Common uses

Amitriptyline is in a group of drugs called tricyclic antidepressants. Amitriptyline affects chemicals in the brain that may become unbalanced.
Amitriptyline is used to treat symptoms of depression.
Amitriptyline may also be used for purposes other than those listed in this medication guide.

Before using

Do not use this medication if you are allergic to amitriptyline, or if you have recently had a heart attack. Do not use amitriptyline if you have taken cisapride (Propulsid) or used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take amitriptyline before the MAO inhibitor has cleared from your body.
Before taking amitriptyline, tell your doctor if you are allergic to any drugs, or if you have:
• heart disease;
• a history of heart attack, stroke, or seizures;
• bipolar disorder (manic-depression);
• schizophrenia or other mental illness;
• diabetes (amitriptyline may raise or lower blood sugar);
• overactive thyroid;
• glaucoma; or
• problems with urination.
If you have any of these conditions, you may not be able to use amitriptyline, or you may need a dosage adjustment or special tests during treatment.
You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Directions

Take amitriptyline tablets by mouth. Follow the directions on the prescription label. Swallow the tablets with a drink of water. You can take the tablets with or without food. Take your doses at regular intervals. Do not take your medicine more often than directed. Do not stop taking except on your prescriber's advice.

Do not use this medication in children unless you have been specifically instructed to do so by your health care provider. Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.

Adolescents, 12 to 18 years old, and elderly patients over 65 years old may have a stronger reaction to this medicine and need smaller
Cautions
Avoid drinking alcohol. It can cause dangerous side effects when taken together with Endep.

Avoid using other medicines that make you sleepy (such as cold medicine, pain medication, muscle relaxers, medicine for seizures, or other antidepressants). They can add to sleepiness caused by Endep.

Grapefruit and grapefruit juice may interact with Endep. Discuss the use of grapefruit products with your doctor before increasing or decreasing the amount of grapefruit products in your diet.

Endep can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid exposure to sunlight or artificial UV rays (sunlamps or tanning beds).

Endep can make your skin more sensitive to sunlight and sunburn may result. Use a sunscreen (minimum SPF 15) and wear protective clothing if you must be out in the sun.

Possible side effects

Visit your doctor immediately if you have any of these symptoms: burning, breathing with difficulties, rash on your face.
Call your doctor if you have any of these side effects:
• You have too fast palpitation;
• you have ill feeling in general, pain in arm or shoulder;
• If one side of the body suddenly become weak or numb;
• Hallucinations, sudden seizure;
• Unbalansed condition, problems with speech and vision;
• Rash on your skin, numbness, severe tingling, weakness in body;
• Numbness or weakness, especially on one side of the body;
• Difficult muscle movements in your parts of face: eyes, tongue, jaw, or neck;
• Uncontrollable trembling;
• Easily hurting and bleeding;
• If you are thirsty with headache, nausea, vomiting, rejecting any food;
• Urinating is less than usual or not at all, fainting.
Less serious side effects might happen, be ready for:
• Rejecting any food, nausea, diarrhea, vomiting, constipation;
• Beeing thirsty, unpleasant after-taste;
• Uncomfortable tingly feeling in hands,legs;
• Problems with sleeping,nightmares;
• feeling tired, woried, dizzy, sleepy;
• Problems with concentration;
• Bad coordination in space;
• A little rash on skin, not precise vision, headache, noise in your ears;
• Sex problems, breast swelling (in men or women); impotence, or less opportunity to have an orgasm.
Before you take Amitriptyline, inform your doctor if you are allergic to any drugs, or if you have:
• Problems with heart;
• Problems with thyroid (overactive);
• Mental illness, such as schizophrenia or others;
• condition of depression quite often;
• diabetes (Endep may raise or lower blood sugar);
• Eyes problems, such as glaucoma.

If you take too much

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of amitriptyline can be fatal.
Symptoms of an amitriptyline overdose may include uneven heartbeats, extreme drowsiness, confusion, agitation, vomiting, blurred vision, feeling hot or cold, sweating, muscle stiffness, feeling light-headed, fainting, seizure (convulsions), or coma.

Additional information

Visit your prescriber or health care professional for regular checks on your progress. It can take several days before you feel the full effect of Amitriptyline.
If you have been taking Amitriptyline regularly for some time, do not suddenly stop taking it. You must gradually reduce the dose or you may get severe side effects. Ask your prescriber or health care professional for advice. Even after you stop taking Amitriptyline it can still affect your body for several days.

If you notice any unusual effects, such as restlessness, worsening of depression, agitation, difficulty sleeping, irritability, anger, acting on dangerous impulses, or suicide thoughts or attempts, you should call your health care provider immediately.

Drug interactions

Before taking amitriptyline, tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft).
Before taking amitriptyline, tell your doctor if you are currently using any of the following drugs:
• cimetidine (Tagamet);
• guanethidine (Ismelin);
• disulfiram (Antabuse); or
• heart rhythm medications such as flecainide (Tambocor), propafenone (Rhythmol), or quinidine (Cardioquin, Quinidex, Quinaglute).
If you are using any of these drugs, you may not be able to use amitriptyline, or you may need dosage adjustments or special tests during treatment.
There are many other medicines that can interact with amitriptyline. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.