Amitriptyline

Description

Amitriptyline is an antidepressant medicine. It is used in the treatment of depression and other conditions such as nerve pain and migraine. It works by increasing the levels of chemical substances in the brain and improving your mood. It also blocks the transmission of pain signals and provides relief from nerve pain. Amitriptyline may cause common side effects such as dizziness, sleepiness, dryness in the mouth, weight gain, nasal congestion, etc. Consult your doctor if these symptoms stay for a long time or if they become severe. Amitriptyline should be taken exactly as advised by your doctor. Take it at the same time every day as it will help you to remember. Do not skip doses or discontinue the treatment without consulting your doctor as it may cause withdrawal symptoms such as fatigue, sleep disturbances, irritability, etc. To avoid these, gradual dose reduction is necessary under your doctor’s supervision. Amitriptyline should be avoided if you are allergic to it. Inform your doctor if you have diabetes, liver problems, or a history of seizures (a condition that occurs due to abnormal brain activity causing fits) or glaucoma (an eye condition that occurs due to increased pressure within the eyeballs) before taking this medicine. Inform your doctor about your current medicines to avoid any undesired effects. Consult your doctor if you are pregnant, planning a pregnancy, or are breastfeeding.

Side effects

Major & minor side effects for Amitriptyline

  • Drowsiness
  • Dizziness
  • Headache
  • Dry mouth
  • Constipation
  • Excessive sweating
  • Weight gain
  • Slow or slurred speech
  • Nasal congestion
  • Confusion
  • Decrease in sexual drive
  • Increased thirst
  • Dizziness when getting up suddenly from a sitting position
  • Difficulty in passing urine

Uses of Amitriptyline

What is it prescribed for?

  • Depression
  • Neuropathic pain
  • Migraine
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Concerns

Commonly asked questions

  • Onset of action
    Amitriptyline has a slow onset of action and may take 4 to 6 weeks to show its effects.
  • Duration of effect
    Amitriptyline may remain in your body for approximately 5 days.
  • Safe with alcohol?
    Consumption of alcohol is not recommended during treatment with Amitriptyline as it may increase the risk of side effects such as drowsiness, confusion, blurred vision, sweating, muscle stiffness, light-headedness, etc. Avoid performing activities that require mental alertness such as driving and/or operating machines if you experience these symptoms.
  • Is it habit forming?
    No habit-forming tendency has been reported with Amitriptyline.
  • Usage in pregnancy?
    Amitriptyline is not recommended for use during pregnancy as it may harm your foetus. Consult your doctor if you are pregnant.
  • Usage while breast-feeding?
    Amitriptyline passes into breastmilk and may cause side effects in your baby. This medicine is not recommended for use if you are breastfeeding.

Allergy

Avoid taking Amitriptyline if you are allergic to it. Seek immediate medical attention if you notice any symptoms such as skin rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, breathing difficulty, etc.

Monoamine oxidase inhibitors

Monoamine oxidase inhibitors are a class of medicines used to treat depression. Amitriptyline is not recommended for use if you have taken this medicine within the last 14 days due to the increased risk of serious side effects.

Heart diseases

Amitriptyline is not recommended for use if you recently had a heart attack as it may further worsen your condition.

Severe liver impairment

Amitriptyline is not recommended for use if you have severe liver problems as it may cause further liver damage.
Warnings for special population

Pregnancy

Amitriptyline is not recommended for use during pregnancy as it may harm your foetus. Consult your doctor if you are pregnant.

Breast-feeding

Amitriptyline passes into breastmilk and may cause side effects in your baby. This medicine is not recommended for use if you are breastfeeding.
General warnings

Driving or operating machines

Amitriptyline may increase your risk of dizziness and sleepiness. Hence, avoid driving or operating machines if you experience these symptoms.

Hypotension (Low blood pressure)

A high dose of Amitriptyline should be used with caution as it may increase your risk of low blood pressure. It is recommended that you regularly monitor your blood pressure while taking this medicine.

Suicidal tendencies

Amitriptyline should be used with caution due to the increased risk of suicidal thoughts. Closely monitor for any change in behaviour or mood while taking this medicine. Consult your doctor immediately if you experience any change in behaviour or suicidal thoughts.

Use in children

Amitriptyline is not recommended for use in children below 18 years of age for the treatment of depression, neuropathic pain, and migraine due to lack of safety and efficacy data.

Elderly

Amitriptyline should be used with caution in elderly people due to the increased risk of side effects. Appropriate dose adjustments may be necessary based on the clinical condition.

Withdrawal symptoms

Amitriptyline should not be discontinued suddenly as it may result in withdrawal symptoms such as headache, weakness, fatigue, sleep disturbances, irritability. etc. Gradual dose reduction should be done over a period under your doctor's supervision.

Missed Dose

Try not to skip a dose of Amitriptyline. Take the missed dose as soon as you remember. If it is time for your next dose, skip the missed one. Do not double the dose to compensate for a missed one.

Overdose

Do not take more than the prescribed dose of Amitriptyline. Seek immediate medical attention if you suspect an overdose with this medicine.
All drugs interact differently for person to person. You should check all the possible interactions with your doctor before starting any medicine.
Interaction with Alcohol

Description

N/A

Instructions

Consumption of alcohol is not recommended during treatment with Amitriptyline as it may increase the risk of side effects such as drowsiness, confusion, blurred vision, sweating, muscle stiffness, light-headedness, etc. Avoid performing activities that require mental alertness such as driving and/or operating machines if you experience these symptoms.
Interaction with Medicine

Fluoxetine

Topiramate

Duloxetine

Warfarin

Diphenhydramine

Zolpidem

Azithromycin

Hydroxychloroquine

Ondansetron

Moxifloxacin

Disease interactions

Heart Disease

Amitriptyline may cause orthostatic hypotension (a sudden drop in blood pressure when standing up from a sitting/lying down position), irregular heartbeats, QT prolongation (a condition in which your heart muscles take a longer time to recharge between a heartbeat), heart attack or stroke (a decrease in blood supply to your brain). Hence, this medicine should be used with caution if you have heart problems. Consult your doctor before starting the treatment with this medicine.

Phaeochromocytoma

Phaeochromocytoma is a rare tumour of the adrenal glands (a small gland located on top of your kidney that is responsible for producing chemical substances known as hormones). Amitriptyline should be used with caution if you have phaeochromocytoma as it may further worsen your condition.

Seizures

Seizure is a condition that occurs due to disturbed nerve cell activity in your brain resulting in abnormal behaviour and loss of consciousness. Amitriptyline should be used with caution if you have a history of seizures as this medicine may trigger seizures.

Diabetes

Amitriptyline should be used with caution if you have diabetes (high blood sugar levels) due to the increased risk of altered blood sugar levels. Regularly monitor your blood sugar levels while taking this medicine.

Glaucoma

Glaucoma is a condition in which the optic nerve (the nerve connecting the eye to the brain) is damaged, usually due to high pressure within your eyeballs. Amitriptyline should be used with caution if you have a history of glaucoma as this medicine may increase the pressure within your eyeballs. Your doctor may periodically monitor your intraocular pressure (pressure inside the eye) during treatment with this medicine.

Bone marrow suppression

Bone marrow suppression is a condition in which there is decreased production of blood cells in your bone marrow (a spongy substance present at the centre of your bones). Amitriptyline should be used with caution if you have a pre-existing condition as it may cause a further decrease in blood counts.

Tardive Dyskinesia

Tardive dyskinesia is a condition with repetitive, involuntary body movements. Amitriptyline should be used with caution if you have tardive dyskinesia as it may further worsen your condition.

Liver Disease

Amitriptyline is broken down in your liver. Hence, this medicine should be used with caution if you have pre-existing liver problems due to the increased risk of severe side effects. It may also cause further liver damage. Your doctor may suggest tests to periodically monitor your liver function and liver enzyme levels while you are taking this medicine.

Hyperthyroidism

Hyperthyroidism is a condition that occurs due to high levels of thyroid hormone in your body. Amitriptyline should be used with caution if you have hyperthyroidism due to the increased risk of developing an irregular heartbeat.

Urinary retention

Urinary retention is a condition in which you cannot empty your bladder completely when you urinate. Amitriptyline should be used with caution if you have such a condition as this medicine may increase your risk of urinary retention.
Food interactions
Information not available.
Lab interactions
Information not available.
Take Amitriptyline with or without food. Do not take more or less than the prescribed dose. Avoid the discontinuation of Amitriptyline without consulting your doctor as it may result in withdrawal symptoms. Amitriptyline may increase your risk of suicidal thoughts. Consult your doctor if you experience any changes in mood or behaviour. Avoid consuming alcohol while taking Amitriptyline as it may cause drowsiness and dizziness. Avoid driving or operating machines if you experience symptoms that may affect your mental alertness.
Miscelleneous

Can be taken with or without food, as advised by your doctor

To be taken as instructed by doctor

Causes sleepiness

How it works
Amitriptyline works by increasing the levels of chemical substances in your brain (norepinephrine and serotonin). Thus, it helps to improve your mood. It also prevents the pain signals from being sent from nerves to the brain, thus provides relief from nerve pain.
Legal Status

Approved

Approved

Approved

Approved

Classification

Category

Tricyclic antidepressants

Schedule

Schedule H

Medicines.org.uk. 2021. [online] Available at: < [Accessed 9 September 2021].

https://www.medicines.org.uk/emc/files/pil.5698.pdf>

Medicines.org.uk. 2021. Amitriptyline 10mg Tablets BP - Summary of Product Characteristics (SmPC) - (emc). [online] Available at: < [Accessed 9 September 2021].

https://www.medicines.org.uk/emc/product/5698/smpc>

Medicines.org.uk. 2021. Amitriptyline Hydrochloride 25mg/5ml Oral Solution - Summary of Product Characteristics (SmPC) - (emc). [online] Available at: < [Accessed 9 September 2021].

https://www.medicines.org.uk/emc/product/1560/smpc>

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Information on this page was last updated on 24 Sep 2021

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