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Information about Elavil

Amitriptyline is a tricyclic antidepressant used to relief depression. The exact mechanism of Amitriptyline action is not known. Probably, it restores the balance of certain natural substances in the brain (serotonin and norepinephrine). It may also be administered to treat chronic pain and other conditions as determined by your physician.

You should not use Amitriptyline in the following cases: you are allergic to any ingredient in Amitriptyline; you are currently taking or have taken a monoamine oxidase (MAO) inhibitor (eg, phenelzine, selegiline) within the last 14 days; you are taking antihistamines (eg, diphenhydramine), cisapride, dofetilide, droperidol, fluoroquinolones (eg, ciprofloxacin), ketolides (eg, telithromycin) macrolides (eg, erythromycin), mibefradil, or pimozide; you are recovering from a heart attack.

In such cases it is obligatory to consult with your doctor or health care provider before taking this drug.

Before using Amitriptyline

Before using Amitriptyline you should tell your doctor if you have any medical conditions listed below: you are pregnant, planning to become pregnant, or are breast-feeding a baby; you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement; you have allergies to medicines, foods, or other substances; you have a history of mental illness (eg, bipolar disorder, mania, manic-depression), or have considered or attempted suicide; you have alcoholism or regularly consume 3 or more alcoholic beverages per day; you have glaucoma, an irregular heartbeat, heart disease, chest pain, liver disease, prostate problems, thyroid disease, or are unable to urinate (urinary retention); you have a history of seizures, epilepsy, or porphyria.

Be aware that Amitriptyline may interact with some medicines. Consult with your health care provider in case you are taking any other drugs, especially any of the following: MAO inhibitors (eg, phenelzine, selegiline) because they can cause serious, sometimes life-threatening, reactions. Do NOT take MAO inhibitors with, or within 2 weeks of taking, Amitriptyline; anticholinergics (eg, scopolamine), bupropion, cimetidine, fluconazole, phenothiazines (eg, chlorpromazine), SSRIs (eg, fluoxetine), terbinafine, or valproic acid because side effects such as blurred vision, difficult urination, drowsiness or sedation, dry mouth, or lightheadedness may occur; antihistamines (eg, diphenhydramine), cisapride, dofetilide, droperidol, fluoroquinolones (eg, ciprofloxacin), ketolides (eg, telithromycin), macrolides (eg, erythromycin), mibefradil, pimozide, or streptogramins (eg, quinupristin/dalfopristin) because serious side effects on the heart (eg, racing heartbeat, dizziness, fainting, life-threatening abnormal heartbeat leading to unconsciousness, and lack of heartbeat, may be increased by Amitriptyline; carbamazepine, thyroid medicines (eg, levothyroxine), or stimulants (eg, albuterol, pseudoephedrine) because their side effects may be increased by Amitriptyline; warfarin because side effects such as serious bleeding may be increased by Amitriptyline; clonidine, guanethidine, or guanfacine because the effectiveness of these medicines may be decreased.

It may not be a complete list of all interactions with other drugs. To prevent any complications you should check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Amitriptyline

Use this medicine as directed by your physician. Amitriptyline should be taken orally with food or on an empty stomach.

You should avoid eating or drinking grapefruit juice while taking Amitriptyline.

Do not stop taking Amitriptyline even if you feel well. Try not to miss any doses.

You should know that improvement in your depression may start in several weeks.

In case you miss a dose of Amitriptyline, take it as soon as possible. If it is almost time for your next intake, skip the missed dose and take it according to your regular dosing schedule. Do not take double doses to catch up.

Important safety information

Be careful when driving, operating machinery, or performing other hazardous activities as Amitriptyline usage may lead to drowsiness, dizziness, or blurred vision. Try to avoid such activities. Alcohol and certain other medicines (eg, sedatives, tranquilizers) may increase the risk of unfavorable reactions while taking Amitriptyline. Dizziness may be increased by alcoholic beverages, hot weather, exercise, and fever. It is recommended to sit up or stand slowly, especially in the morning to prevent dizziness or fainting. You should sit or lie down at the first sign of dizziness or weakness.

Some patients may experience involuntary and uncontrollable movements while taking Amitriptyline. Occurrence is highest among the elderly, especially women. The risk of developing these involuntary movements and the likelihood they will become permanent are increased with long-term use and with high doses. However, it is possible to develop these symptoms after short-term use at low doses.

Contact your health care provider at once if any of the following occur: involuntary movements of the tongue, face, mouth, or jaw (eg, protrusion of tongue, puffing of cheeks, puckering of mouth, chewing movements), sometimes accompanied by involuntary movements of the arms and legs.

Your sensitivity to sunlight may be increased by Amitriptyline. Try to avoid prolonged exposure to the sun and other ultraviolet light (eg, tanning beds). Use sunscreens and wear protective clothing if you are not able to avoid such exposure.

Try not to become overheated in hot weather or during exercise or other activities since heatstroke may take place.

Notify the doctor or dentist that you are using Amitriptyline before you undergo any medical or dental treatments, emergency care, or surgery.

The ELDERLY they may be more sensitive to the effects of Amitriptyline, especially lightheadedness upon standing, rapid heartbeat, breathing problems, difficult urination, and constipation. Use it with caution in this group.

PREGNANCY and BREAST-FEEDING

Amitriptyline is deleterious to the fetus. In case you plan pregnancy, consult with your doctor and discuss the benefits and risks of using this medicine while pregnancy. It is known that Amitriptyline passes into the breast milk. Avoid breast-feeding a baby while taking Amitriptyline.

Possible side effects of Amitriptyline

You should consult with your doctor in case you have any of side effects especially bothersome listed below: abnormal skin sensations; anxiety; bad taste in mouth; black tongue; blurred vision; clumsiness; constipation; diarrhea; difficulty speaking or swallowing; dilation of the urinary tract; disturbed concentration; dizziness; drowsiness; dry mouth; excitement; fever; hair loss; headache; heartburn; hives; incoordination; increased pressure in the eye; inflammation of the tongue; irritability; itching; loss of appetite; mood swings; nausea; nightmares; numbness; rash; restlessness; ringing in the ears; sensitivity to sunlight; sleeplessness; sweating; swelling; swelling of the face and tongue; sore throat; tearing; tingling; tiredness; upset stomach; urinary retention; vomiting; weakness; weight gain.

Seek emergency immediately in case you have any of these severe side effects: severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); confusion; delusions; disorientation; fast heartbeat; fainting; hallucinations; involuntary movements of tongue, face, mouth, or jaw (eg, protrusion of tongue, puffing of cheeks, puckering of mouth, chewing movements), sometimes accompanied by involuntary movements of the arms and legs; lightheadedness; pounding in the chest; seizures; tremors; unusual bleeding or bruising; yellowing of the skin or eyes.

What is the expiration date of the pills?

This information is mentioned on each blister. The expiration date is 2 years from the date of manufacture.