Amitriptyline

The usual starting dose of Amitriptyline (Amitriptyline) for depression in adults is 25 mg 3 times a day. The dose of Amitriptyline (Amitriptyline) is usually started low and increased slowly as prescribed by the doctor until the medication is at a dose that is appropriate and effective. After symptoms improve, the dose may be reduced to the lowest amount that will relieve symptoms. The usual maintenance dose of Amitriptyline (Amitriptyline) for adults ranges from 50 mg to 100 mg per day in divided doses. For some people, the daily dose can be given as a single dose, preferably at bedtime.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Amitriptyline (Amitriptyline) exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Amitriptyline (Amitriptyline) at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause dryness of the mouth; it may cause headaches; it may cause constipation - to prevent this, drink plenty of water or juice, and eat more dietary fibre; it may cause drowsiness or dizziness - use caution when getting up from a lying or sitting position and use caution if driving; it may make your skin more sensitive to UV rays (e.g., sunlight, tanning lamps) - avoid exposure to UV rays as much as possible and protect yourself when out in the sun; it may cause weight gain, mostly with prolonged use. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

10 mg
Each round, blue, biconvex, film-coated tablet, engraved "10" on one side, contains Amitriptyline (Amitriptyline) HCl 10 mg. Nonmedicinal ingredients: microcrystalline cellulose, croscarmellose sodium, magnesium stearate, colloidal silicon dioxide, hydroxypropyl methylcellulose, polyethylene glycol, titanium dioxide, carnauba wax, and Brilliant Blue FCF AL Lake 12%.

25 mg
Each round, yellow, biconvex, film-coated tablet, engraved "25" on one side, contains Amitriptyline (Amitriptyline) HCl 25 mg. Nonmedicinal ingredients: microcrystalline cellulose, croscarmellose sodium, magnesium stearate, colloidal silicon dioxide, hydroxypropyl methylcellulose, polyethylene glycol, titanium dioxide, carnauba wax, and D&C Yellow No. 10 AL 14%-18%.

50 mg
Each round, brown, biconvex, film-coated tablet, engraved "50" on one side, contains Amitriptyline (Amitriptyline) HCl 50 mg. Nonmedicinal ingredients: microcrystalline cellulose, croscarmellose sodium, magnesium stearate, colloidal silicon dioxide, hydroxypropyl methylcellulose, polyethylene glycol, titanium dioxide, carnauba wax, Sunset Yellow AL Lake 40%, and Indigotine AL Lake 12%-14% (Blue No. 2).

75 mg
Each round, orange, biconvex, film-coated tablet, engraved "75" on one side, contains Amitriptyline (Amitriptyline) HCl 75 mg. Nonmedicinal ingredients: microcrystalline cellulose, croscarmellose sodium, magnesium stearate, colloidal silicon dioxide, hydroxypropyl methylcellulose, polyethylene glycol, titanium dioxide, carnauba wax, and Sunset Yellow AL Lake 40%.

Do not take Amitriptyline (Amitriptyline) if you:

• are allergic to Amitriptyline (Amitriptyline) or any ingredients of the medication
• are taking a monoamine oxidase inhibitor ( MAOI; e.g., Phenelzine, Tranylcypromine, Moclobemide) or have taken one in the past 14 days
• have acute Congestive Heart Failure
• have recently had a Heart Attack
• have severely decreased liver function

There may be an interaction between Amitriptyline (Amitriptyline) and any of the following:

• Abiraterone
• acetylsalicylic acid (Asa)
• aclidinium
• alcohol
• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• antiarrythmics (e.g., Amiodarone, Dronedarone, Flecainide, procainamide, quinidine)
• anticholinergic medications (e.g., atropine, Oxybutynin)
• azole antifungals (e.g., fluconazole, itraconazole, ketoconazole)
• antihistamines (e.g., cetirizine, doxylamine, Diphenhydramine, Hydroxyzine, Loratadine)
• antipsychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, Olanzapine, Quetiapine, Risperidone)
• asunaprevir
• barbiturates (e.g., butalbital, Phenobarbital)
• benzodiazepines (e.g., Alprazolam, Diazepam, Lorazepam)
• Benztropine
• beta-2 agonists (e.g., salmeterol, formoterol, terbutaline)
• botulinum toxin
• brimonidine
• bupriopion
• Buspirone
• cannabis
• chloroquine
• cholinesterase inhibitors (e.g., Donepezil, Galantamine, Rivastigmine)
• Cimetidine
• Cinacalcet
• ciprofloxacin
• Clonidine
• Cobicistat
• Dantrolene
• Darifenacin
• Decongestant Nasal sprays (e.g., oxymetazoline, phenylephrine, naphazoline)
• delavirdine
• Desmopressin
• Domperidone
• efavirenz
• Entacapone
• ergot alkaloids (e.g., ergotamine, Dihydroergotamine)
• Flavoxate
• glycopyrrolate
• Guanfacine
• HIV protease inhibitors (e.g., darunavir, lopinavir, ritonavir, saquinavir, tipranavir)
• levodopa
• Levothyroxine
• lithium
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• MAO inhibitors (e.g., moclobemide, phenelzine, Rasagiline, Selegiline, tranylcypromine)
• Methadone
• Methylphenidate
• Metoclopramide
• mifepristone
• Mirabegron
• Mirtazapine
• muscle relaxants (e.g., Baclofen, Cyclobenzaprine, orphenadrine, Tizanidine)
• nefazodone
• nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., Celecoxib, Diclofenac, Ibuprofen, Naproxen)
• opioid analgesics (e.g., Fentanyl, Morphine)
• potassium chloride
• Pramipexole
• Primaquine
• protein kinase inhibitors (e.g., imatinibi, Lapatinib, Nilotinib, Pazopanib, Sunitinib)
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, Ofloxacin)
• rifabutin
• rifampin
• Ropinirole
• St. John's wort
• scopolamine
• seizure medications (e.g., Carbamazepine, Levetiracetam, phenobarbital, Phenytoin, primidone, Topiramate, Valproic acid, zonisamide)
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Fluoxetine, Fluvoxamine, Sertraline)
• serotonin/norepinephrine reuptake inhibitors (SNRIs; e.g., Desvenlafaxine, Duloxetine, Venlafaxine)
• serotonin antagonists (anti-emetic medications; e.g., Granisetron, Ondansetron)
• Solifenacin
• sulfonylureas (e.g., Gliclazide, Glyburide, Tolbutamide)
• terbinafine
• Tetrabenazine
• thiazide diuretics (water pills; e.g., Hydrochlorothiazide, Indapamide, Metolazone)
• tiotropium
• tolcapone
• Tramadol
• Trazodone
• other tricyclic antidepressants (e.g., Clomipramine, Desipramine, Trimipramine)
• "triptan" migraine medications (e.g., Eletriptan, Rizatriptan, Sumatriptan)
• Tryptophan
• umeclidinium
• Warfarin
• Yohimbine
• Zolpidem
• Zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Amitriptyline (Amitriptyline). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Amitriptyline (Amitriptyline).

Abnormal heart rhythms: Amitriptyline (Amitriptyline) has been linked to changes to the normal rhythm of the heart, including an irregular heartbeat called QT prolongation. QT prolongation is a serious life-threatening condition that can cause fainting, seizures, and sudden death. If you are at risk for heart rhythm problems (e.g., people with heart failure, Angina, low potassium or magnesium levels), discuss with your doctor how Amitriptyline (Amitriptyline) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Amitriptyline (Amitriptyline), and whether any special monitoring is needed.

Alcohol and other medications that cause drowsiness: Do not combine Amitriptyline (Amitriptyline) with alcohol or other medications (e.g., antidepressants, sleeping pills, anxiety medications) that cause drowsiness because Amitriptyline (Amitriptyline) can also cause drowsiness and the combinationcan be dangerous.

Drowsiness/reduced alertness: Amitriptyline (Amitriptyline) may reduce mental or physical abilities required for performance of hazardous tasks, such as operating machinery or driving a motor vehicle. Do not undertake such activities until you have determined that it does not have this effect on you.

Heart diseases: Amitriptyline (Amitriptyline) can worsen symptoms of heart disease. If you have a history of heart attack, angina, Stroke, "mini-stroke", or are at risk of experiencing low blood pressure (e.g., dehydration, taking medications for high blood pressure), discuss with your doctor how Amitriptyline (Amitriptyline) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Amitriptyline (Amitriptyline), and whether any special monitoring is needed.

Low blood pressure: Symptoms of low blood pressure, such as weakness or dizziness, particularly when rising suddenly from a sitting or lying position, may occur. People who are prone to low blood pressure (e.g., people taking diuretics) should be cautious when using Amitriptyline (Amitriptyline).

Mania or hypomania: Amitriptyline (Amitriptyline) may cause activation of mania or hypomania. If you experience symptoms such as hallucinations, mania (feeling unusually over-excited or uninhibited), or delusional thinking, or notice them in a family member who is taking Amitriptyline (Amitriptyline), contact your doctor as soon as possible.

People with a history of bipolar disorder should be closely monitored by their doctor while using Amitriptyline (Amitriptyline).

Medical conditions: People with the following conditions should discuss with their doctor how Amitriptyline (Amitriptyline) may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Amitriptyline (Amitriptyline), and whether any special monitoring is needed:

• Benign Prostatic Hyperplasia (enlarged prostate)
• certain blood disorders
• increased eye pressure
• reduced liver function
• narrow-angle glaucoma
• seizures
• urinary retention

Suicidal or agitated behaviour: People taking antidepressants such as Amitriptyline (Amitriptyline) may feel agitated (restless, anxious, aggressive, emotional, trouble sleeping, and feeling not like themselves), or they may want to hurt themselves or others. If you notice any changes in mood, behaviours, thoughts, or feelings in yourself or someone who is taking Amitriptyline (Amitriptyline), contact a doctor immediately. Your doctor will monitor you closely for behaviour changes, especially at the start of treatment or when your dose is increased or decreased.

Surgery: Using Amitriptyline (Amitriptyline) before, during, and after surgery may increase the risk of developing abnormal heart rhythms. The risks and benefits of continuing Amitriptyline (Amitriptyline) during elective surgery should be discussed with your doctor. Your doctor may recommend to stop or reduce the dose of Amitriptyline (Amitriptyline) several days prior to the scheduled surgery.

Thyroid disease: Patients who have an overactive thyroid (Hyperthyroidism) or are taking thyroid medication should be monitored closely by their doctor when taking Amitriptyline (Amitriptyline). People who are taking certain thyroid medications have an increased risk of developing an irregular heartbeat when taking Amitriptyline (Amitriptyline).

Withdrawal: Stopping Amitriptyline (Amitriptyline) abruptly after taking it for a long time may produce nausea, headache, and a general feeling of being unwell. Gradual dosage reduction has been reported to produce (within 2 weeks) transient symptoms including irritability, restlessness, and dream and sleep disturbance. Experiencing these symptoms does not mean you are addicted. Do not suddenly stop taking Amitriptyline (Amitriptyline) if you have been taking it for a while. If you are to stop taking Amitriptyline (Amitriptyline), contact your doctor, who will advise you on how to gradually stop Amitriptyline (Amitriptyline).

Pregnancy: Amitriptyline (Amitriptyline) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Amitriptyline (Amitriptyline), contact your doctor immediately.

Breast-feeding: Amitriptyline (Amitriptyline) passes into breast milk. If you are a breast-feeding mother and are taking Amitriptyline (Amitriptyline), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Amitriptyline (Amitriptyline) have not been established for children under 12 years of age.

This medication is typically used only once a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. Take it regularly and continuously to maintain its beneficial effects. It is not advisable to stop using this product suddenly, particularly if you have been on it for several weeks. If you are considering stopping the medication, talk to your pharmacist first. If you forget a dose, take it as soon as you remember -- unless it is almost time for your next dose. In that case, skip the missed dose. Do not double the next dose to catch up. This medication may be taken with or without food. Consuming alcohol may intensify the effect of this product. If you choose to drink alcohol, do so in moderation. Talk to your health care professional to find out exactly how much alcohol you can drink.