Amitriptyline

Amitriptyline is used for treating depression. It may also be used for other conditions as determined by your doctor.

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.
Avoid eating or drinking grapefruit juice while taking Amitriptyline.
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.

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.

If you miss a dose of Amitriptyline and are using it regularly, 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.

Store Amitriptyline between 68 and 77 degrees F (20 and 25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. 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.

Do not use Amitriptyline if:

• you are allergic to any ingredient in Amitriptyline;
• you are currently taking or have taken a monoamine oxidase inhibitor (MAOI) (e.g., phenelzine, selegiline) within the last 14 days;
• you are taking antihistamines (e.g., diphenhydramine), cisapride, droperidol, a ketolide (e.g., telithromycin) , a macrolide (e.g., erythromycin), mibefradil, or pimozide;
• you are recovering from a heart attack.

• 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 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

• 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 lightheadedness 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

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.

• 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 (e.g., of face, tongue, arms, legs); unusual bleeding or bruising; unusual or severe mental or mood changes; vision problems; yellowing of the skin or eyes.

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.