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.
