Description and Brand Names

Drug information provided by: Micromedex

US Brand Name

  1. Elavil
  2. Vanatrip

Descriptions


Amitriptyline is used to treat symptoms of depression. It works on the central nervous system (CNS) to increase levels of certain chemicals in the brain. This medicine is a tricyclic antidepressant (TCA).

This medicine is available only with your doctor's prescription.

This product is available in the following dosage forms:

  • Tablet

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of amitriptyline in children below 12 years of age. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of amitriptyline in the elderly. However, elderly patients are more likely to have age-related liver problems, which may require an adjustment in the dose for patients receiving amitriptyline.

Pregnancy

Information about this amitriptyline-oral-route
Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Amifampridine
  • Bepridil
  • Cisapride
  • Clorgyline
  • Dronedarone
  • Furazolidone
  • Grepafloxacin
  • Iproniazid
  • Isocarboxazid
  • Levomethadyl
  • Linezolid
  • Mesoridazine
  • Methylene Blue
  • Metoclopramide
  • Moclobemide
  • Nialamide
  • Pargyline
  • Phenelzine
  • Pimozide
  • Piperaquine
  • Procarbazine
  • Ranolazine
  • Selegiline
  • Sparfloxacin
  • Terfenadine
  • Thioridazine
  • Toloxatone
  • Tranylcypromine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acecainide
  • Alfuzosin
  • Almotriptan
  • Amiodarone
  • Amisulpride
  • Amoxapine
  • Amprenavir
  • Apomorphine
  • Aprindine
  • Arsenic Trioxide
  • Artemether
  • Asenapine
  • Astemizole
  • Atazanavir
  • Azimilide
  • Azithromycin
  • Bretylium
  • Brompheniramine
  • Buserelin
  • Buspirone
  • Chloral Hydrate
  • Chloroquine
  • Chlorpheniramine
  • Chlorpromazine
  • Ciprofloxacin
  • Citalopram
  • Clarithromycin
  • Clomipramine
  • Clonidine
  • Cocaine
  • Crizotinib
  • Cyclobenzaprine
  • Dabrafenib
  • Dasatinib
  • Delamanid
  • Desipramine
  • Deslorelin
  • Desvenlafaxine
  • Dextromethorphan
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Domperidone
  • Doxepin
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Droperidol
  • Eletriptan
  • Enflurane
  • Epinephrine
  • Erythromycin
  • Escitalopram
  • Eslicarbazepine Acetate
  • Etilefrine
  • Fentanyl
  • Fingolimod
  • Flecainide
  • Fluconazole
  • Fluoxetine
  • Foscarnet
  • Frovatriptan
  • Gatifloxacin
  • Gemifloxacin
  • Gonadorelin
  • Goserelin
  • Halofantrine
  • Haloperidol
  • Halothane
  • Histrelin
  • Hydroxytryptophan
  • Ibutilide
  • Iloperidone
  • Imipramine
  • Indacaterol
  • Iobenguane I 123
  • Isoflurane
  • Isradipine
  • Ivabradine
  • Ketoconazole
  • Lapatinib
  • Leuprolide
  • Levalbuterol
  • Levofloxacin
  • Levomilnacipran
  • Levothyroxine
  • Lidoflazine
  • Lithium Carbonate
  • Lopinavir
  • Lorcainide
  • Lorcaserin
  • Lumefantrine
  • Mefloquine
  • Meperidine
  • Methadone
  • Methoxamine
  • Midodrine
  • Milnacipran
  • Mirtazapine
  • Moricizine
  • Morphine
  • Morphine Sulfate Liposome
  • Moxifloxacin
  • Nafarelin
  • Naratriptan
  • Nefazodone
  • Nefopam
  • Nilotinib
  • Norepinephrine
  • Norfloxacin
  • Nortriptyline
  • Octreotide
  • Ofloxacin
  • Olodaterol
  • Ondansetron
  • Oxilofrine
  • Oxymorphone
  • Paliperidone
  • Pazopanib
  • Pentamidine
  • Pentazocine
  • Perflutren Lipid Microsphere
  • Phenylephrine
  • Pixantrone
  • Posaconazole
  • Procainamide
  • Prochlorperazine
  • Promethazine
  • Propafenone
  • Propoxyphene
  • Protriptyline
  • Quetiapine
  • Quinidine
  • Quinine
  • Rasagiline
  • Risperidone
  • Rizatriptan
  • Saquinavir
  • Sematilide
  • Sertindole
  • Sertraline
  • Sevoflurane
  • Sibutramine
  • Sodium Phosphate
  • Sodium Phosphate, Dibasic
  • Sodium Phosphate, Monobasic
  • Solifenacin
  • Sorafenib
  • Sotalol
  • Spiramycin
  • Sulfamethoxazole
  • Sultopride
  • Sumatriptan
  • Sunitinib
  • Tapentadol
  • Tedisamil
  • Telavancin
  • Telithromycin
  • Tetrabenazine
  • Toremifene
  • Tramadol
  • Trazodone
  • Trifluoperazine
  • Trimethoprim
  • Trimipramine
  • Triptorelin
  • Tryptophan
  • Umeclidinium
  • Valproic Acid
  • Vandetanib
  • Vardenafil
  • Vasopressin
  • Vemurafenib
  • Venlafaxine
  • Vilanterol
  • Vinflunine
  • Voriconazole
  • Vortioxetine
  • Ziprasidone
  • Zolmitriptan
  • Zotepine

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acenocoumarol
  • Arbutamine
  • Atomoxetine
  • Bethanidine
  • Carbamazepine
  • Cimetidine
  • Diazepam
  • Dicumarol
  • Fluvoxamine
  • Fosphenytoin
  • Galantamine
  • Guanethidine
  • Phenprocoumon
  • Phenytoin
  • Rifapentine
  • Ritonavir
  • S-Adenosylmethionine
  • St John's Wort
  • Topiramate
  • Warfarin

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Tobacco

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Ethanol

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Bipolar disorder (mood disorder with alternating episodes of mania and depression), or risk of or
  • Heart attack, recent—Should not be used in patients with these conditions.
  • Diabetes or
  • Glaucoma or
  • Heart disease or
  • Overactive thyroid or
  • Schizophrenia or
  • Seizures, history of or
  • Urinary retention (trouble urinating), history of—Use with caution. May make these conditions worse.
  • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use

Take this medicine only as directed by your doctor to benefit your condition as much as possible. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

This medicine comes with a medication guide. Read and follow the instructions in the guide carefully. Ask your doctor if you have any questions.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage forms (tablets):
    • For depression:
      • Adults—At first, 75 milligrams (mg) per day given in divided doses, or 50 to 100 mg at bedtime. Your doctor may adjust your dose as needed. However, the dose is usually not more than 150 mg per day, unless you are in the hospital. Some hospitalized patients may need higher doses.
      • Teenagers and Older adults—10 milligrams (mg) three times a day, and 20 mg at bedtime. Your doctor may adjust your dose as needed.
      • Children younger than 12 years of age—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions

It is very important that your doctor check your progress at regular visits to allow for changes in your dose and to check for any unwanted effects.

Amitriptyline may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you or your caregiver notice any of these adverse effects, tell your doctor right away.

Do not take amitriptyline if you have taken a monoamine oxidase (MAO) inhibitor (isocarboxazid [Marplan®], phenelzine [Nardil®], selegiline [Eldepryl®], or tranylcypromine [Parnate®]) in the past 2 weeks. Do not start taking a MAO inhibitor within 5 days of stopping amitriptyline. If you do, you may develop confusion, agitation, restlessness, stomach or intestinal symptoms, sudden high body temperature, extremely high blood pressure, or severe convulsions.

Do not take other medicines unless they have been discussed with your doctor. Using this medicine together with cisapride (Propulsid®), may increase the chance of having serious side effects.

Do not suddenly stop taking this medicine without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This may help prevent a possible worsening of your condition and reduce the possibility of withdrawal symptoms such as headache, nausea, or a general feeling of discomfort or illness.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. This effect may last for a few days after you stop taking this medicine. Check with your doctor before taking any of the above while you are using this medicine.

Before having any kind of surgery, tell the medical doctor in charge that you are using this medicine. Taking amitriptyline together with medicines used during surgery may increase the risk of side effects.

This medicine may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests, or if you have any questions, check with your doctor.

This medicine may cause some people to become drowsy. Make sure you know how you react to this medicine before you drive, use medicines, or do anything else that could be dangerous if you are drowsy or not alert .

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Incidence not known

  1. Abdominal or stomach pain
  2. agitation
  3. black, tarry stools
  4. bleeding gums
  5. blood in urine or stools
  6. blurred vision
  7. burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  8. change in consciousness
  9. changes in patterns and rhythms of speech
  10. chest pain or discomfort
  11. chills
  12. cold sweats
  13. coma
  14. confusion
  15. confusion about identity, place, and time
  16. continuing ringing, buzzing, or other unexplained noise in ears
  17. convulsions
  18. cool, pale skin
  19. cough or hoarseness
  20. dark urine
  21. decrease in frequency of urination
  22. decrease in urine volume
  23. decreased urine output
  24. difficulty in breathing
  25. difficulty in passing urine (dribbling)
  26. difficulty in speaking
  27. disturbance of accommodation
  28. disturbed concentration
  29. dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
  30. double vision
  31. drooling
  32. dry mouth
  33. excitement
  34. fainting
  35. false beliefs that cannot be changed by facts
  36. fast, slow, or irregular heartbeat
  37. fear or nervousness
  38. fever with or without chills
  39. flushed, dry skin
  40. fruit-like breath odor
  41. general feeling of tiredness or weakness
  42. headache
  43. hearing loss
  44. high fever
  45. high or low blood pressure
  46. hostility
  47. inability to move arms, legs, or facial muscles
  48. inability to speak
  49. increased hunger
  50. increased need to urinate
  51. increased ocular pressure
  52. increased sweating
  53. increased thirst
  54. increased urination
  55. irritability
  56. lack of coordination
  57. lethargy
  58. light-colored stools
  59. lip smacking or puckering
  60. loss of appetite
  61. loss of balance control
  62. loss of bladder control
  63. loss of consciousness
  64. lower back or side pain
  65. mental depression or anxiety
  66. muscle spasm or jerking of all extremities
  67. muscle tightness
  68. muscle trembling, jerking, or stiffness
  69. muscle twitching
  70. nausea and vomiting
  71. nightmares or unusually vivid dreams
  72. overactive reflexes
  73. painful or difficult urination
  74. passing urine more often
  75. pinpoint red spots on skin
  76. poor coordination
  77. pounding in the ears
  78. puffing of cheeks
  79. rapid or worm-like movements of tongue
  80. rapid weight gain
  81. restlessness
  82. seeing, hearing, or feeling things that are not there
  83. seizures
  84. severe muscle stiffness
  85. shakiness and unsteady walk
  86. shivering
  87. shortness of breath
  88. shuffling walk
  89. sleeplessness
  90. slow speech
  91. slurred speech
  92. sore throat
  93. sores, ulcers, or white spots on lips or in mouth
  94. stiffness of limbs
  95. stupor
  96. sudden loss of consciousness
  97. sweating
  98. swelling of face, ankles, or hands
  99. swelling or puffiness of face
  100. swollen glands
  101. talking or acting with excitement you cannot control
  102. trouble in speaking
  103. trouble sleeping
  104. troubled breathing
  105. twisting movements of body pain or discomfort in arms, jaw, back, or neck
  106. unable to sleep
  107. uncontrolled chewing movements
  108. uncontrolled movements, especially of arms, face, neck, back, and legs
  109. unexplained weight loss
  110. unpleasant breath odor
  111. unsteadiness, trembling, or other problems with muscle control or coordination
  112. unusual bleeding or bruising
  113. unusual tiredness or weakness
  114. unusually pale skin
  115. upper right abdominal pain
  116. vomiting of blood
  117. weakness in arms, hands, legs, or feet
  118. weight gain or loss
  119. yellow eyes and skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of Overdose

  1. Clumsiness
  2. drowsiness
  3. low body temperature
  4. muscle aches
  5. muscle weakness
  6. sleepiness
  7. tiredness
  8. weak or feeble pulse

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

  1. Bigger, dilated, or enlarged pupils (black part of eye)
  2. black tongue
  3. bloating
  4. breast enlargement in females
  5. constipation
  6. decreased interest in sexual intercourse
  7. diarrhea
  8. hair loss, thinning of hair
  9. hives or welts
  10. inability to have or keep an erection
  11. increased in sexual ability, desire, drive, or performance
  12. increased interest in sexual intercourse
  13. increased sensitivity of eyes to light
  14. loss in sexual ability, desire, drive, or performance
  15. loss of sense of taste
  16. redness or other discoloration of skin
  17. severe sunburn
  18. skin rash
  19. swelling of testicles
  20. swelling of the breasts or breast soreness in males
  21. swelling of the parotid glands
  22. swelling or inflammation of the mouth
  23. unexpected or excess milk flow from breasts

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.