HOW TO USE: Take amitriptyline
tablets by mouth. Follow the directions on the prescription
label. Swallow the tablets with a drink of water.
You can take the tablets with or without food. Take
your doses at regular intervals. Do not take your
medicine more often than directed. Do not stop taking
except on your prescriber's advice.
Contact your pediatrician or health care professional
regarding the use of this medicine in children. Special
care may be needed.
Adolescents, 12 to 18 years old, and elderly patients
over 65 years old may have a stronger reaction to
this medicine and need smaller doses.
SIDE EFFECTS: Side effects that you should
report to your prescriber or health care professional
as soon as possible: abnormal production of milk in
females; blurred vision or eye pain; breast enlargement
in both males and females; confusion, hallucinations
(seeing or hearing things that are not really there);
difficulty breathing; fainting spells; fever with
increased sweating; irregular or fast, pounding heartbeat,
palpitations; muscle stiffness, or spasms; pain or
difficulty passing urine, loss of bladder control;
seizures (convulsions); sexual difficulties (decreased
sexual ability or desire, difficulty ejaculating);
stomach pain; swelling of the testicles; tingling,
pain, or numbness in the feet or hands; unusual weakness
or tiredness; yellowing of the eyes or skin.
Side effects that usually do not require medical attention
(report to your prescriber or health care professional
if they continue or are bothersome): anxiety; constipation,
or diarrhea; drowsiness or dizziness; dry mouth; increased
sensitivity of the skin to sun or ultraviolet light;
loss of appetite; nausea, vomiting; skin rash or itching;
weight gain or loss.
PRECAUTIONS: Visit your prescriber or health
care professional for regular checks on your progress.
It can take several days before you feel the full
effect of amitriptyline.
If you have been taking amitriptyline regularly for
some time, do not suddenly stop taking it. You must
gradually reduce the dose or you may get severe side
effects. Ask your prescriber or health care professional
for advice. Even after you stop taking amitriptyline
it can still affect your body for several days.
You may get drowsy or dizzy. Do not drive, use machinery,
or do anything that needs mental alertness until you
know how amitriptyline affects you. Do not stand or
sit up quickly, especially if you are an older patient.
This reduces the risk of dizzy or fainting spells.
Alcohol may increase dizziness and drowsiness. Avoid
alcoholic drinks.
Do not treat yourself for coughs, colds or allergies
without asking your prescriber or health care professional
for advice. Some ingredients can increase possible
side effects.
Your mouth may get dry. Chewing sugarless gum or sucking
hard candy, and drinking plenty of water will help.
Amitripyline may cause dry eyes and blurred vision.
If you wear contact lenses you may feel some discomfort.
Lubricating drops may help. See your ophthalmologist
if the problem does not go away or is severe.
Amitriptyline may make your skin more sensitive to
the sun. Keep out of the sun, or wear protective clothing
outdoors and use a sunscreen. Do not use sun lamps
or sun tanning beds or booths.
If you are diabetic, check your blood sugar more often
than usual, especially during the first few weeks
of treatment with amitriptyline. Amitriptyline can
affect blood glucose (sugar) levels. Call your prescriber
or health care professional for advice if you notice
a change in the results of blood or urine glucose
tests.
If you are going to have surgery or will need an x-ray
procedure that uses contrast agents, tell your prescriber
or health care professional that you are taking this
medicine.
DRUG INTERACTIONS: Amitriptyline can interact
with many other medicines. Some interactions can be
very important. Make sure your prescriber or health
care professional knows about all other medicines
you are taking. Many important interactions are listed
below:
Do not take amitriptyline with any of the following
medications: astemizole (HismanalŽ); cisapride (PropulsidŽ);
probucol; terfenadine (SeldaneŽ); thioridazine (MellarilŽ);
medicines called MAO inhibitors-phenelzine (NardilŽ),
tranylcypromine (ParnateŽ), isocarboxazid (MarplanŽ),
selegiline (EldeprylŽ); other medicines for mental
depression (may be duplicate therapies or cause additive
side effects).
Amitriptyline may also interact with any of the following
medications: alcohol; antacids; atropine and related
drugs like hyoscyamine, scopolamine, tolterodine and
others; barbiturate medicines for inducing sleep or
treating seizures (convulsions), such as phenobarbital;
blood thinners, such as warfarin; bromocriptine; bupropion;
cimetidine; clonidine; cocaine; delavirdine; diphenoxylate;
disulfiram; donepezil; drugs for treating HIV infection;
female hormones, including contraceptive or birth
control pills and estrogen; galantamine; herbs and
dietary supplements like ephedra (Ma huang), kava
kava, SAM-e, St. John's wort, valerian, or others
; imatinib, STI-571; kaolin; pectin; labetalol; levodopa
and other medicines for movement problems like Parkinson's
disease; lithium; medicines for anxiety or sleeping
problems; medicines for colds, flu and breathing difficulties,
like pseudoephedrine; medicines for hay fever or allergies
(antihistamines); medicines for weight loss or appetite
control; medicines used to regulate abnormal heartbeat
or to treat other heart conditions (examples: amiodarone,
bepridil, disopyramide, dofetilide, encainide, flecainide,
ibutilide, mibefradil, procainamide, propafenone,
quinidine, and others); metoclopramide; muscle relaxants,
like cyclobenzaprine; other medicines for mental or
mood problems and psychotic disturbances; prescription
pain medications like morphine, codeine, tramadol
and others; procarbazine; seizure (convulsion) or
epilepsy medicine such as carbamazepine or phenytoin;
stimulants like dexmethylphenidate or methylphenidate;
some antibiotics (examples: erythromycin, gatifloxacin,
levofloxacin, linezolid, moxifloxacin, sotalol, sparfloxacin)
; tacrine; thyroid hormones such as levothyroxine.
Tell your prescriber or health care professional about
all other medicines you are taking, including non-prescription
medicines, nutritional supplements, or herbal products.
Also tell your prescriber or health care professional
if you are a frequent user of drinks with caffeine
or alcohol, if you smoke, or if you use illegal drugs.
These may affect the way your medicine works. Check
with your health care professional before stopping
or starting any of your medicines.
NOTES: Prescriber needs to know if you have
any of these conditions: an alcohol problem; asthma,
difficulty breathing; blood disorders or disease;
diabetes; difficulty passing urine, prostate trouble;
glaucoma; having intramuscular injections; heart disease
or previous heart attack; liver disease; over active
thyroid; Parkinson's disease; schizophrenia; seizures
(convulsions); stomach disease; an unusual or allergic
reaction to amitriptyline, other medicines, foods,
dyes, or preservatives; pregnant or trying to get
pregnant; breast-feeding.
MISSED DOSE: If you miss a dose normally taken
at bedtime to avoid daytime drowsiness, it may be
better to miss that dose. If you take more than one
dose a day and miss a dose, take it as soon as you
can. If it is almost time for your next dose, take
only that dose. Follow your prescriber's advice on
missed doses. Do not take double or extra doses.
STORAGE: Keep out of the reach of children
in a container that small children cannot open.
Store at room temperature between 15 and 30 degrees
C (59 and 86 degrees F). Throw away any unused medicine
after the expiration date.
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