told state media.
"Let's not keep suffering losses, pain, mourning in our families."
The Church has said talks are impossible as long as "the people continue to be repressed and killed" by "groups close to the government."
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