The
following information is a summary about Amitriptyline.
It is not intended to replace a doctor's instructions.
Amitriptyline HCl USES
For the relief of symptoms of depression. Endogenous
depression is more likely to be alleviated than are
other depressive states.
Amitriptyline HCl DIRECTIONS
75 mg of amitriptyline HCl a day in divided doses
is usually satisfactory. If necessary, this may be
increased to a total of 150 mg per day. Increases
are made preferably in the late afternoon and/or
bedtime doses. A sedative effect may be apparent
before the antidepressant effect is noted, but an
adequate therapeutic effect may take as long as 30
days to develop. An alternate method of initiating
therapy in outpatients is to begin with 50 to 100
mg amitriptyline HCl at bedtime. This may be increased
by 25 or 50 mg as necessary in the bedtime dose to
a total of 150 mg per day.
Amitriptyline HCl SIDE EFFECTS
Amitriptyline HCl may block the antihypertensive
action of guanethidine or similarly acting compounds.
It should be used with caution in patients with a
history of seizures and, because of its atropine-like
action, in patients with a history of urinary retention,
angle-closure glaucoma or increased intraocular pressure.
In patients with angle-closure glaucoma, even average
doses may precipitate an attack. Patients with cardiovascular
disorders should be watched closely. Tricyclic antidepressant
drugs, including amitriptyline HCl, particularly
when given in high doses, have been reported to produce
arrhythmias, sinus tachycardia, and prolongation
of the conduction time. Myocardial infarction and
stroke have been reported with drugs of this class.
Close supervision is required when amitriptyline
HCl is given to hyperthyroid patients or those receiving
thyroid medication..
Amitriptyline HCl PRECAUTIONS
Schizophrenic patients may develop increased symptoms
of psychosis; patients with paranoid symptomatology
may have an exaggeration of such symptoms. Depressed
patients, particularly those with known manic-depressive
illness, may experience a shift to mania or hypomania.
In these circumstances the dose of amitriptyline
may be reduced or a major tranquilizer such as perphenazine
may be administered concurrently. The possibility
of suicide in depressed patients remains until significant
remission occurs. Potentially suicidal patients should
not have access to large quantities of this drug.
Prescriptions should be written for the smallest
amount feasible. Concurrent administration of amitriptyline
HCl and electroshock therapy may increase the hazards
associated with such therapy. Such treatment should
be limited to patients for whom it is essential.
When possible, the drug should be discontinued several
days before elective surgery. Both elevation and
lowering of blood sugar levels have been reported.
Amitriptyline HCl should be used with caution in
patients with impaired liver function.
Amitriptyline HCl DRUG INTERACTIONS
Tell your doctor of all prescription and nonprescription
meds you may use, especially of: carbamazepine, narcotic
pain relievers (e.g., codeine), drugs used to aid
sleep, antidepressants (e.g., SSRI-types such as
fluoxetine or fluvoxamine), MAO inhibitors (e.g.,
furazolidone, linezolid, phenelzine, procarbazine,
selegiline, tranylcypromine), psychiatric medicine
(e.g., nefazodone), "triptan"-type drugs, anti-anxiety
drugs (e.g., diazepam), sibutramine. Also, report
use of certain antihistamines (e.g., diphenhydramine)
which are also present in many cough-and-cold products.
Do not start or stop any medicine without doctor
or pharmacist approval.
Amitriptyline HCl OVERDOSE
If overdose is suspected, contact your local poison
control center or emergency room immediately.
Amitriptyline HCl NOTES
While on therapy with amitriptyline HCl, patients
should be advised as to the possible impairment of
mental and/or physical abilities required for performance
of hazardous tasks, such as operating machinery or
driving a motor vehicle.
MISSED DOSE
If you miss a dose, use Tramadol as soon as you remember.
If it is near the time of the next dose, skip the
missed dose and resume your usual dosing schedule.
Do not "double-up" the dose to catch up.
Amitriptyline HCl STORAGE
Store Tramadol at room temperature between 36 and
77 degrees F (2 -25 degrees C) away from light and
moisture.
