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Buying amitriptyline is used to treat mental/mood problems such as depression. It can help improve mood and feelings of well-being, relieve anxiety and tension, help you sleep better, and increase your energy levels. This medication belongs to a class of drugs called tricyclic antidepressants. It affects the balance of certain natural chemicals in the brain (neurotransmitters such as serotonin).

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Read your pharmacist’s medication guide before using amitriptyline and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth as directed by your doctor, usually 1 to 4 times a day. If you take it only once a day, take it at bedtime to help reduce daytime drowsiness. The dosage is based on your medical condition and response to treatment.

To reduce the risk of side effects (such as drowsiness, dry mouth, and dizziness), your doctor may advise you to start this medication at a low dose and gradually increase it. Follow your doctor’s instructions carefully.

Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day. Do not increase your dose or use this medication more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase.

Continue taking this medication even if you feel well. Do not stop taking this medication without consulting your doctor. Some conditions may worsen when this medication is suddenly stopped. You may also experience symptoms such as mood swings, headache, fatigue, and changes in sleep. To prevent these symptoms while you are stopping treatment with this medication, your doctor may gradually reduce your dose. Consult your doctor or pharmacist for more information. Report any new or worsening symptoms immediately.

This medication may not work right away. You may see some benefits within a week. However, it may take up to four weeks before you feel the full effect.

Tell your doctor if your condition persists or worsens (for example, if your feelings of sadness become worse or if you have thoughts of suicide).

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Drowsiness, dizziness, dry mouth, blurred vision, constipation, weight gain, or difficulty urinating may occur. If these effects persist or worsen, contact your doctor or pharmacist immediately.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

To relieve a dry mouth, suck on (sugar-free) hard candy or ice chips, chew (sugar-free) gum, drink water, or use a saliva substitute.

Eat fiber, drink plenty of water, and exercise to prevent constipation. You may also need to take a laxative. Ask your pharmacist which type of laxative is right for you.

Remember, this medication has been prescribed because your doctor has determined that the benefit outweighs the risk of side effects. Many people who use this medication do not experience serious side effects.

Tell your doctor right away if you experience any serious side effects, including heartburn that does not go away, easy bleeding/bruising, trembling, mask-like facial expressions, muscle spasms, severe stomach/abdominal pain, decreased sexual ability/desire, and enlarged/painful breasts.

Seek immediate medical attention if you have any serious side effects, including black stools, vomit that looks like coffee grounds, severe dizziness, fainting, seizures, eye pain/swelling/redness, dilated pupils, vision changes (such as seeing rainbows around lights at night).

This medication may rarely cause a serious condition called neuroleptic malignant syndrome (NMS). Seek immediate medical attention if you experience symptoms such as fever, muscle stiffness, extreme confusion, sweating, or a fast/irregular heartbeat.

A serious allergic reaction to this medication is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, or difficulty breathing.

This is not a complete list of possible side effects. Talk to your doctor or pharmacist if you notice any side effects other than those listed above.

Precautionary measures

Before taking amitriptyline, tell your doctor or pharmacist if you are allergic to amitriptyline or any other tricyclic antidepressants (such as nortriptyline), or if you have any other allergies. This product may contain inactive ingredients that can cause allergic reactions or other problems. Talk to your pharmacist for more information.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: bleeding problems, breathing problems, liver problems, recent heart attack, problems with urination (such as due to enlarged prostate), overactive thyroid (hyperthyroidism), personal or family history of glaucoma (angle closure), personal or family history of mental/mood disorders (such as bipolar disorder, psychosis), family history of suicide, seizures, conditions that may increase your risk of seizures (such as another brain disorder, alcohol intake).

Buying amitriptyline can cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause a serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness and fainting) that require immediate medical attention.

The risk of QT prolongation may be increased if you have certain medical conditions or are taking other medications that can cause QT prolongation. Before taking amitriptyline, tell your doctor or pharmacist about all the medications you are taking and if you have any of the following conditions: specific heart problems (heart failure, slow heart rate, QT prolongation on an ECG), family history of certain heart problems (QT prolongation on an ECG, sudden cardiac death).

Low blood potassium or magnesium levels can also increase your risk of QT prolongation. This risk may increase if you take certain medications (such as diuretics/water pills) or if you have heavy sweating, diarrhea, or vomiting. Talk to your doctor about using amitriptyline safely.

This medication may make you dizzy or drowsy, or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, operate machinery, or do anything that requires alertness or clear vision until you can do so safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning beds and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor immediately if you get sunburned or develop blisters or redness on your skin.

If you have diabetes, this medication may make it harder to control your blood sugar. Check your blood sugar regularly and tell your doctor about the results. Your doctor may need to adjust your diabetes medication, exercise program, or diet.

Older adults may be more sensitive to the side effects of this medication, especially bleeding, dry mouth, dizziness, drowsiness, confusion, constipation, difficulty urinating, and QT prolongation (see above). Dizziness, drowsiness, and confusion can increase the risk of falls.

During pregnancy, this medication should only be used when necessary. Discuss the risks and benefits with your doctor.

Because untreated mental/mood problems (such as depression, anxiety, and panic disorder) can be serious, do not stop taking this medication unless directed by your doctor. If you are planning to become pregnant, become pregnant, or think you may be pregnant, discuss the benefits and risks of taking this medication during pregnancy with your doctor right away.

This medication passes into breast milk; its effect on a nursing baby is unknown. Consult your doctor before breastfeeding.

Interactions

Drug interactions can change how your medications work or increase your risk of serious side effects. This document does not contain all possible drug interactions. Keep a list of all your products (including prescription and over-the-counter medications and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medications without your doctor’s approval.

Some products that may interact with this medication include arbutamine, disulfiram, thyroid supplements and other drugs that may cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen/naproxen, “blood thinners” such as dabigatran/warfarin), anticholinergics (such as belladonna alkaloids), certain high blood pressure medicines (drugs that work in the brain such as clonidine, guanabenz).

Using MAOIs with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAOIs (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) while taking this medication. Most MAOIs should also not be taken for two weeks before and after treatment with this medication. Ask your doctor when you should start or stop taking this medication.

Other medications can affect the removal of amitriptyline from your body, thus affecting how amitriptyline works. These include cimetidine, medications to treat irregular heartbeats (such as quinidine/propafenone/flecainide), and antidepressants (such as SSRIs, including paroxetine/fluoxetine/fluvoxamine). This is not a complete list.

Many medications taken alongside amitriptyline can affect heart rhythm (QT prolongation in the ECG), including amiodarone, dofetilide, pimozide, procainamide, quinidine, sotalol, and macrolide antibiotics (such as erythromycin). Before taking amitriptyline, tell your doctor or pharmacist all medications you are currently taking.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness, including alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain relievers (such as codeine).

Check the labels on all your medications (such as allergy or cough and cold products) because they may contain decongestants or ingredients that cause drowsiness. Ask your pharmacist how to use these products safely.

Aspirin can increase the risk of bleeding when used with this medication. For example, if your doctor has prescribed low-dose aspirin for heart attack or stroke prevention (usually 81-162 milligrams per day), you should continue taking it unless your doctor tells you otherwise. Ask your doctor or pharmacist for more information.

Amitriptyline is very similar to nortriptyline. Do not use medications containing nortriptyline while taking amitriptyline.