Amitriptyline HCl Tablets

(generic for Elavil)

This medication has several uses.  It was originally introduced as an antidepressant.  It is commonly used for sleep and works very well for pain.  For depression, doses of up to 150 milligrams are needed.  For sleep, 25 to 50 milligrams are helpful.  For pain, the dose varies widely.  This medication is not addictive but is sedating.  Do not drive or operate dangerous equipment after using this drug.  It can safely be used with narcotics, non-steroidals and muscle relaxants as well as most over-the-counter medications.  We stock this medication at the practice since it is safe, useful and inexpensive.

The following is the package insert.  It is complete and lengthy but not easily understood

A mood-elevating medicine (antidepressant) generally used for the relief of depression in patients over 12 years of age. Doctors occasionally may prescribe it for other reasons.

Precautions: DO NOT USE if you are allergic to this medicine or its relatives, if you are using monoamine oxidase inhibitors (e.g., Nardil, Parnate, Marplan), or if you are recovering from a heart attack.

BEFORE USING THIS MEDICATION, tell your doctor or pharmacist if you are pregnant, planning to become pregnant, or are breastfeeding; if you are taking, will be taking, or stop taking any prescription or nonprescription medicine; if you have any other medical conditions such as angle-closure glaucoma, heart disease, angina, overactive thyroid, increased intraocular pressure, irregular heartbeat, kidney disease, liver disease, mental illness, or urinary retention; if you have a seizure disorder, have had a stroke or suicidal tendencies; or if you are undergoing electroshock therapy.

Side Effects: Every medicine can cause side effects, but many people have no, or minor, side effects. Tell your doctor or pharmacist if any of the following occurs: Nausea; vomiting; constipation; appetite loss; stomach pain or cramps; diarrhea; confusion; seizures; anxiety; weakness; drowsiness; nightmares; fatigue; headache; incoordination; dizziness; pounding in the chest; increased or decreased blood pressure; fast heartbeat; rash; flushing; hives; sensitivity to light; sweating; swelling of testicles; changes in sex drive; breast enlargement; milk production in females; blurred vision; fever; ringing in ears; weight changes; fluid retention; changes in blood sugar levels; unusual bruising; inflammation of mouth; hair loss; sleeplessness; restlessness; tremor; delusions; hallucinations; hypomania or mania; disorientation; panic; dizziness or lightheadedness when rising quickly from a sitting or lying position; numbness or tingling in arms or legs; black tongue; fainting; peculiar taste in mouth; abnormal skin sensations; sore throat; small red spots under the skin; impotence; enlarged pupils; activation of psychosis; proneness to falling; difficulty moving; involuntary movements; slurred speech; changes in urination; dry mouth.

Guidelines for Use: USE EXACTLY AS PRESCRIBED.

• Initiate dose at a low level and increase gradually.
• Lower doses are recommended for elderly, adolescent, and outpatients, as compared to hospitalized patients.
• It is not possible to prescribe a single dosage schedule that is equally effective for all patients. The recommended dosage is only a guide which your doctor may modify depending on your age, severity of the disease, how long you have had the disease, your medical history, and the degree of psychotherapeutic support available to you.
• Usual adult dosage for outpatients is 75 mg/day in divided doses. An alternative method is to begin with 50 to 100 mg at bedtime and increase the bedtime dose by 25 to 50 mg. If necessary, dosage may be increased to a total of 150 mg/day.
• Children and elderly patients may begin with 10 mg 3 times a day with 20 mg at bedtime.
• Maintenance dose is 50 to 100 mg given as a single dose at bedtime.
• Smaller initial doses may be needed to minimize side effects.
• Do not change the dose or stop taking it unless advised to do so by your doctor.
• If a dose is missed, take it as soon as possible. If several hours have passed or if it is nearing time for the next dose, do not double the dose to catch up, unless advised to do so by your doctor. If more than one dose is missed, contact your doctor or pharmacist.
• Do not use in combination with an MAOI or within 14 days of discontinuing treatment with an MAOI. After stopping this medicine, wait at least 2 weeks before starting an MAOI.
• This medicine may take up to 30 days to control symptoms of depression.
• It may be necessary to continue therapy for 3 months or longer once symptoms are controlled. Generally, lower doses are used during the maintenance period to lessen the chance of relapse.
• Using this medicine with alcohol or other central nervous system depressants (eg, pain relievers, sedatives, antihistamines) may cause added drowsiness.
• May cause drowsiness or blurred vision. Use caution while driving or performing other tasks requiring mental alertness, coordination, or physical dexterity.
• May cause sensitivity to sunlight. Avoid prolonged exposure to the sun. Use sunscreens and wear protective clothing until tolerance is determined.
• Taking this medicine at bedtime may help reduce side effects (eg, daytime drowsiness). Discuss this possibility with your doctor.
• Notify your doctor if dry mouth, constipation, blurred vision, increased heart rate, impaired coordination, difficult urination, excessive sedation, or seizure occur.
• Notify your doctor if you experience drowsiness, dizziness, or dizziness or lightheadedness when rising quickly from a seated or lying position. Your doctor may need to reduce the dose.
• Notify your doctor if you develop a fever or sore throat.
• Symptoms of nausea, headache, or fatigue may develop if therapy is stopped suddenly after long-term use.
• Lab tests may be required. Be sure to keep appointments.
• Store at room temperature in a child-resistant container.
• Supervise the drug carefully at home.

This information is advisory only; it does not contain all information about this medicine. If you have any questions about your medicine, ask your doctor, pharmacist, or health care provider.

Copyright 1999 by Facts & Comparisons, used by permission from Southwood Pharmaceuticals

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