Elavil (Amitriptyline)

AMITRIPTYLINE (Brand names: Elavil®, Endep®, Elatrol®, Tryptizol®, Trepiline®, Laroxyl®, Tryptanol®) is tricyclic antidepressant. Amitriptyline can lift your spirits by treating your depression, especially if it is associated with sleep dysfunction. Improvement of sleep patterns can be the first benefit of treatment. Your doctor may prescribe amitriptyline for other conditions such as relief from chronic nerve pain, insomnia, migraines and bed wetting treatment for children in small dosage(10 to 25 mg) as well. Amitriptyline was approved by the FDA in May 1983.

They need to know if you have any of these conditions:
an alcohol problem
asthma, difficulty breathing
bipolar disorder or a family history of bipolar disorder
blood disorders or disease
diabetes
difficulty passing urine, prostate trouble
glaucoma
having intramuscular injections
heart disease or previous heart attack
liver disease
over active thyroid
Parkinson's disease
schizophrenia
seizures (convulsions)
stomach disease
thoughts or plans of suicide; a previous suicide attempt or family history of suicide attempt
an unusual or allergic reaction to amitriptyline, other medicines, foods, dyes, or preservatives
pregnant or trying to get pregnant
breast-feeding

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 doses.

If you miss a dose normally taken at bedtime to avoid daytime drowsiness, it may be better to miss that dose. If you take more than one dose a day and miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Follow your prescriber's advice on missed doses. Do not take double or extra doses.

Amitriptyline can interact with many other medicines. Some interactions can be very important. Make sure your prescriber or health care professional knows about all other medicines you are taking. Many important interactions are listed below:

Do not take amitriptyline with any of the following medications:
astemizole (Hismanal®)
cisapride (Propulsid®)
probucol
terfenadine (Seldane®)
thioridazine (Mellaril®)
medicines called MAO inhibitors-phenelzine (Nardil®), tranylcypromine (Parnate®), isocarboxazid (Marplan®), selegiline (Eldepryl®)
other medicines for mental depression (may be duplicate therapies or cause additive side effects)

Amitriptyline may also interact with any of the following medications:
alcohol
antacids
atropine and related drugs like hyoscyamine, scopolamine, tolterodine and others
barbiturate medicines for inducing sleep or treating seizures (convulsions), such as phenobarbital
blood thinners, such as warfarin
bromocriptine
bupropion
cimetidine
clonidine
cocaine
delavirdine
diphenoxylate
disulfiram
donepezil
drugs for treating HIV infection
female hormones, including contraceptive or birth control pills and estrogen
galantamine
herbs and dietary supplements like ephedra (Ma huang), kava kava, SAM-e, St. John's wort, valerian, or others
imatinib, STI-571
kaolin; pectin
labetalol
levodopa and other medicines for movement problems like Parkinson's disease
lithium
medicines for anxiety or sleeping problems
medicines for colds, flu and breathing difficulties, like pseudoephedrine
medicines for hay fever or allergies (antihistamines)
medicines for weight loss or appetite control
medicines used to regulate abnormal heartbeat or to treat other heart conditions (examples: amiodarone, bepridil, disopyramide, dofetilide, encainide, flecainide, ibutilide, mibefradil, procainamide, propafenone, quinidine, and others)
metoclopramide
muscle relaxants, like cyclobenzaprine
other medicines for mental or mood problems and psychotic disturbances
prescription pain medications like morphine, codeine, tramadol and others
procarbazine
seizure (convulsion) or epilepsy medicine such as carbamazepine or phenytoin
stimulants like dexmethylphenidate or methylphenidate
some antibiotics (examples: erythromycin, gatifloxacin, levofloxacin, linezolid, moxifloxacin, sotalol, sparfloxacin)
tacrine
thyroid hormones such as levothyroxine

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

Side effects that you should report to your prescriber or health care professional as soon as possible:
abnormal production of milk in females
anxiety, agitation, panic attacks, inability to sleep, irritability, hostility or extreme anger, aggressiveness, engaging in unusual or dangerous activities, restlessness or inability to sit still, extreme elation or feeling of happiness that may switch back and forth with a depressed or sad mood
blurred vision or eye pain
breast enlargement in both males and females
confusion, hallucinations (seeing or hearing things that are not really there)
difficulty breathing
fainting spells
fever with increased sweating
irregular or fast, pounding heartbeat, palpitations
muscle stiffness, or spasms
pain or difficulty passing urine, loss of bladder control
seizures (convulsions)
sexual difficulties (decreased sexual ability or desire, difficulty ejaculating)
stomach pain
swelling of the testicles
tingling, pain, or numbness in the feet or hands
unusual weakness or tiredness
yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
anxiety
constipation, or diarrhea
drowsiness or dizziness
dry mouth
increased sensitivity of the skin to sun or ultraviolet light
loss of appetite
nausea, vomiting
skin rash or itching
weight gain or loss

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. A Medication Guide About Using Antidepressants in Children and Teenagers is available from your health care professional and should be read by the patients and their family or caregivers. Discuss this Medication Guide with the health care provider if this drug is being used in a child or adolescent.

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.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how amitriptyline affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may increase dizziness and drowsiness. Avoid alcoholic drinks.

Do not treat yourself for coughs, colds, or allergies without asking your prescriber or health care professional for advice. Some ingredients can increase possible side effects.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water will help.

Amitriptyline may cause dry eyes and blurred vision. If you wear contact lenses you may feel some discomfort. Lubricating drops may help. See your ophthalmologist if the problem does not go away or is severe.

Amitriptyline may make your skin more sensitive to the sun. Keep out of the sun, or wear protective clothing outdoors and use a sunscreen. Do not use sun lamps or sun tanning beds or booths.

If you are diabetic, check your blood sugar more often than usual, especially during the first few weeks of treatment with amitriptyline. Amitriptyline can affect blood glucose (sugar) levels. Call your prescriber or health care professional for advice if you notice a change in the results of blood or urine glucose tests.

If you are going to have surgery or will need an x-ray procedure that uses contrast agents, tell your prescriber or health care professional that you are taking this medicine.

Keep out of the reach of children in a container that small children cannot open.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medicine after the expiration date.