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Amitriptyline / Chlordiazepoxide Side Effects

Medically reviewed by Drugs.com. Last updated on Dec 9, 2024.

Applies to amitriptyline / chlordiazepoxide: oral tablet.

Important warnings This medicine can cause some serious health issues

Oral route (tablet)

Warning: Risks from concomitant use with opioids, abuse, misuse, addition, dependence, withdrawal reactions, and suicidal thoughts and behaviors:Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death.

Reserve concomitant prescribing of these drugs for patients for whom alternative treatment options are inadequate.

Limit dosages and durations to the minimum required.

Follow patients for signs and symptoms of respiratory depression and sedation.The use of benzodiazepines, including amitriptyline/chlordiazepoxide, exposes users to risks of abuse, misuse, and addiction, which can lead to overdose or death.

Abuse and misuse of benzodiazepines commonly involve concomitant use of other medications, alcohol, and/or illicit substances, which is associated with an increased frequency of serious adverse outcomes.

Before prescribing amitriptyline / chlordiazepoxide and throughout treatment, assess each patient’s risk for abuse, misuse, and addiction.The continued use of benzodiazepines, including amitriptyline / chlordiazepoxide, may lead to clinically significant physical dependence.

The risks of dependence and withdrawal increase with longer treatment duration and higher daily dose.

Abrupt discontinuation or rapid dosage reduction of amitriptyline / chlordiazepoxide after continued use may precipitate acute withdrawal reactions, which can be life-threatening.

To reduce the risk of withdrawal reactions, use a gradual taper to discontinue amitriptyline / chlordiazepoxide or reduce the dosage.Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients in short-term studies.

Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors.

Amitriptyline / chlordiazepoxide is not approved for use in pediatric patients.

Precautions

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for any unwanted effects.

Tell your doctor if you are pregnant or planning to become pregnant. Using this medicine during the later pregnancy may cause problems in your newborn baby (eg, sedation or withdrawal symptoms). Tell your doctor right away if your baby has an abnormal sleep pattern, diarrhea, feeding problems, a high-pitched cry, irritability, low muscle tone, restlessness, shakiness or tremors, sluggishness, trouble breathing, weight loss, vomiting, or fails to gain weight. If you think you have become pregnant while using the medicine, tell your doctor right away.

Do not take chlordiazepoxide and amitriptyline combination with or within 14 days of taking a drug with monoamine oxidase (MAO) inhibitor activity (eg, isocarboxazid [Marplan®], phenelzine [Nardil®], procarbazine [Matulane®], selegiline [Eldepryl®], or tranylcypromine [Parnate®]). Do not take an MAO inhibitor within 14 days of taking chlordiazepoxide and amitriptyline combination. If you do, you may develop extremely high blood pressure or seizures. .

This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.

Do not change your dose or Stop taking amitriptyline / chlordiazepoxide without checking first with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This may help prevent a possible worsening of your condition and reduce the possibility of withdrawal symptoms including headache, nausea, a general feeling of discomfort or illness, seizures, stomach or muscle cramps, tremors, or unusual behavior.

Symptoms of an overdose include: blurred vision, confusion, difficulty sleeping, disorientation, dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position, fast, slow, or irregular heartbeat, hallucinations, headache, loss of consciousness, mood or other mental changes, seeing, hearing, or feeling things that are not there, nightmares, seizures, sweating, trouble breathing, trouble sleeping, unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness, or unusual excitement, nervousness, restlessness, or irritability. Call your doctor right away if you notice these symptoms.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, barbiturates, medicine for seizures, muscle relaxants, or anesthetics, including some dental anesthetics. This effect may last for a few days after you Stop taking amitriptyline / chlordiazepoxide. Check with your doctor before taking any of the above while you are using this medicine.

This medicine may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. Also tell your doctor if you have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. If you or your caregiver notice any of these side effects, tell your doctor right away.

This medicine may cause some people, especially elderly patients, to become drowsy, dizzy, lightheaded, clumsy or unsteady, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert or able to think or see well.

Check with your doctor right away if blurred vision, difficulty with reading, or any other change in vision occurs during or after treatment. Your doctor may want your eyes be checked by an ophthalmologist (eye doctor).

Before having any kind of surgery, tell the medical doctor in charge that you are using this medicine. Taking amitriptyline together with medicines used during surgery may increase the risk of side effects.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Other side effects

Some side effects of amitriptyline / chlordiazepoxide may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common side effects

  • bloating
  • clumsiness or unsteadiness
  • dryness of mouth or unpleasant taste
  • weight gain

Less common side effects

  • diarrhea
  • nausea or vomiting

Serious side effects

Along with its needed effects, amitriptyline / chlordiazepoxide may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking amitriptyline / chlordiazepoxide:

Less common side effects

  • blurred vision or other changes in vision
  • confusion
  • constipation
  • difficulty in urinating
  • dizziness or lightheadedness
  • eye pain
  • fainting
  • irregular heartbeat
  • irritability
  • mental depression
  • nervousness
  • seeing, hearing, or feeling things that are not there
  • shakiness
  • talking, feeling, and acting with excitement
  • trouble in sleeping

Incidence not known

  • actions that are out of control
  • chest pain or discomfort
  • decreased interest in sexual intercourse
  • false or unusual sense of well-being
  • fast, slow, or irregular heartbeat
  • inability to have or keep an erection
  • increased in sexual ability, desire, drive, or performance
  • increased interest in sexual intercourse
  • increased sensitivity to sunlight
  • loss in sexual ability, desire, drive, or performance
  • pain or discomfort in the arms, jaw, back or neck
  • redness or other discoloration of skin
  • severe sunburn
  • shakiness and unsteady walk
  • skin rash
  • sore throat and fever
  • sweating
  • swelling of the breasts or breast soreness in males
  • swelling of the testicles
  • swelling or inflammation of the mouth
  • unexpected or excess milk flow from breasts
  • unsteadiness, trembling, or other problems with muscle control or coordination

Get emergency help immediately if any of the following symptoms of overdose occur while taking amitriptyline / chlordiazepoxide:

Symptoms of overdose

For healthcare professionals

Applies to amitriptyline / chlordiazepoxide: oral tablet.

General adverse events

The most frequently reported side effects included drowsiness, dry mouth, constipation, and blurred vision.[Ref]

Psychiatric

Nervous system

Gastrointestinal

Dermatologic

Cardiovascular

Genitourinary

Hematologic

Metabolic

Other

Ocular

Hepatic

Endocrine

Musculoskeletal

Respiratory

See also:

References

1. (2017) "Product Information. Amitriptyline-Chlordiazepoxide (amitriptyline-chlordiazepoxide)." Mylan Pharmaceuticals Inc

Further information

Amitriptyline/chlordiazepoxide side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.