Description and purpose

Active substance: amitriptyline.

Drug class: tricyclic antidepressant (TCA). Amitriptyline belongs to a class of older antidepressant medicines that are still widely used for mood disorders and some types of chronic pain.

Typical uses in the UK: licensed mainly for depression. Clinicians also commonly prescribe amitriptyline off-label for neuropathic pain, migraine prevention, chronic tension-type pain in the head and some problems with sleep. Your prescriber will decide if it is appropriate for your situation.

Available strong points: tablets come in several strengths. This guide refers to 50 mg tablets as an example, but your individual dose and regimen will be chosen by your clinician.

Shortcuts: jump to how to accept it, view personal engagement and communications build trust and rapport. when medicines are used togethercreate multiple original paraphrases of the content contained within the opening and closing angle brackets: <, or reexamine the>. legal footing in the United Kingdom.

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Taking amitriptyline

Follow the directions printed on the label in addition to the patient leaflet supplied with your medicine. If you are unsure about any instruction, speak to the pharmacist or the prescriber before changing the way you take it.

  • Adhere to the prescribed dose. Keep the leaflet and any printed instructions for later reference if your treatment continues.
  • You may take amitriptyline with food or on an empty stomach. If it causes nausea, try taking it after a light snack.
  • Because sedation is a common effect, many people are advised to take the dose in the evening or at bedtime.
  • Avoid grapefruit and grapefruit juice while using amitriptyline as they may raise blood levels of the drug.
  • Do not halt the medicine abruptly. Gradual dose changes under medical supervision reduce the chance of withdrawal effects.
  • Improvements in mood or chronic pain may take several weeks. Continue treatment unless your prescriber advises otherwise.

For advice about a missed tablet, see tips for missed dosing. For new medicines or supplements check risk of a drug people relating to one another possibilities.

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How the drug carries out its effects

Amitriptyline works by limiting the reuptake of the neurotransmitters serotonin and noradrenaline in the brain, increasing their availability at nerve synapses. It also interacts with histamine and acetylcholine receptors, which explains peripheral effects such as drowsiness and dry mouth.

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What to do after missing your dose

  • As soon as you forget a dose and it is not near the time for your next scheduled dose, take it when you remember.
  • If the next dose is due soon, skip the missed tablet and continue with the regular schedule.
  • Do not try to catch up on a i skipped one dose by taking an extra dose.

If you miss doses frequently or are uncertain what to do, contact your prescriber or local pharmacist for tailored advice.

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Secure seasonal storage spaces provide room for off-season items. and safety

  • Store at approximately 20 to 25 degrees Celsius; short periods between 15 and 30 degrees are acceptable.
  • Keep the medicine away from strong heat, damp environments and direct sunlight. Do not store in bathrooms.
  • Keep tablets out of reach of children and animals. Return unused or out-of-date medicines to a pharmacy for safe disposal.

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Critical warnings and core safety measures

Do not take amitriptyline if any of the following apply to you:

  • You are allergic to amitriptyline or any ingredient in the product.
  • You are taking, or have recently taken, a monoamine oxidase inhibitor (MAOI). A washout period is usually required before starting amitriptyline.
  • You are taking medicines that are known to cause serious cardiac rhythm problems when combined with tricyclic antidepressants.
  • You are recovering from a recent heart attack.

Prior to starting, alert your prescriber if required. any of the following apply:

  • The themes include pregnancy, conceiving plans, and breastfeeding.
  • A history of bipolar disorder, recent suicidal thoughts or past deliberate self-harm.
  • Heavy or problematic alcohol use.
  • Medical conditions such as glaucoma, urinary retention due to prostate enlargement, thyroid disease, liver impairment, epilepsy or porphyria.
  • Any known heart disease, chest pain or arrhythmia.

Other important cautions:

  • This medicine can reduce alertness and affect coordination or vision. Avoid driving or using tools or machines until you know how it affects you.
  • Alcoholic beverages will increase drowsiness and may aggravate incidental effects; reduce or avoid alcohol while taking amitriptyline.
  • Young people under 25 starting antidepressants may rarely become more agitated or have worsening mood or suicidal thoughts. Seek urgent help if this occurs.

If you have any of the above issues arrange a review with your prescriber so the risks and benefits can be discussed and optional choices explored.

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Anticipated the dynamics of interaction opportunities

Always provide a complete list of prescribed medicines, over-the-counter products and herbal remedies to your healthcare team. Key the dynamics of interaction concerns include:

  • MAO inhibitors (for example phenelzine or selegiline): combining these with amitriptyline may cause severewhat is possiblely life-threatening reactions. Observe recommended washout intervals between treatments.
  • Drugs that prolong the QT interval or otherwise affect cardiac rhythm, such as pimozide or some antibiotics, can increase cardiac risk when used with TCAs.
  • Certain other antidepressants and some antipsychotics - may increase sedation or raise amitriptyline concentrations.
  • Anticholinergic medicines, including some antihistamines and antiemetics, may produce additive dry mouth, constipation and urinary retention.
  • Selected antifungals, terbinafine and some antiviral agents can raise amitriptyline levels.
  • Enzyme inducers like carbamazepine may reduce amitriptyline concentrations and change its effectiveness.
  • Anticoagulants include warfarin.: combining drugs can alter bleeding risk and may require closer ongoing monitoring.

Also take care with herbal products such as Saint John's wort which can interact with antidepressant therapy. Speak to a pharmacist when a new medicine is prescribed.

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Possible effects to expect

Many additional effects are mild and settle over time. Contact your clinician if they persist or become troublesome.

  • Common impacts: tiredness, drowsiness, dizziness, dry mouth and constipation.
  • Other frequent effects: nausea, appetite changes, blurred vision, altered sleep and reduced muscle strength.
  • Sexual undesired reactions including reduced libido or difficulties with sexual function may occur.

Act quickly and seek medical attention for new or worsening symptoms. serious or urgent symptoms:

  • Allergic reactions such as rash, facial swelling or breathing difficulty.
  • Severe chest pain, fainting, palpitations or a very fast or irregular heartbeat.
  • Marked changes in mood or behaviour, increased depression or new suicidal thinking.
  • Sudden neurological signs such as slurred speech, weakness on one side or severe loss of coordination.
  • Epileptic seizures, uncontrollable movements or high fever with confusion.
  • Unexpected bleeding, extensive bruising or signs of liver problems such as yellowing of the skin or very dark urine.

If you have suicidal thoughts or are in a mental health crisis, contact emergency services, go to the nearest emergency department or use NHS urgent mental health services such as NHS 111 where available.

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Other medicines and similar drugs

Choice of treatment depends on diagnosis, previous medication responses, side effect profile and co-existing medical problems. Discuss treatment options under the care of your clinician. Examples of contingency options include:

  • Other tricyclics: nortriptyline, imipramine and clomipramine. Nortriptyline is sometimes better tolerated with less sedation.
  • SSRIs (selective serotonin reuptake inhibitors): sertraline, fluoxetine, citalopram and escitalopram are common first-line options due to a generally favourable tolerability profile.
  • SNRIs (serotonin-noradrenaline reuptake inhibitors): duloxetine and venlafaxine; duloxetine is often used when nerve pain is a major symptom.
  • Other agents: mirtazapine or trazodone may be chosen when sedative effects are desirable, for example to help sleep.
  • For chronic nerve pain specifically: gabapentin or pregabalin are commonly used where appropriate.

When comparing choices consider likely adverse health effects, pharmacologic drug engagement and communication effects and cost. Peruse the UK cost section for approximate price differences between generic options.

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Typical costs in the UK

Prices differ by pharmacy, region and whether prescriptions are obtained through the NHS or paid for privately. The figures below are approximate retail prices for generic preparations and are for guidance only.

  • Amitriptyline 50 mg, 28 tablets: roughly 2 to 6 pounds for a generic pack; private consultation and dispensing charges may add about 5 to 20 pounds.
  • Sertraline capsules 50 mg, 28 tablets: commonly about 1 to 3 pounds for generic versions.
  • Duloxetine dosage form 60 mg, 28 capsules: approximately 3 to 10 pounds for generic brands.
  • Nortriptyline 25 mg, 28 capsules: around 2 to 7 pounds depending on supplier.
  • Gabapentin 300 mg, 100 capsules: often between 2 and 8 pounds; pregabalin typically costs more per pack.

NHS prescriptions: in Englin addition to there is usually a standard charge per item unless you qualify for an exemption; prescriptions are generally free in Scotland, Wales and Northern Ireland. A Prescription Prepayment Certificate (PPC) may save money if you need multiple items.

Prices change regularly. Check with local or online pharmacies for current costs before you buy.

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Auxiliary resources with contact details

  • Speak to your GP, a practice nurse or your community pharmacist for personalised advice about amitriptyline and treatment broadened options.
  • Do not share prescription medicines. Only the person named on a prescription should take that medicine.
  • If you are in a mental health crisis or have thoughts of self-harm, contact emergency services, attend the nearest accident and emergency department or use NHS urgent mental health services such as NHS 111 where available.

For exact dosage instructions and also the manufacturer details consult the patient information leaflet supplied with your medicine or ask your pharmacist for the full leaflet.

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Additional aspects about Amitriptyline