Amitriptyline

Pronunciation

Generic Name: amitriptyline (am-ee-TRIP-tih-leen)
Brand Name: Elavil

Antidepressants may increase the risk of suicidal thoughts or actions in children, teenagers, and young adults. However, depression and certain other mental problems may also increase the risk of suicide. Talk with the patient's doctor to be sure that the benefits of using amitriptyline outweigh the risks.

Family and caregivers must closely watch patients who take amitriptyline. It is important to keep in close contact with the patient's doctor. Tell the doctor right away if the patient has symptoms like worsened depression, suicidal thoughts, or changes in behavior. Discuss any questions with the patient's doctor.

Amitriptyline is not approved for use in children. Talk with the doctor.


Amitriptyline is used for:

Treating depression. It may also be used for other conditions as determined by your doctor.

Amitriptyline is a tricyclic antidepressant. How tricyclic antidepressants improve depression symptoms is not fully understood. They are thought to increase the activity of certain chemicals in the brain (norepinephrine, serotonin), which help improve mood.

Do NOT use amitriptyline if:

  • you are allergic to any ingredient in amitriptyline
  • you are currently taking or have taken linezolid or a monoamine oxidase inhibitor (MAOI) (eg, phenelzine, selegiline) within the last 14 days
  • you are taking cisapride
  • you are recovering from a heart attack

Contact your doctor or health care provider right away if any of these apply to you.

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Before using amitriptyline:

Some medical conditions may interact with amitriptyline. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have a history of mental illness (eg, bipolar disorder, mania, manic-depression), or have considered or attempted suicide
  • if you have alcoholism or regularly consume 3 or more alcoholic beverages per day
  • if you have increased eye pressure or glaucoma, an irregular heartbeat, heart disease, chest pain, liver disease, prostate problems, thyroid disease, or are unable to urinate (urinary retention)
  • if you have a history of seizures, epilepsy, or porphyria
  • if you are taking a medicine that contains methylene blue

Some MEDICINES MAY INTERACT with amitriptyline. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Linezolid or MAOIs (eg, phenelzine, selegiline) because they can cause serious, sometimes life-threatening, reactions. Do NOT take MAO inhibitors with, or within 2 weeks of taking, amitriptyline
  • Anticholinergics (eg, scopolamine), bupropion, cimetidine, fluconazole, phenothiazines (eg, chlorpromazine), SSRIs (eg, fluoxetine), terbinafine, or valproic acid because side effects such as blurred vision, difficult urination, drowsiness or sedation, dry mouth, or light-headedness may occur
  • Antihistamines (eg, diphenhydramine), cisapride, droperidol, ketolides (eg, telithromycin), macrolides (eg, erythromycin), mibefradil, pimozide, or streptogramins (eg, quinupristin/dalfopristin) because serious side effects on the heart (eg, racing heartbeat, dizziness, fainting, life-threatening abnormal heartbeat leading to unconsciousness, and lack of heartbeat, may be increased by amitriptyline
  • Carbamazepine, thyroid medicines (eg, levothyroxine), or stimulants (eg, albuterol, pseudoephedrine) because their side effects may be increased by amitriptyline
  • Warfarin because side effects such as serious bleeding may be increased by amitriptyline
  • Clonidine, guanethidine, or guanfacine because the effectiveness of these medicines may be decreased

This may not be a complete list of all interactions that may occur. Ask your health care provider if amitriptyline may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use amitriptyline:

Use amitriptyline as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Amitriptyline comes with an additional patient information sheet called a Medication Guide. Read it carefully and reread it each time you get amitriptyline refilled.
  • Amitriptyline may be taken with food or on an empty stomach.
  • Amitriptyline may take up to 30 days to control symptoms of depression. Continue to use amitriptyline even if you feel well. Do not miss any doses.
  • If you miss a dose of amitriptyline, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use amitriptyline.

Important safety information:

  • Amitriptyline may cause dizziness, drowsiness, or blurred vision. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to amitriptyline. Using amitriptyline alone, with other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.
  • Amitriptyline may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
  • Check with your doctor before you drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using amitriptyline; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
  • Involuntary and uncontrollable movements may develop in patients taking amitriptyline. Occurrence is highest among the elderly, especially women. The risk of developing these involuntary movements and the likelihood they will become permanent are increased with long-term use and with high doses. However, it is possible to develop these symptoms after short-term use at low doses. Contact your health care provider at once if any of the following occur: involuntary movements of the tongue, face, mouth, or jaw (eg, protrusion of tongue, puffing of cheeks, puckering of mouth, chewing movements), sometimes accompanied by involuntary movements of the arms and legs.
  • Some people may be at risk for eye problems from amitriptyline. Your doctor may want you to have an eye exam to see if you are at risk for these eye problems. Call your doctor right away if you have eye pain, vision changes, or swelling or redness in or around the eye.
  • Amitriptyline may cause sensitivity to sunlight. Avoid prolonged exposure to the sun and other ultraviolet light (eg, tanning beds). Use sunscreens and wear protective clothing until tolerance is determined.
  • Do not become overheated in hot weather or during exercise or other activities since heatstroke may occur.
  • Children, teenagers, and young adults who take amitriptyline may be at increased risk for suicidal thoughts or actions. Watch all patients who take amitriptyline closely. Contact the doctor at once if new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.
  • Diabetes patients - Amitriptyline may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
  • Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using amitriptyline.
  • Use caution in the ELDERLY; they may be more sensitive to its effects, especially light-headedness upon standing; rapid heartbeat; breathing problems; difficult urination; and constipation.
  • PREGNANCY and BREAST-FEEDING: Amitriptyline has been shown to cause harm to the human fetus. If you plan on becoming pregnant, discuss with your doctor the benefits and risks of using amitriptyline during pregnancy. Amitriptyline is excreted in the breast milk. Do not breast-feed while taking amitriptyline.

Possible side effects of amitriptyline:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Blurred vision; change in sexual desire or ability; constipation; diarrhea; dizziness; drowsiness; dry mouth; headache; loss of appetite; nausea; tiredness; trouble sleeping; weakness.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; confusion; dark urine; delusions; difficulty speaking or swallowing; fainting; fast or irregular heartbeat; fever, chills, or sore throat; hallucinations; new or worsening agitation, anxiety, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being, restlessness, or inability to sit still; numbness or tingling in an arm or leg; one-sided weakness; seizures; severe or persistent dizziness or headache; severe or persistent trouble sleeping; slurred speech; suicidal thoughts or actions; tremor; trouble urinating; uncontrolled muscle movements (eg, of face, tongue, arms, legs); unusual bleeding or bruising; unusual or severe mental or mood changes; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of amitriptyline:

Store amitriptyline at room temperature, below 86 degrees F (30 degrees C) in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep amitriptyline out of the reach of children and away from pets.

General information:

  • If you have any questions about amitriptyline, please talk with your doctor, pharmacist, or other health care provider.
  • Amitriptyline is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • Do not use amitriptyline for other health conditions.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • If your symptoms do not improve after taking amitriptyline for 4 weeks, inform your doctor.
  • If using amitriptyline for an extended period of time, obtain refills before your supply runs out.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take amitriptyline or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about amitriptyline. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to amitriptyline. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using amitriptyline.

Issue Date: September 3, 2014
Database Edition 14.3.1.003
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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