Amitriptyline

Amitriptyline is used to treat symptoms of depression. Amitriptyline is in a class of medications called tricyclic antidepressants (mood elevators). It works by increasing the amounts of certain natural substances in the brain.

How should this medicine be used?
Amitriptyline comes as a tablet to take by mouth. It is usually taken one to four times a day. To help you remember to take amitriptyline, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take amitriptyline exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Your doctor will probably start you on a low dose of amitriptyline and gradually increase your dose.
It may take a few weeks or longer before you feel the full benefit of amitriptyline. Continue to take amitriptyline even if you feel well. Do not stop taking amitriptyline without talking to your doctor. Stopping amitriptyline suddenly may cause withdrawal symptoms (upset stomach, headache, and lack of energy). Your doctor will probably decrease your dose gradually.

What special precautions should I follow?
Before taking amitriptyline,
• tell your doctor and pharmacist if you are allergic to amitriptyline or any other medications.
• do not take amitriptyline if you are taking monoamine oxidase (MAO) inhibitors, including phenelzine (Nardil) and tranylcypromine (Parnate), or have stopped taking them within the past 2 weeks; or if you are taking cisapride (Propulsid).
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: antihistamines; cimetidine (Tagamet); diet pills; disulfiram (Antabuse); ethchlorvynol (Placidyl); guanethidine (Ismelin); ipratropium (Atrovent); quinidine (Quinidex); medications for irregular heartbeats such as flecainide (Tambocor) and propafenone (Rythmol); medications for anxiety, asthma, colds, irritable bowel disease, mental illness, nausea, Parkinson's disease, seizures, ulcers, or urinary problems; other antidepressants; phenobarbital (Bellatal, Solfoton); sedatives; selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft); sleeping pills; thyroid medications; and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you drink large amounts of alcohol; if you have recently had a heart attack; and if you have or have ever had glaucoma; an enlarged prostate; difficulty urinating; mental illness; seizures; an overactive thyroid gland (hyperthyroidism); diabetes; or liver, kidney, or heart disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking amitriptyline, call your doctor immediately.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking amitriptyline.
• you should know that amitriptyline may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
• remember that alcohol can add to the drowsiness caused by this medication.

What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.

What should I do if I forget a dose?
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?
Amitriptyline may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
• upset stomach
• vomiting
• drowsiness
• weakness or tiredness
• excitement or anxiety
• difficulty falling asleep or staying asleep
• nightmares
• restlessness
• headaches
• dry mouth
• constipation
• difficulty urinating
• blurred vision
• pain, burning, or tingling in the hands or feet
• changes in sex drive or ability
• excessive sweating
• changes in appetite or weight
• confusion
• unsteadiness
Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:
• slow or difficult speech
• dizziness or faintness
• weakness or numbness of an arm or a leg
• crushing chest pain
• rapid, pounding, or irregular heartbeat
• severe skin rash or hives
• swelling of the face and tongue
• yellowing of the skin or eyes
• jaw, neck, and back muscle spasms
• shaking hands that you cannot control
• difficulty sitting still
• fainting
• unusual bleeding or bruising
• seizures
• seeing things or hearing voices that do not exist (hallucinating)
Amitriptyline may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

What storage conditions are needed for this medication?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.