Amitriptyline

What is amitriptyline?

Amitriptyline (also called Elavil®) is used to treat depression. It also may be used to prevent migraine headache and to treat nerve pain and sleep problems. Amitriptyline is available as 10-mg, 25-mg, and 50-mg tablets. All are taken by mouth.

Laboratory testing

An enzyme in the body called cytochrome P450 2D6 (CYP2D6) has the ability to break down certain medicines including amitriptyline. A genetic test can be done to determine if your CYP2D6 breaks down medicines slower or faster than normal. If your body breaks down the medicine slower or faster than normal, you may need to take a different dose of amitriptyline or avoid taking the medicine. For information about CYP2D6 and its effect on amitriptyline, talk with your doctor or pharmacist, and see “Do you know… Cytochrome P450 2D6 (CYP2D6) and medicines.” For more details, go to stjude.org/pg4kds.

Possible side effects of amitriptyline

• Feeling dizzy, drowsy, or unsteady
• Feeling more tired than usual
• Nausea, vomiting
• Constipation, diarrhea
• Stomach pain
• Low blood pressure
• Fainting, especially when you stand up or sit up quickly
• Visual problems, including blurred or double vision, dry eyes, or eye pain
• Dry mouth
• Nervous or irritable
• Seizures
• Headache
• Skin rash
• Skin more sensitive to the sun
• Weight gain or loss
• Pain or trouble passing urine, loss of bladder control, or the need to urinate more often than usual
• Fever with increased sweating
• Changes in blood sugar levels
• Confused or seeing things that are not there (hallucinations)
• Irregular or fast heartbeat
• More asthma symptoms for those who have asthma

These are the most common side effects, but there may be others. Please report all side effects to the doctor or nurse.

In case of a severe side effect or reaction, call the doctor, nurse, or pharmacist at 901-595-3300. If you are outside the Memphis area, dial toll-free 1-866-2STJUDE (1-866-278-5833), and press 0 once the call is connected.

Special instructions for amitriptyline

• Most often, amitriptyline is taken one (1) time a day. Taking this medicine at bedtime may keep you from feeling sleepy during the day. If you have trouble sleeping while taking amitriptyline, then take it in the morning.
• If you are taking amitriptyline for depression, it may take several weeks for the medicine to start working.
• If you are taking amitriptyline for nerve pain, the medicine should begin to work within 5 to 7 days.
• Store this medicine at room temperature in a dry place.
• Do not stop taking this medicine until your doctor tells you to do so. If you take this drug for a long time, you should slowly decrease your dose before you stop taking it. Stopping the medicine too quickly may cause these symptoms:
  • Dizzy feeling
  • Nausea, vomiting
  • Headache
  • Feeling more tired than usual
  • Sleep problems
  • Feeling irritable
• This medicine may cause you to feel dizzy and drowsy. Do not operate heavy equipment or drive a car until you see how this medicine affects you.
• Many of the side effects that you might have may decrease or go away after you have taken this medicine for a while.
• If you are taking amitriptyline more than one (1) time a day and you forget to take a dose, follow these guidelines:
  • If your next dose is not due for more than 4 hours, take the missed dose as soon as you remember.
  • If your next dose is due in less than 4 hours, skip the missed dose. Take your next dose at the planned time. Never take a double dose.
• If you have diabetes, you should check your blood sugar levels more often while you are taking amitriptyline.
• If you wear contact lenses and feel some discomfort, rewetting drops may help. Call your doctor if the problem does not go away or becomes severe.
• Amitriptyline makes your skin extra sensitive to sunlight. You should wear sunscreen lotion and clothing that protects your skin when you are outside during daylight hours.
• If the patient taking this medicine is a child or teen, please ask the pharmacy for a copy of the handout “Do you know… Children and teens taking antidepressants.”
• Amitriptyline may affect the way other medicines work. Some medicines may affect the way amitriptyline works. These medicines include:
  • Warfarin;
  • Clonidine;
  • Alcohol (found in many over-the-counter cough and cold medicines);
  • Cimetidine;
  • Levothyroxine;
  • Other medicines used to treat depression, such as fluoxetine and paroxetine; and
  • Medicines used to treat seizures, such as carbamazepine, phenobarbital, and valproic acid.
• Always tell your doctor if you are taking these medicines or if you start taking any new medicine while taking amitriptyline.
• This medicine can increase the risk of falls.