Amitriptyline is used to treat depression.
It can also be used to treat night time bed-wetting in children.
Amitriptyline may also be used treat other mood disorders as decided by your doctor.
Take Amitriptyline exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
You may take Amitriptyline with or without food. It is best taken in the evening or right before bedtime.
Amitriptyline must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed otherwise, as stopping it suddenly could worsen your condition.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have the following conditions:
- heart disease or recovering from a heart attack
- severe liver disease
as Amitriptyline may not be suitable for you.
Do not take Amitriptyline if you are taking or have taken other mood medicines known as monoamine oxidase inhibitors (MAOIs) such as isocarboxazid, phenelzine and tranylcypromine in the last 14 days.
Do not take this medicine with a gastric reflux medicine known as cisapride.
Inform your doctor if you have the following conditions:
- other mood disorders such as schizophrenia
- history of epilepsy (fits or seizures)
- difficulty urinating
- glaucoma (high pressure in the eye)
- diabetes
- heart disease
- brain damage
- alcoholism
- thyroid disease
- suicidal thoughts
Let your doctor know if you are pregnant or breastfeeding.
Alert your doctor if you have recently undergone electroshock therapy (also known as electroconvulsive therapy or ECT).
Inform your doctor that you are taking Amitriptyline if you are going for an operation, including minor surgery.
Medicines for depression such as Amitriptyline may increase the risk of suicidal thoughts and behaviour. As depression and some psychiatric disorders are themselves associated with an increased risk of suicide, it is important for you or your family members to monitor your condition especially at the start of treatment and if your dosage is still being adjusted. If you experience new or sudden changes in mood, behaviour, thoughts or feelings or a worsening of your depression with suicidal thoughts or attempts, harm to self or harm to others, contact your doctor immediately.
Be sure to check with your doctor or pharmacist before giving Amitriptyline to an elderly person. Elderly people may be more sensitive to the side effects.
Certain genetic traits (CYP2D6/CYP2C19) can affect your response to this medicine. Your doctor may need to perform genetic testing to know if this medicine is suitable for you.
Poor metabolisers may experience side effects, while ultrarapid metabolisers may not fully respond to this medicine. Although not routinely done, your doctor may advise you to take genetic testing to check if Amitriptyline is best suited for you. If you know you have this gene type, inform your doctor.
Amitriptyline may cause sleepiness, dizziness and blur your vision. If affected, do not drive or take part in any activity in which you need to be alert. Dizziness may be worse when you get up from sitting or lying down position, especially if you are taking Amitriptyline for the first time or if your dose is still being adjusted. This is normal and should disappear gradually as you get used to the medicine. It will help if you get up slowly from a sitting or lying down position.
Other common side effects include any of the following: rash, diarrhoea, dry mouth, nausea, vomiting, weight gain or loss, difficulty sleeping, nightmares and unpleasant taste.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- irregular or fast heartbeat
- difficulty passing urine
- changes in sex drive
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
This medicine may cause the level of your red blood cells, white blood cells and platelets to drop.
Red blood cells carry oxygen around your body. A fall in the level of red blood cells may make you feel tired and worn out.
White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you at higher risk for infections, such as coughs, colds and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Alert your doctor if you have a fever, or a cough or flu that does not go away.
Platelets help your blood to clot when there is a cut in the skin. A fall in the level of your platelets may put you at risk of bleeding more than usual. Do not take part in activities where you may fall or get injured, such as contact sports. Alert your doctor if you get any unusual bruising (large bruises or several bruises, especially if the bruises appeared on their own) or bleeding that takes a long time to stop (for example, too much bleeding when you floss or brush your teeth).
Do not take Amitriptyline if you are taking or have taken other mood medicines known as monoamine oxidase inhibitors (MAOIs) such as isocarboxazid, phenelzine and tranylcypromine in the last 14 days.
Do not take this medicine with a gastric reflux medicine known as cisapride.
Inform your doctor and pharmacist if you are taking any of these medicines:
- medicines to treat fungal infection e.g. fluconazole, terbinafine
- other mood medicines e.g. pimozide, sertindole
- medicines to treat epilepsy e.g. carbamazepine, phenobarbital
- medicines for high blood pressure e.g. guanethidine, clonidine
- medicines for heart disease e.g. quinidine, flecainide
- medicine used to treat alcoholism e.g. disulfiram
- stomach medicine e.g. cimetidine
- herbal supplements such as St John’s wort
This list does not include all medicines that may interact with Amitriptyline.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicine, supplements and medicines that you buy without prescription.
Avoid alcohol.
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.
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