How does amitriptyline work to relieve depression symptoms. What are the common and serious side effects of amitriptyline. Which drugs should not be taken with amitriptyline and why. How can amitriptyline interact with other medications.

Understanding Amitriptyline: A Tricyclic Antidepressant

Amitriptyline is a widely prescribed medication belonging to the class of drugs known as tricyclic antidepressants. It’s primarily used to alleviate symptoms of depression by working on the central nervous system. This generic drug, available only as an oral tablet, increases certain chemicals in the brain to improve mood and overall mental well-being.

How does amitriptyline function in the body? The medication works by influencing neurotransmitters in the brain, particularly serotonin and norepinephrine. By increasing the levels of these chemicals, amitriptyline helps to regulate mood, reduce anxiety, and improve overall mental health. This process can take several weeks to show noticeable effects, so patience is key when starting this medication.

Dosage and Administration of Amitriptyline

Amitriptyline is available only as a prescription medication and comes in tablet form for oral administration. The dosage can vary significantly depending on the individual’s condition, age, and response to treatment. It’s crucial to follow the prescribing physician’s instructions carefully.

Can amitriptyline cause drowsiness? Yes, it’s common for amitriptyline to cause drowsiness, especially during the initial hours after taking the medication. Due to this side effect, doctors often recommend taking the dose at bedtime. This timing can help minimize daytime drowsiness and potentially improve sleep quality for those struggling with insomnia related to depression.

Typical Dosage Ranges

• Initial dose: Usually 25-50 mg per day
• Maintenance dose: Can range from 50-150 mg per day
• Maximum dose: Generally not to exceed 300 mg per day

It’s important to note that these are general guidelines, and actual dosages may differ based on individual factors and medical history. Never adjust your dose without consulting your healthcare provider.

Common Side Effects of Amitriptyline

Like all medications, amitriptyline can cause side effects. While not everyone experiences these, it’s important to be aware of potential reactions. Common side effects are usually mild and often subside as the body adjusts to the medication.

What are the most frequently reported side effects of amitriptyline? The most common side effects include:

• Drowsiness and dizziness
• Dry mouth
• Blurred vision
• Constipation
• Weight gain
• Increased sweating
• Difficulty urinating

These side effects are generally mild and may diminish over time. However, if they persist or become bothersome, it’s important to consult with your healthcare provider. They may adjust your dosage or suggest strategies to manage these effects.

Serious Side Effects and Precautions

While less common, amitriptyline can potentially cause more serious side effects that require immediate medical attention. It’s crucial to be aware of these and seek help if they occur.

Which serious side effects should prompt immediate medical attention? Some serious side effects include:

• Irregular heartbeat or palpitations
• Severe dizziness or fainting
• Confusion or hallucinations
• Seizures
• Yellowing of the skin or eyes (jaundice)
• Unusual bleeding or bruising
• Signs of an allergic reaction (rash, itching, swelling, severe dizziness, difficulty breathing)

In rare cases, amitriptyline may increase the risk of suicidal thoughts, especially in young adults and children. Close monitoring is essential, particularly during the initial stages of treatment or when dosages are adjusted.

Drug Interactions with Amitriptyline

Amitriptyline can interact with various medications, potentially altering its effectiveness or increasing the risk of side effects. It’s crucial to inform your healthcare provider about all medications, supplements, and herbal products you’re taking.

Which drugs should never be combined with amitriptyline? Some medications that should not be taken with amitriptyline include:

• Monoamine Oxidase Inhibitors (MAOIs): Combining these with amitriptyline can lead to a dangerous condition called serotonin syndrome.
• Quinidine: This can increase amitriptyline levels in the body, potentially leading to toxicity.
• Certain antipsychotics and antidepressants: These may increase the risk of a potentially fatal condition called neuroleptic malignant syndrome.

Additionally, amitriptyline may interact with various other medications, including certain antihypertensives, antihistamines, and drugs that affect liver enzymes. Always consult with a healthcare professional before starting or stopping any medication while taking amitriptyline.

Amitriptyline and Pregnancy: What You Need to Know

The use of amitriptyline during pregnancy requires careful consideration and should only be done under the close supervision of a healthcare provider. The potential risks and benefits must be weighed carefully.

Is amitriptyline safe during pregnancy? The FDA categorizes amitriptyline as a Pregnancy Category C drug, which means that animal studies have shown an adverse effect on the fetus, but there are no adequate and well-controlled studies in humans. However, the potential benefit may warrant use of the drug in pregnant women despite potential risks.

Some studies have suggested a slight increase in the risk of certain birth defects with the use of tricyclic antidepressants during pregnancy. However, untreated depression during pregnancy also carries risks for both the mother and the developing baby. Therefore, the decision to use amitriptyline during pregnancy should be made on an individual basis after thorough discussion with a healthcare provider.

Considerations for Breastfeeding Mothers

Amitriptyline does pass into breast milk, and its effects on nursing infants are not fully known. Some reports suggest that it may cause drowsiness in breastfed infants. If you are breastfeeding or plan to breastfeed, discuss the potential risks and benefits with your healthcare provider.

Long-Term Use of Amitriptyline: Benefits and Risks

Amitriptyline is often prescribed for long-term use, particularly in the management of chronic depression. While it can be highly effective in maintaining mental health, long-term use does come with certain considerations.

What are the potential benefits of long-term amitriptyline use? Long-term benefits may include:

• Sustained improvement in mood and overall mental health
• Reduced risk of depression relapse
• Improved sleep patterns
• Potential pain management benefits for certain chronic pain conditions

However, long-term use of amitriptyline also carries potential risks. These may include:

• Increased risk of weight gain
• Potential for dependence or withdrawal symptoms if stopped abruptly
• Increased risk of side effects affecting cardiovascular health
• Possible cognitive effects, particularly in older adults

Regular follow-ups with a healthcare provider are essential for monitoring the ongoing benefits and potential risks of long-term amitriptyline use. Dosage adjustments or alternative treatments may be considered if side effects become problematic or if the medication’s effectiveness diminishes over time.

Amitriptyline Beyond Depression: Other Medical Uses

While primarily known as an antidepressant, amitriptyline has found applications in treating various other medical conditions. Its ability to modulate pain perception and influence neurotransmitter levels has made it a versatile medication in the medical field.

For which other conditions might amitriptyline be prescribed? Some off-label uses of amitriptyline include:

• Chronic pain management: Particularly effective for neuropathic pain conditions
• Migraine prevention: Can help reduce the frequency and severity of migraines
• Fibromyalgia: May help alleviate pain and improve sleep quality
• Irritable Bowel Syndrome (IBS): Can help manage symptoms, especially in cases with predominant diarrhea
• Insomnia: Low doses may be prescribed to improve sleep quality
• Post-traumatic stress disorder (PTSD): May help manage symptoms in some cases

It’s important to note that when prescribed for these conditions, the dosage and treatment approach may differ from its use in depression. Always follow your healthcare provider’s instructions and guidance when using amitriptyline for any condition.

Mechanism of Action in Pain Management

In pain management, amitriptyline is believed to work by influencing the way the brain processes pain signals. It may increase the levels of certain neurotransmitters that help to dampen pain perception. This effect, combined with its sedative properties, can be particularly helpful in managing chronic pain conditions that often coexist with sleep disturbances.

Comparing Amitriptyline to Other Antidepressants

Amitriptyline belongs to the older class of antidepressants known as tricyclics. While still effective, it’s often compared to newer classes of antidepressants, such as Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs).

How does amitriptyline compare to newer antidepressants? Here are some key points of comparison:

• Efficacy: Amitriptyline is generally as effective as newer antidepressants for treating depression.
• Side effect profile: Newer antidepressants typically have fewer side effects and are better tolerated.
• Drug interactions: Amitriptyline has more potential drug interactions compared to newer antidepressants.
• Overdose risk: Tricyclics like amitriptyline can be more dangerous in overdose compared to newer antidepressants.
• Pain management: Amitriptyline may be more effective for certain types of pain compared to some newer antidepressants.

The choice between amitriptyline and other antidepressants depends on various factors, including the specific symptoms being treated, potential side effects, other medical conditions, and individual response to treatment. Your healthcare provider will consider these factors when determining the most appropriate medication for your situation.

Amitriptyline vs. SSRIs

SSRIs like fluoxetine (Prozac) or sertraline (Zoloft) are often prescribed as first-line treatments for depression due to their more favorable side effect profile. However, amitriptyline may be preferred in cases where sleep disturbances or chronic pain are significant factors, as it tends to be more sedating and effective for pain management.

Managing Side Effects of Amitriptyline

While amitriptyline can be highly effective in treating depression and other conditions, managing its side effects is crucial for successful long-term treatment. Many side effects are mild and may diminish over time, but some strategies can help minimize their impact.

How can one manage common side effects of amitriptyline? Here are some strategies:

• Dry mouth: Sip water frequently, chew sugar-free gum, or use artificial saliva products.
• Constipation: Increase fiber intake, stay hydrated, and consider gentle laxatives if needed.
• Weight gain: Monitor diet closely, engage in regular physical activity, and discuss with your healthcare provider if significant weight gain occurs.
• Drowsiness: Take the medication at bedtime to minimize daytime sleepiness.
• Blurred vision: This often improves with time. If persistent, consult your eye doctor.
• Dizziness: Rise slowly from sitting or lying positions, especially when first starting the medication.

It’s important to communicate any persistent or bothersome side effects to your healthcare provider. They may adjust your dosage, recommend specific management strategies, or consider alternative treatments if necessary.

Addressing Sexual Side Effects

Sexual side effects, such as decreased libido or difficulty achieving orgasm, can occur with amitriptyline use. These effects can be challenging but are often manageable. Strategies may include adjusting the timing of medication doses, reducing the dosage if possible, or adding medications to counteract these effects. Open communication with both your healthcare provider and partner is crucial in addressing these concerns.

Withdrawal and Discontinuation of Amitriptyline

Discontinuing amitriptyline, especially after long-term use, should be done gradually under medical supervision. Abrupt cessation can lead to withdrawal symptoms, which can be uncomfortable and potentially dangerous.

What are the potential withdrawal symptoms of amitriptyline? Common withdrawal symptoms may include:

• Nausea and vomiting
• Headache
• Dizziness
• Irritability
• Anxiety or agitation
• Flu-like symptoms
• Sleep disturbances
• Electric shock sensations (often described as “brain zaps”)

To minimize these symptoms, your healthcare provider will typically recommend a gradual tapering of the dose over several weeks or even months, depending on your individual situation. This slow reduction allows your body to adjust to decreasing levels of the medication.

Reasons for Discontinuation

There are various reasons why discontinuation of amitriptyline might be considered:

• Remission of depression symptoms
• Intolerable side effects
• Switching to a different medication
• Pregnancy or planning to become pregnant
• Development of contraindications (such as certain heart conditions)

Regardless of the reason, never stop taking amitriptyline without first consulting your healthcare provider. They can guide you through the process safely and effectively, minimizing the risk of withdrawal symptoms and ensuring your mental health remains stable during the transition.

Side effects, dosage, uses and more

1. Amitriptyline oral tablet is available as a generic drug. It’s not available as a brand-name drug.
2. Amitriptyline comes only as a tablet you take by mouth.
3. Amitriptyline oral tablet is used to help relieve symptoms of depression.

Amitriptyline is a prescription drug. It comes as a tablet you take by mouth.

Amitriptyline oral tablet is not available as a brand-name drug. It’s only available as a generic drug. Generic drugs typically cost less than brand-name drugs.

Why it’s used

Amitriptyline is used to help relieve symptoms of depression.

How it works

Amitriptyline belongs to a class of drugs called tricyclic antidepressants. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Amitriptyline works on your central nervous system to increase the level of certain chemicals in your brain, which improves your depression.

Amitriptyline can cause dizziness and drowsiness during the first few hours after you take it. If you notice drowsiness while you take this drug, your doctor may have you take your dose at bedtime.

Amitriptyline can also cause other side effects.

More common side effects

The more common side effects of amitriptyline can include:

• confusion
• numbness and tingling in your arms and legs
• headache
• constipation or diarrhea
• blurred vision
• skin rash
• swelling of your face and tongue
• nausea
• unexpected weight gain or loss
• dizziness
• dry mouth

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• Heart attack. Symptoms can include:
  • chest pain
  • shortness of breath
  • pain or pressure in your chest or upper body
• Stroke. Symptoms can include:
  • weakness in one part or side of your body
  • slurred speech
• Seizures
• Withdrawal (if you suddenly stop taking this drug). Symptoms can include:
  • headache
  • nausea
  • trouble sleeping
  • depression
  • mood swings
• Increases or decreases in blood sugar
• Suicidal thoughts or actions
• Orthostatic hypotension (sudden drop in blood pressure when standing)

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare professional who knows your medical history.

Amitriptyline oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk with your doctor or pharmacist.

Examples of drugs that can cause interactions with amitriptyline are listed below.

Drugs you should not take with amitriptyline

Taking certain drugs with amitriptyline may cause serious side effects. You should not take these drugs and amitriptyline at the same time. Examples of these drugs include:

• Monoamine oxidase inhibitors (MAOIs). Examples of these drugs include:
  • phenelzine
  • tranylcypromine
  • selegiline

Using an MAOI with amitriptyline can lead to seizures or even death. Do not take an MAOI within two weeks of stopping amitriptyline, unless told to do so by your doctor. Also, do not start taking amitriptyline if you stopped taking a MAOI in the last two weeks, unless told to do so by your doctor. If you aren’t sure whether any of the drugs you take is an MAOI, ask your doctor or pharmacist.

• Quinidine. Taking this drug with amitriptyline could increase the amount of amitriptyline in your body. This could lead to dangerous side effects.

Drugs that cause more negative effects

Taking amitriptyline with certain drugs raises your risk of negative effects. Examples of these drugs include:

• Topiramate. Taking this drug with amitriptyline could increase the amount of amitriptyline in your body. This raises your risk of side effects. Your doctor may adjust your dosage of amitriptyline if you take it with topiramate.
• Sertraline, fluoxetine, and paroxetine. These drugs can increase the dangerous side effects of amitriptyline.
• Cimetidine. Taking this drug with amitriptyline could increase the amount of amitriptyline in your body. This raises your risk of side effects.
• Anticholinergic drugs. Examples include diphenhydramine, oxybutynin, solifenacin, and olanzapine. Taking these drugs with amitriptyline raises your risk of side effects such as fever, especially during hot weather.
• Neuroleptic drugs. Examples include clozapine, risperidone, and haloperidol. Taking these drugs with amitriptyline raises your risk of side effects such as fever, especially during hot weather.

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

• your age
• the condition being treated
• the severity of your condition
• other medical conditions you have
• how you react to the first dose

Forms and strengths

Generic: Amitriptyline

• Form: oral tablet
• Strengths: 10 mg, 25 mg, 50 mg, 75 mg, 100 mg, 150 mg

Dosage for depression

Adult dosage (ages 18–64 years)

• Typical starting dosage: 75 mg per day, usually in divided doses.
• Dosage increases: Your doctor will slowly increase your dosage if needed.
• Maximum dosage: 150 mg per day.
• Alternative dosage regimen: Start with 50 to 100 mg at bedtime. This may be increased by 25 or 50 mg as needed in the bedtime dose, for a total of 150 mg per day.

Child dosage (ages 12–17 years)

Typical starting dosage: 10 mg three times a day with 20 mg at bedtime, for a total of 50 mg per day.

Child dosage (ages 0–11 years)

It hasn’t been confirmed that amitriptyline is safe and effective for use in children younger than 17 years.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lowered dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

When to call the doctor

Call your doctor if you notice worsening depression or suicidal thoughts. Also call your doctor right away if you become pregnant while taking this drug.

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FDA warning: Suicidal thoughts and behavior

• This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.
• Amitriptyline can increase the risk of suicidal thoughts and behavior, especially in children, adolescents, and young adults. People of all ages who are started on antidepressant therapy should be watched closely for signs of changes in behavior or worsening depression.

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Worsening depression warning

You might experience an initial worsening of your depression, thoughts of suicide, and behavioral changes when you first start taking amitriptyline. This risk may last until the drug starts working for you.

Withdrawal symptoms warning

If you’ve been taking this medication for a long time, you should not stop taking it suddenly. Stopping it suddenly may cause side effects such as nausea, headache, and tiredness. Do not stop taking this drug without talking with your doctor. They will tell you how to slowly lower your dosage over time.

Allergy warning

This drug can cause a severe allergic reaction. Symptoms can include:

• skin rash or hives
• trouble breathing
• swelling of your face or tongue

If you develop these symptoms, call 911 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Alcohol interaction warning

The use of drinks that contain alcohol while taking amitriptyline raises your risk of serious side effects, including extreme drowsiness.

Warnings for people with certain health conditions

For people with heart disorders: Taking this drug could cause heart problems, such as irregular heart rhythm, heart attack, and stroke. Do not take this drug if you’re recovering from a recent heart attack.

For people with bipolar disorder: Before starting you on treatment with antidepressants such as amitriptyline, it’s important for your doctor to check your risk of bipolar disorder. Your doctor should do this because a major depressive episode is usually the first symptom noticed in people with bipolar disorder. This drug should not be used in people with bipolar disorder.

For people with a history of seizures: Taking this drug raises your risk of seizures. If you have a history of seizures, your doctor will monitor you closely while you’re taking this drug. If you have a seizure while taking this drug, stop taking it and call your doctor right away.

For people with a history of glaucoma or increased eye pressure: Taking this drug could increase the pressure in your eyes. If you have a history of glaucoma or increased eye pressure, your doctor will monitor you closely while you’re taking this drug.

For people who have schizophrenia: This drug can worsen certain symptoms of schizophrenia. If you have this condition, let your doctor know before starting this drug.

For people who have urinary retention (difficulty emptying your bladder completely): Taking this drug can worsen urinary retention. If you have this condition, let your doctor know before starting this drug.

Warnings for other groups

For pregnant women: Talk with your doctor if you’re pregnant or plan to become pregnant. Research in animals has shown adverse effects to the fetus when the mother takes the drug. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus. This drug should only be used if the potential benefit justifies the potential risk

For women who are breastfeeding: Amitriptyline passes into breast milk and may cause side effects in a child who is breastfed. Talk with your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

For seniors: The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects. These side effects include fast heart rate, difficulty urinating, constipation, dry mouth, and blurred vision.

For children: It has not been confirmed that this drug is safe and effective for use in children younger than 12 years. Use of this drug in children must balance the potential risks with the clinical need.

Amitriptyline oral tablet is used for long-term treatment. It comes with risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all: If you don’t take amitriptyline, your depression may worsen. If you stop taking this medication suddenly you may have withdrawal side effects such as nausea, headache, and tiredness.

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

• irregular heart rhythm
• severely low heart rate
• convulsions
• hallucinations
• confusion
• stiff muscles

If you think you’ve taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 1-800-222-1222 or through their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: Over time you should notice an improvement in your symptoms of depression. This can take more than a month.

Keep these considerations in mind if your doctor prescribes amitriptyline for you.

General

• You can take amitriptyline with or without food.
• You can cut or crush the tablet.

Storage

• Store amitriptyline at room temperature between 68°F and 77°F (20°C and 25°C). It can be kept for brief periods between 59°F and 86°F (15°C and 30°C).
• Keep this drug away from light.
• Don’t store this drug in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

• Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
• Don’t worry about airport X-ray machines. They can’t hurt your medication.
• You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
• Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Your doctor will monitor your mental health while you take this drug. Be sure to tell your doctor about any unusual changes in your behavior and mood.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk with your doctor about other drug options that may work for you.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Side effects, dosage, uses and more

1. Amitriptyline oral tablet is available as a generic drug. It’s not available as a brand-name drug.
2. Amitriptyline comes only as a tablet you take by mouth.
3. Amitriptyline oral tablet is used to help relieve symptoms of depression.

Amitriptyline is a prescription drug. It comes as a tablet you take by mouth.

Amitriptyline oral tablet is not available as a brand-name drug. It’s only available as a generic drug. Generic drugs typically cost less than brand-name drugs.

Why it’s used

Amitriptyline is used to help relieve symptoms of depression.

How it works

Amitriptyline belongs to a class of drugs called tricyclic antidepressants. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Amitriptyline works on your central nervous system to increase the level of certain chemicals in your brain, which improves your depression.

Amitriptyline can cause dizziness and drowsiness during the first few hours after you take it. If you notice drowsiness while you take this drug, your doctor may have you take your dose at bedtime.

Amitriptyline can also cause other side effects.

More common side effects

The more common side effects of amitriptyline can include:

• confusion
• numbness and tingling in your arms and legs
• headache
• constipation or diarrhea
• blurred vision
• skin rash
• swelling of your face and tongue
• nausea
• unexpected weight gain or loss
• dizziness
• dry mouth

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• Heart attack. Symptoms can include:
  • chest pain
  • shortness of breath
  • pain or pressure in your chest or upper body
• Stroke. Symptoms can include:
  • weakness in one part or side of your body
  • slurred speech
• Seizures
• Withdrawal (if you suddenly stop taking this drug). Symptoms can include:
  • headache
  • nausea
  • trouble sleeping
  • depression
  • mood swings
• Increases or decreases in blood sugar
• Suicidal thoughts or actions
• Orthostatic hypotension (sudden drop in blood pressure when standing)

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare professional who knows your medical history.

Amitriptyline oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk with your doctor or pharmacist.

Examples of drugs that can cause interactions with amitriptyline are listed below.

Drugs you should not take with amitriptyline

Taking certain drugs with amitriptyline may cause serious side effects. You should not take these drugs and amitriptyline at the same time. Examples of these drugs include:

• Monoamine oxidase inhibitors (MAOIs). Examples of these drugs include:
  • phenelzine
  • tranylcypromine
  • selegiline

Using an MAOI with amitriptyline can lead to seizures or even death. Do not take an MAOI within two weeks of stopping amitriptyline, unless told to do so by your doctor. Also, do not start taking amitriptyline if you stopped taking a MAOI in the last two weeks, unless told to do so by your doctor. If you aren’t sure whether any of the drugs you take is an MAOI, ask your doctor or pharmacist.

• Quinidine. Taking this drug with amitriptyline could increase the amount of amitriptyline in your body. This could lead to dangerous side effects.

Drugs that cause more negative effects

Taking amitriptyline with certain drugs raises your risk of negative effects. Examples of these drugs include:

• Topiramate. Taking this drug with amitriptyline could increase the amount of amitriptyline in your body. This raises your risk of side effects. Your doctor may adjust your dosage of amitriptyline if you take it with topiramate.
• Sertraline, fluoxetine, and paroxetine. These drugs can increase the dangerous side effects of amitriptyline.
• Cimetidine. Taking this drug with amitriptyline could increase the amount of amitriptyline in your body. This raises your risk of side effects.
• Anticholinergic drugs. Examples include diphenhydramine, oxybutynin, solifenacin, and olanzapine. Taking these drugs with amitriptyline raises your risk of side effects such as fever, especially during hot weather.
• Neuroleptic drugs. Examples include clozapine, risperidone, and haloperidol. Taking these drugs with amitriptyline raises your risk of side effects such as fever, especially during hot weather.

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

• your age
• the condition being treated
• the severity of your condition
• other medical conditions you have
• how you react to the first dose

Forms and strengths

Generic: Amitriptyline

• Form: oral tablet
• Strengths: 10 mg, 25 mg, 50 mg, 75 mg, 100 mg, 150 mg

Dosage for depression

Adult dosage (ages 18–64 years)

• Typical starting dosage: 75 mg per day, usually in divided doses.
• Dosage increases: Your doctor will slowly increase your dosage if needed.
• Maximum dosage: 150 mg per day.
• Alternative dosage regimen: Start with 50 to 100 mg at bedtime. This may be increased by 25 or 50 mg as needed in the bedtime dose, for a total of 150 mg per day.

Child dosage (ages 12–17 years)

Typical starting dosage: 10 mg three times a day with 20 mg at bedtime, for a total of 50 mg per day.

Child dosage (ages 0–11 years)

It hasn’t been confirmed that amitriptyline is safe and effective for use in children younger than 17 years.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lowered dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

When to call the doctor

Call your doctor if you notice worsening depression or suicidal thoughts. Also call your doctor right away if you become pregnant while taking this drug.

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FDA warning: Suicidal thoughts and behavior

• This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.
• Amitriptyline can increase the risk of suicidal thoughts and behavior, especially in children, adolescents, and young adults. People of all ages who are started on antidepressant therapy should be watched closely for signs of changes in behavior or worsening depression.

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Worsening depression warning

You might experience an initial worsening of your depression, thoughts of suicide, and behavioral changes when you first start taking amitriptyline. This risk may last until the drug starts working for you.

Withdrawal symptoms warning

If you’ve been taking this medication for a long time, you should not stop taking it suddenly. Stopping it suddenly may cause side effects such as nausea, headache, and tiredness. Do not stop taking this drug without talking with your doctor. They will tell you how to slowly lower your dosage over time.

Allergy warning

This drug can cause a severe allergic reaction. Symptoms can include:

• skin rash or hives
• trouble breathing
• swelling of your face or tongue

If you develop these symptoms, call 911 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Alcohol interaction warning

The use of drinks that contain alcohol while taking amitriptyline raises your risk of serious side effects, including extreme drowsiness.

Warnings for people with certain health conditions

For people with heart disorders: Taking this drug could cause heart problems, such as irregular heart rhythm, heart attack, and stroke. Do not take this drug if you’re recovering from a recent heart attack.

For people with bipolar disorder: Before starting you on treatment with antidepressants such as amitriptyline, it’s important for your doctor to check your risk of bipolar disorder. Your doctor should do this because a major depressive episode is usually the first symptom noticed in people with bipolar disorder. This drug should not be used in people with bipolar disorder.

For people with a history of seizures: Taking this drug raises your risk of seizures. If you have a history of seizures, your doctor will monitor you closely while you’re taking this drug. If you have a seizure while taking this drug, stop taking it and call your doctor right away.

For people with a history of glaucoma or increased eye pressure: Taking this drug could increase the pressure in your eyes. If you have a history of glaucoma or increased eye pressure, your doctor will monitor you closely while you’re taking this drug.

For people who have schizophrenia: This drug can worsen certain symptoms of schizophrenia. If you have this condition, let your doctor know before starting this drug.

For people who have urinary retention (difficulty emptying your bladder completely): Taking this drug can worsen urinary retention. If you have this condition, let your doctor know before starting this drug.

Warnings for other groups

For pregnant women: Talk with your doctor if you’re pregnant or plan to become pregnant. Research in animals has shown adverse effects to the fetus when the mother takes the drug. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus. This drug should only be used if the potential benefit justifies the potential risk

For women who are breastfeeding: Amitriptyline passes into breast milk and may cause side effects in a child who is breastfed. Talk with your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

For seniors: The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects. These side effects include fast heart rate, difficulty urinating, constipation, dry mouth, and blurred vision.

For children: It has not been confirmed that this drug is safe and effective for use in children younger than 12 years. Use of this drug in children must balance the potential risks with the clinical need.

Amitriptyline oral tablet is used for long-term treatment. It comes with risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all: If you don’t take amitriptyline, your depression may worsen. If you stop taking this medication suddenly you may have withdrawal side effects such as nausea, headache, and tiredness.

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

• irregular heart rhythm
• severely low heart rate
• convulsions
• hallucinations
• confusion
• stiff muscles

If you think you’ve taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 1-800-222-1222 or through their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: Over time you should notice an improvement in your symptoms of depression. This can take more than a month.

Keep these considerations in mind if your doctor prescribes amitriptyline for you.

General

• You can take amitriptyline with or without food.
• You can cut or crush the tablet.

Storage

• Store amitriptyline at room temperature between 68°F and 77°F (20°C and 25°C). It can be kept for brief periods between 59°F and 86°F (15°C and 30°C).
• Keep this drug away from light.
• Don’t store this drug in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

• Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
• Don’t worry about airport X-ray machines. They can’t hurt your medication.
• You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
• Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Your doctor will monitor your mental health while you take this drug. Be sure to tell your doctor about any unusual changes in your behavior and mood.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk with your doctor about other drug options that may work for you.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Amitriptyline – ABIDI Pharm Tashkentda

Antidepressant

Instructions for use of the medicinal product

AMITRIPTYLINE

Trade name :

Amitriptyline

International nonproprietary name :

Amitriptyline

Dosage form :

Film-coated tablets containing 10 mg, 25 mg of amtriptyline.

Pharmacotherapeutic group :

Antidepressant.

Pharmacological properties :

AMITRIPTYLINE is a tricyclic antidepressant from the group of non-selective monoamine neuronal uptake inhibitors. It has a pronounced thymoanaleptic and sedative effect.

Pharmacodynamics :

The mechanism of the antidepressant action of amitriptyline is associated with inhibition of the reuptake of catecholamines (norepinephrine, dopamine and serotonin) in the central nervous system. Amitriptyline is a muscarinic cholinergic receptor antagonist in the CNS and in the periphery. It also has antihistamine (H1) and antiadrenergic properties.

Pharmacokinetics :

After oral administration of amitriptyline, peak plasma concentrations are reached within 4-8 hours. Its bioavailability is from 33 to 62%. Since amitriptyline slows down transit time in the gastrointestinal tract, absorption may be delayed, especially in case of overdose. With intramuscular administration, peak plasma concentrations are higher and are reached earlier. Effective blood concentrations of amitriptyline and nortriptyline (its active metabolite, on average, from 120 to 240 ng / ml).

The concentration of amitriptyline in tissues is higher than in plasma, where it is 92% bound to proteins.

Metabolized in the liver, plasma half-life of 10 to 28 hours for amitriptyline and 16 to 80 hours for nortriptyline. It is excreted mainly in the urine. Complete elimination within 7 days.

Amitriptyline crosses the placental barrier and is excreted in breast milk at concentrations similar to those in plasma. mostly in the urine. elimination from plasma from 10 to 28 hours for amitriptyline and from 16 to 80 hours for nortriptyline.

Indications :

The drug is used strictly according to the doctor’s prescription.

Depression of any etiology. It is especially effective in anxiety-depressive states, due to the severity of the sedative effect. It does not exacerbate productive symptoms (delusions, hallucinations), unlike antidepressants with a stimulating effect.

Mixed emotional and behavioral disorders, phobic disorders.

Pediatric enuresis (excluding children with hypotonic bladder).

Psychogenic anorexia, bulimic neurosis.

Chronic neurogenic pain. For migraine prevention.

Dosage and administration :

Assign orally (during or after meals).

The initial daily dose for oral administration is 50-75 mg (25 mg in 2-3 doses), then the dose is gradually increased by 25-50 mg until the desired antidepressant effect is obtained. The optimal daily therapeutic dose is 150-200 mg (the maximum part of the dose is taken at night). In severe depression resistant to therapy, the dose is increased to 300 mg or more, up to the maximum tolerated dose. In these cases, it is advisable to start treatment with intramuscular or intravenous administration of the drug, while using higher initial doses, accelerating the increase in dosages under the control of the somatic condition. After obtaining a stable antidepressant effect after 2-4 weeks, the doses are gradually and slowly reduced. In the event of signs of depression with a decrease in doses, it is necessary to return to the previous dose.

If the patient’s condition does not improve within 3-4 weeks of treatment, then further therapy is inappropriate.

In elderly patients with mild disorders, in outpatient practice, doses are 25-50-100 mg (max.) in divided doses or 1 time per day at night.

Children as antidepressant: 6-12 years. Inside 10-30 mg (1-5 mg / kg) per day in 2 divided doses; older than 12 years (12-18) orally 10 mg 3 times a day and 20 mg at bedtime, if necessary, and taking into account tolerance, the dose is increased to 100 mg per day in divided doses or once at bedtime.

For the prevention of migraine, chronic pain of a neurogenic nature (including prolonged headaches) from 12.5 – 25 mg to 100 mg / day.

Drug interaction :

Amitriptyline potentiates CNS depression with the following drugs: neuroleptics, sedatives and hypnotics, anticonvulsants, central and narcotic analgesics, anesthetics, alcohol.

When amitriptyline is co-administered with neuroleptics and/or anticholinergics, a febrile temperature reaction and paralytic ileus may occur.

Amitriptyline potentiates the hypertensive effects of catecholamines, but inhibits the effects of drugs that affect the release of norepinephrine, amitriptyline may reduce the antihypertensive effect of sympatholytics (octadine, guanethidine and drugs with a similar mechanism of action).

Simultaneous administration of amitriptyline and cimetidine may increase plasma concentrations of amitriptyline. Simultaneous administration of amitriptyline with MAO inhibitors can be fatal. The break in treatment between taking MAO inhibitors and tricyclic antidepressants should be at least 14 days!

Side effects :

Mainly associated with the anticholinergic effect of the drug, disturbance of accommodation, increased intraocular pressure, dry mouth, stool retention, intestinal obstruction, urinary retention, fever, drowsiness. All these phenomena usually disappear after adaptation to the drug or dose reduction.

From the side of the cardiovascular system: tachycardia, arrhythmias, orthostatic arterial hypotension.

From the gastrointestinal tract: nausea, vomiting, anorexia, stomatitis, taste disturbances, epigastric discomfort, rarely liver dysfunction.

From the endocrine system: gynecomastia, galactorrhea, changes in ADH secretion, decreased libido, potency.

Other: agranulocytosis and other blood changes, skin rash, hair loss, swollen lymph nodes, weight gain with prolonged use.

Amitriptyline at doses above 150 mg/day lowers the seizure threshold, so the risk of seizures should be considered in patients with a history of seizures, and in those patients who are predisposed to this due to age and injury.

Treatment with amitriptyline in the elderly should be carried out under careful somatic control and with the use of minimal doses of the drug, increasing them gradually, in order to avoid the development of delirious disorders, hypomania and other complications.

Patients in the depressive phase of MDP may progress to the manic stage.

While taking amitriptyline, it is forbidden to drive vehicles, maintain mechanisms and other types of work that require increased concentration of attention.

Overdose .

Drowsiness, disorientation, confusion, dilated pupils, fever, shortness of breath, dysarthria, agitation, hallucinations, seizures, muscle rigidity, stupor, coma, vomiting, arrhythmia, hypotension, heart failure, respiratory depression.

Relief measures: discontinuation of amitriptyline therapy, gastric lavage, fluid infusion, administration of physostigmine 1–3 mg every 1/2–2 hours IM or IV -ti minute interval to determine the minimum effective dose, but not more than 2 mg), physostigmine should be used only in patients in a coma, with respiratory depression, epileptic seizures. Severe hypotension and marked cardiac arrhythmia; symptomatic therapy, maintenance of blood pressure and water and electrolyte balance. Showing monitoring of cardiovascular activity (ECG) for 5 days, tk. relapse can occur after 4 hours or later.

Contraindications :

Decompensated heart defects.

Acute and recovery period of myocardial infarction.

Conduction disorders of the heart muscle.

Hypertension stage 3

Acute diseases of the liver and kidneys, with severe dysfunction.

Blood diseases.

Peptic ulcer of the stomach and duodenum in the acute stage.

Glaucoma.

Prostate hypertrophy.

Bladder atony.

Pyloric stenosis, paralytic ileus.

Simultaneous treatment with MAO inhibitors.

Pregnancy, breastfeeding period.

Children under 6 years of age (injectable forms up to 12 years of age).

Hypersensitivity to amitriptyline.

Form :

10 tablets in a blister. 1, 2, 3, 5, 6 and 10 blisters per pack.

1000 tablets in vials of LDPE.

Storage conditions :

List B.

Store in a dry, dark place, out of the reach of children, at a temperature not exceeding 40ºС.

The drug must not be used after the expiry date which is stated on the package.

Shelf life :

Shelf life – 3 years.

Pharmacy leave conditions :

Available on prescription.

Manufacturer :

Darou Pakhsh Pharmaceutical Mfg. Co – I.R.I.

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Danish description simplified by the author’s version from the website zdravica. ua. The description was created on the basis of information, as it is submitted in the official instructions for the administration of the drug.

Before you buy and zastosovuvaty Amitriptyline, it is necessary to consult with a doctor and take recommendations about how to live, and it is also important to read the instructions, as it was served in a package with a medicinal case.

Self-medication may not be safe for your health. Information about the drug Amitriptyline is hoped only for your knowledge, before you turn to your doctor. Vіn accurately establish the diagnosis, recognize the dose and method of treatment.

DO NOT TAKE YOUR BATH! IT MAY NOT BE SAFE FOR YOUR HEALTH!

Amitriptyline: a short instruction before stopping

For the remainder of the year, the world’s market was hit by an inactive antidepressant. The stench mayut different centers in the flow, different effects and storage. Ale, one of the most popular and demanded axis has already been deprived of Amitriptyline for dozens of years. It is a first-generation antidepressant, which may have an antidepressant, sedative, sleepy, and anti-inflammatory effect. Also Vіn maє y іnshі dії:

• Painful.
• Vegetostabilizing.
• Antidiarrheal.

Helps to deal with psychosomatic symptoms that are attributable to the patient, including enuresis.

In case of guilt, do not repair any injection on the body of a mentally healthy person.

Amitriptyline warehouse is the main drug of amitriptyline. Vin can be released in various forms (powder, tablets or tablets for injections) and in fallow in the form of additional speech.

If you want to buy Amitriptyline of the best quality in the form of overcooked varieties, then go to the Zdravitsa online pharmacy. We proponuєmo bezlіch likarskih tovarіv for affordable varіstyu. The price for Amitriptyline is always low and democratic, and you can make a reservation online with home delivery.

Indications before congestion Amitriptyline: if it is prescribed

• it is prescribed for depression, like vinyl for other reasons;
• in schizophrenic psychoses;
• if the patient is suffering from emotional disturbances;
• for behavioral disorders and severe problems with self-control;
• for bulimia nervosa;
• is prescribed to children, as if they suffer from childish enuresis, but only as a cause of gynecology not by congenital illnesses, but by hypotension of sich mihur;
• with chronic pain syndrome, which may be psychological, neurogenic in nature;
• for migraine prophylaxis.

What are the contraindications before ingestion of Amitriptyline?

1. Individual intolerance to amitriptyline or other components in the warehouse.
2. After a severe myocardial infarction, or during the period of renewal of the body after a new one.
3. Heart failure of various stages.
4. If the conductivity is damaged.
5. Still symptomatic arterial hypertension.
6. For paralytic bowel obstruction.
7. Yakshko є virazkovy ailment of the slough and twelve-fingered intestines, especially in case of aggravated ailments.
8. In case of ailments of the liver of abonir, it is injected into the functions of these organs.
9. In case of any blood diseases.

The drug may be indicated for children, but only under suvorim control and for 6 years. Іn’єktsії can be attributed to 12 years.

More exact data and features of the drug taken can be found in your expert trader. Vіn is guilty of conducting a comprehensive examination, turning the body over to the body, reconsidering that the patient does not suffer from illnesses, like changing the intake of Amitriptyline. In addition, it is necessary to correctly put together a plan of jubilation and combination of medicinal speeches in order to avoid negative reactions.

Interactions with other drugs

• Quite crazy with MAO inhibitors.
• It is not possible to take the drug at the same time with alcohol, or be it with alcohol-based drugs.
• May have a greater effect, if you take yoga at the same time with other drugs that are injected into the central nervous system.
• Antipsychotics and antipsychotics are used to treat metabolism.

Amitriptyline: method of administration and dosing

Please take the center. The first dose becomes 25 mg to 50 mg at bedtime. Then incrementally for 5 days, the dose is increased to 200 mg per day. I will become a stretcher for another day. If nothing else is known, then the drug can carry out decongestion and increase dosing up to 300 mg.