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Amitriptyline for Neuropathy
(a mee trip' ti leen)
Brand name(s): Elavil®;
Endep®; Limbitrol® (combination with chlordiazepoxide)
Contents of this page:
Why is this medication
prescribed?
Amitriptyline is used to treat symptoms of depression.
Amitriptyline is in a class of medications called
tricyclic antidepressants. It works by increasing the
amounts of certain natural substances in the brain.
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How should this
medicine be used?
Amitriptyline comes as a tablet to take by mouth. It is
usually taken one to four times a day. To help you
remember to take amitriptyline, take it around the same
time every day. Follow the directions on your
prescription label carefully, and ask your doctor or
pharmacist to explain any part you do not understand.
Take amitriptyline exactly as directed. Do not take more
or less of it or take it more often than prescribed by
your doctor.
Your doctor will probably start you on a low dose of
amitriptyline and gradually increase your dose.
It may take a few weeks or longer before you feel the
full benefit of amitriptyline. Continue to take
amitriptyline even if you feel well. Do not stop taking
amitriptyline without talking to your doctor. Stopping
amitriptyline suddenly may cause withdrawal symptoms
(upset stomach, headache, and lack of energy). Your
doctor will probably decrease your dose gradually.
Your doctor or pharmacist will give you the
manufacturer’s patient information sheet when you begin
treatment with amitriptyline. Read the information
carefully and ask your doctor or pharmacist if you have
any questions.
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Other uses for this medicine
Amitriptyline is also sometimes used to treat
chronic pain, eating disorders, and certain skin
problems. Talk to your doctor about the possible risks
of using this medication for your condition.
This medication may be prescribed for other uses; ask
your doctor or pharmacist for more information.
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What
special precautions should I follow?
Before taking amitriptyline,
- tell your doctor and pharmacist if you are
allergic to amitriptyline or any other medications.
- do not take amitriptyline if you are taking
monoamine oxidase (MAO) inhibitors, including
phenelzine (Nardil) and tranylcypromine (Parnate),
or have stopped taking them within the past 2 weeks;
or if you are taking cisapride (Propulsid).
- tell your doctor and pharmacist what other
prescription and nonprescription medications,
vitamins, nutritional supplements, and herbal
products you are taking. Be sure to mention any of
the following: antihistamines; cimetidine (Tagamet);
diet pills; disulfiram (Antabuse); ethchlorvynol
(Placidyl); guanethidine (Ismelin); ipratropium
(Atrovent); quinidine (Quinidex); medications for
irregular heartbeats such as flecainide (Tambocor)
and propafenone (Rythmol); medications for anxiety,
asthma, colds, irritable bowel disease, mental
illness, nausea, Parkinson's disease, seizures,
ulcers, or urinary problems; other antidepressants;
phenobarbital (Bellatal, Solfoton); sedatives;
selective serotonin reuptake inhibitors (SSRIs) such
as citalopram (Celexa), fluoxetine (Prozac,
Sarafem), fluvoxamine (Luvox), paroxetine (Paxil),
and sertraline (Zoloft); sleeping pills; thyroid
medications; and tranquilizers. Your doctor may need
to change the doses of your medications or monitor
you carefully for side effects.
- tell your doctor if you have or have ever had,
or anyone in your family has or has ever had,
depression, bipolar disorder (mood that changes from
depressed to abnormally excited), or mania
(frenzied, abnormally excited mood), or if you have
, or anyone in your family has, thought about or
attempted suicide. Also tell your doctor if you
drink large amounts of alcohol; if you have recently
had a heart attack; and if you have or have ever had
glaucoma; an enlarged prostate; difficulty
urinating; seizures; an overactive thyroid gland
(hyperthyroidism); diabetes; or liver, kidney, or
heart disease.
- tell your doctor if you are pregnant, plan to
become pregnant, or are breast-feeding. If you
become pregnant while taking amitriptyline, call
your doctor immediately.
- if you are having surgery, including dental
surgery, tell the doctor or dentist that you are
taking amitriptyline.
- you should know that amitriptyline may make you
drowsy. Do not drive a car or operate machinery
until you know how this medication affects you.
- remember that alcohol can add to the drowsiness
caused by this medication.
- you should know that your mental health may
change in unexpected ways, especially at the
beginning of your treatment and any time that your
dose is increased or decreased. These changes may
occur at any time if you have depression or another
mental illness, whether or not you are taking
amitriptyline or any other medication. You, your
family, or your caregiver should call your doctor
right away if you experience any of the following
symptoms: new or worsening depression; thinking
about harming or killing yourself or planning or
trying to do so; extreme worry; agitation; panic
attacks; difficulty falling asleep or staying
asleep; aggressive behavior; irritability; acting
without thinking; severe restlessness; and frenzied
abnormal excitement. Be sure that your family or
caregiver knows which symptoms may be serious so
they can call the doctor when you are unable to seek
treatment on your own.
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What
special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your
normal diet.
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What should I do if I forget a dose?
Take the missed dose as soon as you remember it.
However, if it is almost time for the next dose, skip
the missed dose and continue your regular dosing
schedule. Do not take a double dose to make up for a
missed one.
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What side effects can this medication cause?
Amitriptyline may cause side effects. Tell your doctor
if any of these symptoms are severe or do not go away:
- upset stomach
- vomiting
- drowsiness
- weakness or tiredness
- excitement or anxiety
- difficulty falling asleep or staying asleep
- nightmares
- restlessness
- headaches
- dry mouth
- constipation
- difficulty urinating
- blurred vision
- pain, burning, or tingling in the hands or feet
- changes in sex drive or ability excessive
sweating
- changes in appetite or weight
- confusion
- unsteadiness
Some side effects can be serious. The following
symptoms are uncommon, but if you experience any of them
or those listed in the IMPORTANT WARNING
section, call your doctor immediately:
- slow or difficult speech
- dizziness or faintness
- weakness or numbness of an arm or a leg
- crushing chest pain
- rapid, pounding, or irregular heartbeat
- severe skin rash or hives
- swelling of the face and tongue
- yellowing of the skin or eyes
- jaw, neck, and back muscle spasms
- shaking hands that you cannot control
- difficulty sitting still
- fainting
- unusual bleeding or bruising
- seizures
- seeing things or hearing voices that do not
exist (hallucinating)
Amitriptyline may cause other side effects. Call your
doctor if you have any unusual problems while taking
this medication.
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What storage conditions are needed for this
medicine?
Keep this medication in the container it came in,
tightly closed, and out of reach of children. Store it
at room temperature and away from excess heat and
moisture (not in the bathroom). Throw away any
medication that is outdated or no longer needed. Talk to
your pharmacist about the proper disposal of your
medication.
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In case of emergency/overdose
In case of overdose, call your local poison
control center at 1-800-222-1222. If the victim has
collapsed or is not breathing, call local emergency
services at 911.
Symptoms of overdose may include:
- irregular heartbeat
- seizures
- coma
- confusion
- problems concentrating
- seeing things that do not exist (hallucinating)
- agitation
- drowsiness
- rigid muscles
- vomiting
- fever
- cold body temperature
IMPORTANT WARNING:
Studies have shown that children
and teenagers who take antidepressants ('mood
elevators') such as amitriptyline are more
likely to think about harming or killing
themselves or to plan or try to do so than
children who do not take antidepressants.
Children younger than 18 years of age should not
normally take amitriptyline. If your child’s
doctor has prescribed amitriptyline for your
child, you should watch his or her behavior very
carefully, especially at the beginning of
treatment and any time his or her dose is
increased or decreased. Your child may develop
serious symptoms very suddenly, so it is
important to pay attention to his or her
behavior every day. Call your child’s doctor
right away if he or she experiences any of these
symptoms: new or worsening depression; thinking
about harming or killing him- or herself or
planning or trying to do so; extreme worry;
agitation; panic attacks; difficulty falling or
staying asleep; irritability; aggressive
behavior; acting without thinking; severe
restlessness; frenzied abnormal excitement, or
any other sudden or unusual changes in behavior.
Your child’s doctor will want to see your child
often while he or she is taking amitriptyline,
especially at the beginning of his or her
treatment. Your child’s doctor may also want to
speak with you or your child by telephone from
time to time. Be sure that your child keeps all
appointments for office visits or telephone
conversations with his or her doctor. Talk to
your child’s doctor about the risks of giving
amitriptyline to your child.
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