$Unique_ID{BRK01823}
$Pretitle{}
$Title{AMITRIPTYLINE}
$Subject{Amitril (Warner Chilcott)
amitriptyline hydrochloride (various manufacturers)
Elavil (Merck Sharp & Dohme)
Endep (Roche)}
$Volume{}
$Log{
Elavil*0182301.scf
Endep*0182302.scf}

Copyright (C) 1991 Publications International, Ltd.


AMITRIPTYLINE
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BRAND NAMES (Manufacturers):
     Amitril (Warner Chilcott)
     amitriptyline hydrochloride (various manufacturers)
     Elavil (Merck Sharp & Dohme)
     Endep (Roche)
TYPE OF DRUG:
     Tricyclic antidepressant
INGREDIENT:
     amitriptyline
DOSAGE FORM:
     Tablets (10 mg, 25 mg, 50 mg, 75 mg, 100 mg, and 150 mg)
STORAGE:
     Store at room temperature in a tightly closed container.

USES

     Amitriptyline is used to relieve the symptoms of mental depression.  This
medication belongs to a group of drugs referred to as the tricyclic
antidepressants.  These medicines are thought to relieve depression by
increasing the concentration of certain chemicals necessary for nerve
transmission in the brain.

TREATMENT

     This medication should be taken exactly as your doctor prescribes.  It
can be taken with water or with food to lessen the chance of stomach
irritation, unless your doctor tells you to do otherwise.
     The effects of therapy with this medication may not become apparent for
two or three weeks.
     If you miss a dose of this medication, take the missed dose as soon as
possible, and then return to your regular dosing schedule.  However, if the
dose you missed was a once-a-day bedtime dose, do not take that dose in the
morning; check with your doctor instead.  If the dose is taken in the morning,
it may cause some unwanted side effects.  Never double the dose.

SIDE EFFECTS

     Minor.

     Constipation, cramps, diarrhea, dizziness, drowsiness, dry mouth,
fatigue, heartburn, loss of appetite, nausea, peculiar tastes in the mouth,
restlessness, sweating, vomiting, weakness, or weight gain or loss.  As your
body adjusts to the medication, these side effects should disappear.
     This medication may cause increased sensitivity to sunlight.  You should,
therefore, avoid prolonged exposure to sunlight and sunlamps.  Wear protective
clothing and use an effective sunscreen.
     Amitriptyline may cause your urine to turn blue-green; this effect is
harmless.
     Dry mouth can be relieved by chewing sugarless gum or by sucking on ice
chips or hard candy.
     To relieve constipation, increase the amount of fiber in your diet (fresh
fruits and vegetables, salads, bran, and whole-grain breads), exercise, and
drink more water (unless your doctor directs you to do otherwise).
     To avoid dizziness when you stand, contract and relax the muscles of your
legs for a few moments before rising.  Do this by alternately pushing one foot
against the floor while raising the other foot slightly, so that you are
"pumping" your legs in a pedaling motion.

     Major.

     Tell your doctor about any side effects that are persistent or
particularly bothersome.  IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
agitation, anxiety, blurred vision, chest pain, confusion, convulsions,
difficulty in urinating, enlarged or painful breasts (in both sexes),
fainting, fever, fluid retention, hair loss, hallucinations, headaches,
impotence, mood changes, mouth sores, nervousness, nightmares, numbness in the
fingers or toes, palpitations, ringing in the ears, seizures, skin rash, sleep
disorders, sore throat, tremors, uncoordinated movements or balance problems,
unusual bleeding or bruising, or yellowing of the eyes or skin.

INTERACTIONS

     Amitriptyline interacts with a number of other types of medications:
     1. Extreme drowsiness can occur when this medicine is taken with central
nervous system depressants (such as alcohol, antihistamines, barbiturates,
benzodiazepine tranquilizers, muscle relaxants, narcotics, pain medications,
phenothiazine tranquilizers, and sleeping medications) or with other
antidepressants.
     2. Amitriptyline may decrease the effectiveness of antiseizure
medications and may block the blood-pressure-lowering effects of clonidine and
guanethidine.
     3. Oral contraceptives (birth control pills) or estrogen-containing drugs
can increase the side effects and reduce the effectiveness of the tricyclic
antidepressants (including amitriptyline).
     4. Cimetidine can decrease the elimination of amitriptyline from the
body, thus increasing the possibility of side effects.
     5. Tricyclic antidepressants may increase the side effects of thyroid
medication and of over-the-counter (nonprescription) cough, cold, allergy,
asthma, sinus, and weight-control medications.
     6. The concurrent use of tricyclic antidepressants and monoamine oxidase
(MAO) inhibitors should be avoided because the combination may result in
fever, convulsions, or high blood pressure.  At least 14 days should separate
the use of amitriptyline and the use of an MAO inhibitor.
     Before starting to take amitriptyline, BE SURE TO TELL YOUR DOCTOR about
any medications you are currently taking, especially any of those listed
above.

WARNINGS

     * Tell your doctor if you have had unusual or allergic reactions to
medications, especially to amitriptyline or any of the other tricyclic
antidepressants (imipramine, doxepin, trimipramine, amoxapine, protriptyline,
desipramine, maprotiline, nortriptyline).
     * Tell your doctor if you have a history of alcoholism, or if you have
ever had asthma, high blood pressure, liver or kidney disease, heart disease,
a heart attack, circulatory disease, stomach problems, intestinal problems,
difficulty in urinating, enlarged prostate gland, epilepsy, glaucoma, thyroid
disease, mental illness, or electroshock therapy.
     * If this drug makes you dizzy or drowsy, do not take part in any
activity that requires alertness, such as driving a car or operating
potentially dangerous equipment.
     * Before having surgery or other medical or dental treatment, tell your
doctor or dentist you are taking this drug.
     * Do not stop taking this drug suddenly.  Abruptly stopping it can cause
nausea, headache, stomach upset, fatigue, or a worsening of your condition.
Your doctor may want to reduce the dosage gradually.
     * The effects of this medication may last as long as seven days after you
have stopped taking it, so continue to observe all precautions during that
period.
     * Be sure to tell your doctor if you are pregnant.  Studies have not been
done in humans; however, studies in animals have shown that this type of
medication can cause side effects to the fetus when given to the mother in
large doses during pregnancy.  Also, tell your doctor if you are
breast-feeding an infant.  Small amounts of this drug can pass into breast
milk and may cause unwanted side effects, such as irritability or sleeping
problems, in nursing infants.

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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
