Apo-Amitriptyline

Brand Name:Apo-Amitriptyline, Novo-Triptyn, Triavil

Prescription needed: Yes

What is this drug used for?

Amitriptyline is most commonly used to treat symptoms of depression. It can also be used for anxiety, different chronic pain conditions (e.g. fibromyalgia, nerve pain), migraines, eating problems, bedwetting and attention deficit hyperactivity disorder.

For depression, anxiety and other mood disorders, it works by increasing the amounts of so called “feel good” chemicals in the brain. Because it can cause one to feel more sleepy than other similar medications, it is often prescribed when a person with low mood is also feeling anxious or having difficulty sleeping.

Is there any reason not to take this drug?

You should not take this drug if you are allergic to amitriptyline or similar medications such as imipramine, nortriptyline, desipramine. Before taking this medication, tell your doctor specifically if you have or have ever had:

  • a problem with alcohol or drug abuse
  • feelings of worsening depression or suicidal
  • a condition called bipolar disorder
  • a recent heart attack
  • any heart rhythm problems
  • an enlarged prostate
  • difficulty going to the bathroom (e.g. urinary incontinence or urinary retention)
  • seizures
  • an overactive thyroid gland (hyperthyroidism)
  • problems with your liver

What about possible side effects?

It is extremely important that you take this medication as given to you by your doctor. Too much of this medication can cause severe side effects.

The most common side effects are:

  • feeling sleepy, tired and weak (this medication is usually started at bedtime but you still may feel these symptoms during the day)
  • dry mouth
  • constipation
  • difficulty urinating
  • dizziness, lightheadedness
  • feeling confused
  • weight gain

These side effects are usually related to dose, the use of other medications and other factors (e.g. older age, other medical conditions). As well, some of these side effects may go away with time. Talk to your doctor or pharmacist about whether you have any risk factors that may make you more sensitive to these side effects. Contact your doctor if these symptoms continue or become worse.

Other less common and possibly severe side effects include:

  • blurred vision
  • changes in sex drive or ability
  • excessive sweating
  • low blood pressure (feeling faint when standing up) and fast heart beat (contact your doctor if you have these symptoms)
  • rapid, pounding, or irregular heartbeat (contact your doctor immediately)
  • severe skin rash or hives, increased sensitivity to the sun (contact your doctor immediately)
  • seizures
  • very rare cases of hepatitis (inflammation of the liver) and jaundice (yellowing of skin and eyes) have been reported - call your doctor immediately
  • tremors or shaking hands that you can’t control
  • jaw, neck, and back muscle spasms

This is not a complete list of side effects. If you are concerned about these or other unusual symptoms while taking this medication, ask your doctor and/or pharmacist for more information and advice.

What if I am taking other drugs?

Always provide your doctor with a list of all other drugs you are taking (including over-the-counter medications and herbal/natural products) as they may interact with and/or may change the safety or effectiveness of either drug. Tell your doctor specifically if you are taking any of these drugs as he/she may need to make changes in your prescriptions and/or monitor you more closely:
  • phenelzine, tranylcypromine, moclobemide – avoid the use of these drugs together. Must wait at least 2 weeks after stopping one before you can start the other.
  • amiodarone, quinidine, erythromycin, clarithromycin, risperidone, sotalol (increase your chances of having heart rhythm side effects)
  • drugs that can cause tiredness, sedation, dizziness or increase the chances of having the same side effects - talk to your doctor or pharmacist if you are taking any of the following drugs:
  • antihistamines (e.g. diphenhydramine, hydroxyzine)
  • opioid pain medications (e.g. codeine, oxycodone, morphine, hydromorphone)
  • other antidepressants (e.g. sertraline, paroxetine, trazodone), medications for anxiety (e.g. lorazepam, diazepam) and antipsychotics (e.g. risperidone, haloperidol)
  • muscle relaxants (e.g. cyclobenzaprine)
  • drugs for epilepsy (gabapentin, phenytoin, phenobarbital, carbamazepine, valproic acid)
  • oxybutynin, tolterodine (may increase your chances of side effects with urinating, constipation or dry mouth)
  • rifampin, carbamazepine, phenobarbital (may see decrease blood levels of amitriptyline and a decrease in how well the drug works)
  • amphetamine-like drugs, methylphenidate (may increase your chances of having side effects such as high blood pressure, rapid heart beat)
  • cimetidine

This is not a complete list of drug interactions. Ask your doctor or pharmacist to review your list of medications.

Other information:

If you are taking this medication for depression or anxiety: It takes several weeks (4-6 wks) before this medication will even start to work. Do not stop this medication if you don’t feel it is working. Your doctor will follow you and adjust the dose over time to find the right dose. Sometimes people feel worse in the beginning and want to stop their medication. This is usually due to side effects which tend to go away with time. However, if you feel any of the following symptoms, contact your doctor right away:

  • new or worsening feelings of depression
  • thoughts of suicide
  • extreme worry
  • agitation or panic attacks
  • aggressive behavior
  • acting without thinking
  • severe restlessness
  • frenzied abnormal excitement
  • any other sudden or unusual changes in behavior

Children: Not recommended under 12 years of age for depression, or under 6 years of age for bedwetting.

Seniors: Are extremely sensitive to the side effects of these medications. Lower doses are required especially at the start of therapy. Amitriptyline should be substituted for a similar drug with fewer side effects.

Pregnancy: Talk to your doctor. Not treating the depression is often worse than the possible effects of the medication.

Women who are nursing: This drug passes into breast milk. Talk to your doctor.

People who drive or operate machinery: Should not do so until they know the impact this drug has on them personally. This drug can cause drowsiness.

Alcohol: Minimize alcohol use if you are taking this drug as if may increase its sedative effects.

Overdose: If you experience palpitations or lose consciousness or if you seriously exceed the recommended dosage, call 911 or have someone do it for you.

Stopping the drug: Do not stop taking this drug until you have discussed it with your doctor. Stopping abruptly may cause withdrawal symptoms.

If you miss a dose: Take it as soon as you remember. If the next dose is scheduled within three hours, take a single dose and skip next scheduled dose. After that, resume your regular schedule.

Storage conditions: Closed container; cool, dry location away from excess moisture (not in the bathroom) and light; always out of reach of children.

Dietary precautions: None