What is Amitriptyline?
Amitriptyline is a prescriptional medication that is mainly used to treat symptoms of depression.
What are the uses of Amitriptyline?
Amitriptyline belongs to the category of antidepressant medications. It boosts the production of certain natural chemical messengers (neurotransmitters) of the brain, which helps to regulate the mood.
Amitriptyline can be prescribed in the following conditions;
- Eating disorders
- Post-herpetic neuralgia (the burning, stabbing pains, or aches that may last for months or years after a shingles infection)
- Prophylactic treatment of chronic tension-type headache (CTTH)
- Treatment of nocturnal enuresis in children aged 6 years
The medication may be prescribed for other uses; ask your physician or pharmacist for detailed information.
How do you use Amitriptyline?
- Take this medicine orally; one to four times a day, with or without food or as prescribed by your physician (if to be taken once daily, it is advisable to take it during night time as it helps to reduce daytime sleepiness)
- Take this tablet daily at the same time every day.
- Follow all the instructions on the prescription label.
- Do not stop taking this medication abruptly without consulting your doctor.
- Do not take it more or less, or take it more than often than prescribed by your doctor.
- Do not stop using it even if you feel well.
Your physician may start you with a low dose and gradually increase your dose. It may take 1-4 weeks before you begin to notice the full benefits of the medication.
If You Miss the Dose
- If you happen to miss a dose of Amitriptyline, take the missed dose as soon as you remember.
- However, if it is almost time for the next dose, do not take the missed dose and continue with your next scheduled dose.
- Do not take a double dose to compensate for the missed dose.
What are the side-effects and risks of Amitriptyline?
Like all other medications, Amitriptyline may cause side effects. Although it is unlikely to happen in everyone, it is important that you are aware of what could be the possible side effects.
- Congested nose
- Dry mouth
- Tremors in hands or other parts of the body
- Irregular heartbeat or fast heartbeat
- Weight gain
- Excessive sweating
- Problem with the ability of the eye to change its focus from distant to near objects (and vice versa)
- Slurred or slow speech
Common side effects:
- Feeling thirsty
- Urination disorders
- Sexual disturbances (decreased sex-drive, problems with erection)
- Disturbances in attention
- Low sodium levels in the blood
- Changes in taste
- Numbness or tingling in the arms or legs
- Heart block
- Disturbed coordination
- Dilated pupils
Uncommon side effects:
- Liver function impairment
- Excitement, anxiety, difficulties sleeping, nightmares
- Worsening of cardiac failure
- Collapse conditions
- Increased pressure in the eyeball
- Increased blood pressure
- Increased production of breast milk or breast milk outflow without breastfeeding
- Skin rash, nettle rash (urticarial), swelling of the face and tongue
- Difficulties passing urine
Rare side effects:
- Abnormal results of liver function tests.
- Decreased appetite
- Weight loss
- Delirium (especially in elderly patients), hallucinations
- Abnormality in the heart's rhythm, or heartbeat pattern
- Increased sensitivity to sunlight
- Breast enlargement in men
- Swelling of the salivary glands
- Hair loss
Very rare side effects:
- Disorder of the peripheral nerves
- Acute increase of pressure in the eye (acute glaucoma)
- Heart muscle disease
- A feeling of inner restlessness and a compelling need to be in constant motion
- Particular forms of abnormal heart rhythm (so-called torsades de pointes)
- Allergic inflammation of the lung alveoli and the lung tissue.
An increased risk of bone fractures has been observed in patients taking this medication. In some cases, Amitriptyline may take a bit longer to work, so if you may have thoughts of killing or harming yourself. Contact your physician immediately or go to the hospital straight away.
This is not a complete list of side effects, and others may occur. Please consult your doctor to know more about other possible side effects.
Who should not take Amitriptyline?
Inform your physician if you have the following conditions before starting Amitriptyline:
- Recently have had a heart attack (myocardial infarction)
- Heart problems such as disturbances in heart rhythm which are seen on an electrocardiogram (ECG), heart block, or coronary artery disease
- Severe liver disease.
- A slow heart rate
- A problem where your heart cannot pump the blood around your body as well as it should (a condition called heart failure)
- An overactive thyroid gland
- A problem that gives you a low level of potassium or magnesium, or a high level of potassium in your blood
- A surgery planned. It might be necessary to stop the treatment with Amitriptyline before you are given anesthetics. In the case of acute surgery, the anesthetist should be informed about the treatment of Amitriptyline.
- Narrow-angle glaucoma (loss of vision due to abnormally high pressure in the eye)
- Diabetes as you might need and adjustment of your antidiabetic medicine.
- Epilepsy, a history of convulsions or fits
- Difficulty in passing urine
- Pyloric stenosis (narrowing of the gastric outlet) and paralytic ileus (blocked intestine)
- Enlarged prostate
- Bipolar disorder
This medicine should not be used for children below 6 years of age.
Talk to your doctor before taking Amitriptyline if:
- You are taking any other medication, are pregnant, breastfeeding, or planning a pregnancy.
- You are allergic to Amitriptyline or any of its ingredients or have any other allergies.
- You are allergic to any other medication.
- You are taking any other drugs, over-the-counter medicines, herbal products, or nutritional supplements.
Besides, certain medicines may interfere with its working and thus might not be safe to take them together. Some of them are:
- Monoamine oxidase inhibitors such as phenelzine, iproniazid, isocarboxazid, nialamide, tranylcypromine. Even if you have finished taking one of the following MAOIs: phenelzine, iproniazid, isocarboxazid, nialamide, or tranylcypromine, you will need to wait for 2 weeks before you start taking your Amitriptyline tablets.
- Valproic acid
- Thyroid Medications
- St. John's Wort (hypericum perforatum) – a herbal remedy used for depression
- Adrenaline, ephedrine, isoprenaline, noradrenaline, phenylephrine, and phenylpropanolamine (these may be present in cough or cold medicine and some anesthetics)
- Medications to treat high blood pressure, for example, calcium-channel blockers (e.g., diltiazem and verapamil), guanethidine, betanidine, clonidine reserpine, and methyldopa
- Anticholinergic drugs such as certain medicines to treat Parkinson's disease and gastrointestinal disorders (e.g., atropine, hyoscyamine)
- Oral contraceptives
- Antifungal medications such as fluconazole, terbinafine, ketoconazole, and itraconazole
- Pimozide and sertindole
This may not be a comprehensive list, and other drugs may interact with Amitriptyline. Please inform your doctor if you are taking any of the medicines listed above.
When should you not take Amitriptyline?
You should not take Amitriptyline if:
- It has passed the expiry date of the medicine printed on the pack.
- The packaging shows signs of tampering.
- You are lactose intolerant.
Amitriptyline may cause drowsiness and/or dizziness, especially during the initial treatment phase affecting the ability to carry out normal daily activities. You should not drive or operate machinery or perform jobs requiring you to be alert until these effects wear off.
Ask your doctor about the safe use of alcoholic beverages during your treatment with Amitriptyline as it can make the side effects of Amitriptyline worse.