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Key Takeaways
- Tricyclic antidepressant (TCA) used for depression; works by boosting serotonin and norepinephrine.
- Common side effects include drowsiness, dry mouth, constipation, blurred vision, dizziness (more pronounced in older adults and adolescents).
- Can cause dangerous heart rhythm changes (QT prolongation); avoid after a recent heart attack.
- Stopping without medical guidance can trigger withdrawal effects like mood changes, nausea, and sleep disruption.
Uses
What is amitriptyline used for?
Amitriptyline is commonly used to treat depression.
Amitriptyline may also be used for other conditions as determined by your health care provider.
How does amitriptyline work (mechanism of action)?
Amitriptyline is an antidepressant that belongs to a group of medicines called tricyclic antidepressants (TCAs). It works by increasing the amount of natural chemicals called norepinephrine and serotonin in the brain.
How is amitriptyline supplied (dosage forms)?
Amitriptyline is available in the following dosage forms that are taken by mouth.
- 10 mg oral tablets
- 25 mg oral tablets
- 50 mg oral tablets
- 75 mg oral tablets
- 100 mg oral tablets
- 150 mg oral tablets
How should I store amitriptyline?
Amitriptyline should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place, in a tightly closed container. Protect from light.
Side Effects
What are the most common side effects of amitriptyline?
The most common side effects of amitriptyline are listed below. Tell your health care provider if you have any of these side effects that bother you.
- Constipation
- Inability to empty your bladder
- Dry mouth
- Drowsiness
- Dizziness
- Confusion
- Blurred vision
- Nausea and vomiting
There may be other side effects of amitriptyline that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of amitriptyline?
While less common, the most serious side effects of amitriptyline are described below, along with what to do if they happen.
Severe Allergic Reactions. Amitriptyline may cause allergic reactions, which can be serious. Stop taking amitriptyline and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Suicidal Thoughts or Actions. Amitriptyline or other antidepressants may increase the risk of suicidal thoughts or actions in a small number of children, teenagers, or young adults in the first few months of taking the medicine or when the dose is changed. Depression or other serious mental health conditions are the most important causes of suicidal thoughts or actions. If you or your child is about to harm themselves, call 911 or call or text 988, the Suicide & Crisis Lifeline. Call your health care provider right away if you have any of the following symptoms.
- New or increased thoughts of suicide or death
- Suicide attempt
- New or increased feelings of anxiety, depression, or other unusual changes in your mood or behavior
Glaucoma. Amitriptyline may increase pressure inside the eye and cause or worsen narrow-angle glaucoma in some people. This can lead to blindness. Ask your health care provider if you should have your eyes examined to see if you are at risk. Tell your health care provider right away if you have any of the following symptoms.
- Loss of vision
- Eye pain or redness
- Severe headache or vomiting
- Seeing bright, colorful circles around lights (vision halos)
Extremely Elevated Mood (Mania). People with bipolar disorder can have severe high and low moods. The first symptom of bipolar disorder may be depression. People with bipolar disorder who take an antidepressant, such as amitriptyline, may have a higher risk of having mania or a manic episode. Call your doctor right away if you have any of the following symptoms of a manic episode.
- Very increased energy
- Significant trouble sleeping
- Racing, fast-paced thoughts
- Reckless behavior
- Unusually grand ideas
- Excessive happiness or irritability
- Talking faster or more than usual
Heart Rhythm Changes. Amitriptyline may cause a rare, dangerous heart rhythm problem called QT prolongation and torsade de pointes. Some people have a higher risk of this, including people who are older, have other people in their family who have had these conditions, have low potassium or magnesium levels, or who take some medicines for other heart rhythm problems. Tell your health care provider right away if you faint or have changes in your heart rate or rhythm, such as a fast or skipping heartbeat.
Low Sodium Levels (Hyponatremia). Amitriptyline may cause low sodium levels. Call your health care provider if you have any of the following symptoms of a low sodium level.
- Headache
- Muscle weakness or cramps
- Change in your mental condition, such as hallucinations, confusion, or decreased awareness or alertness
Serotonin Syndrome. Serotonin syndrome is when there is too much of a substance called serotonin in your body. Amitriptyline can cause serotonin syndrome when it is taken alone or with other medicines that affect serotonin. This condition can be life-threatening. Get emergency help if you have any of the following symptoms of serotonin syndrome.
- Sweating, fever, or flushing
- Confusion
- Feeling agitated or restless
- Seeing or hearing unusual things
- Dizziness
- Fast or racing heartbeat
- Nausea, vomiting, or diarrhea
- Muscle twitching, stiffness, or tremor
- Seizures
Warnings & Precautions
Who should not use amitriptyline?
Allergies to Ingredients. People who are allergic to any of the following should not use amitriptyline.
- Amitriptyline
- Elavil
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in the specific amitriptyline products they stock.
Drug Interactions. Amitriptyline should not be taken while you are using certain other medicines. Before taking amitriptyline, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
Heart Attack. Amitriptyline should not be taken if you’ve just had a heart attack.
What should I know about amitriptyline before using it?
Do not take amitriptyline unless it has been prescribed to you by a health care provider. Take it as prescribed.
Do not share amitriptyline with other people, even if they have the same condition as you. It may harm them.
Keep amitriptyline out of the reach of children.
Amitriptyline can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how amitriptyline affects you.
Amitriptyline can make your skin more sensitive to light from the sun, sunlamps, and tanning beds. This is called photosensitivity. Exposure to this light can cause severe sunburns, blisters, and swelling. If you need to be in sunlight, wear sunscreen, a hat, and clothing that covers your skin.
Do not stop taking amitriptyline without talking to your health care provider. Stopping too quickly may cause serious side effects. Call your health care provider right away if you have any of the following symptoms.
- Irritability
- High or low energy or mood
- Feeling restless
- Changes in sleep habits
- Headache
- Nausea
Older adults and adolescents can be at greater risk for some side effects from amitriptyline. Talk to your health care provider about your risks if you are in either of these age groups.
What should I tell my health care provider before using amitriptyline?
Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if amitriptyline is right for you.
In particular, make sure that you discuss any of the following.
Current and Past Health Conditions. Tell your health care provider if you have any of the following.
- Heart problems
- High blood pressure
- Liver problems
- Seizures or convulsions
- Bipolar disorder, mania, or schizophrenia
- Glaucoma
- Inability to empty your bladder
- Overactive thyroid
- History of stroke
- Diabetes
Pregnancy. It is not known if or how amitriptyline could affect pregnancy or harm an unborn baby. Tell your health care provider if you are or plan to become pregnant. Your health care provider will advise you if you should take amitriptyline while you are pregnant or trying to get pregnant.
Breastfeeding. Amitriptyline passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will advise you if you should stop breastfeeding or stop amitriptyline.
Interactions
Does amitriptyline interact with foods or drinks?
There are no known interactions between amitriptyline and foods or drinks.
Avoid drinking alcohol while taking amitriptyline. The combination can increase sleepiness or affect your alertness or concentration.
Does amitriptyline interact with other medicines (drug interactions)?
Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
In particular, make sure that you discuss if you are using any of the following before using amitriptyline.
- A monoamine oxidase inhibitor (MAOI) within the past 2 weeks, which is a medicine usually used for depression or Parkinson’s disease
- Cisapride, which is a medicine that may be used for speeding up movement in the gut
- Topiramate, which is a medicine that is commonly used for migraine or seizures
- A selective serotonin reuptake inhibitor (SSRI) or a serotonin norepinephrine reuptake inhibitor (SNRI), which are medicines commonly used for anxiety and depression
- An antipsychotic, which is a medicine for certain mental health conditions
- Certain medicines used to manage irregular heart rhythms, such as flecainide, propafenone, or quinidine
- A thyroid medicine, such as levothyroxine, which is used to raise thyroid hormone levels
- Any other medicine that causes dizziness and sleepiness (such as prescription pain medicines, sleep medicines, and medicines for anxiety)
- An anticholinergic medicine, which includes antihistamines and medicines commonly used for overactive bladder, Parkinson’s disease, or stomach problems
- Cimetidine, which is a medicine that is commonly used for indigestion or stomach ulcers
- Disulfiram, which is a medicine that is commonly used to help people avoid drinking alcohol
- Electroconvulsive therapy (ECT)
Many other medicines may alter the blood levels of amitriptyline. Tell your health care provider about all medicines that you take or have recently taken.
Do not take additional medications that contain amitriptyline, like chlordiazepoxide/amitriptyline tablets or perphenazine/amitriptyline tablets.
Overdose/Missed Dose
What should I do if I accidentally use too much amitriptyline?
If you or someone else has used too much amitriptyline, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of amitriptyline?
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.
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Amitriptyline Hydrochloride
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