Amitriptyline is used for:

The relief of depression. It may also be used to treat chronic pain and other conditions as determined by your doctor.

Amitriptyline is a tricyclic antidepressant. How tricyclic antidepressants improve depression symptoms is not fully understood. They are thought to increase the activity of certain chemicals in the brain (norepinephrine, serotonin), which help improve mood.

Do NOT use Amitriptyline if:

• you are allergic to any ingredient in Amitriptyline
• you are currently taking or have taken a monoamine oxidase (MAO) inhibitor (eg, phenelzine, selegiline) within the last 14 days
• you are taking antihistamines (eg, diphenhydramine), cisapride, dofetilide, droperidol, fluoroquinolones (eg, ciprofloxacin), ketolides (eg, telithromycin) macrolides (eg, erythromycin), mibefradil, or pimozide
• you are recovering from a heart attack

Contact your doctor or health care provider right away if any of these apply to you.

Before using Amitriptyline :

Some medical conditions may interact with Amitriptyline. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have a history of mental illness (eg, bipolar disorder, mania, manic-depression), or have considered or attempted suicide
• if you have alcoholism or regularly consume 3 or more alcoholic beverages per day
• if you have glaucoma, an irregular heartbeat, heart disease, chest pain, liver disease, prostate problems, thyroid disease, or are unable to urinate (urinary retention)
• if you have a history of seizures, epilepsy, or porphyria

Some MEDICINES MAY INTERACT with Amitriptyline. Tell your health care provider if you are taking any other medicines, especially any of the following:

• MAO inhibitors (eg, phenelzine, selegiline) because they can cause serious, sometimes life-threatening, reactions. Do NOT take MAO inhibitors with, or within 2 weeks of taking, Amitriptyline
• Anticholinergics (eg, scopolamine), bupropion, cimetidine, fluconazole, phenothiazines (eg, chlorpromazine), SSRIs (eg, fluoxetine), terbinafine, or valproic acid because side effects such as blurred vision, difficult urination, drowsiness or sedation, dry mouth, or lightheadedness may occur
• Antihistamines (eg, diphenhydramine), cisapride, dofetilide, droperidol, fluoroquinolones (eg, ciprofloxacin), ketolides (eg, telithromycin), macrolides (eg, erythromycin), mibefradil, pimozide, or streptogramins (eg, quinupristin/dalfopristin) because serious side effects on the heart (eg, racing heartbeat, dizziness, fainting, life-threatening abnormal heartbeat leading to unconsciousness, and lack of heartbeat, may be increased by Amitriptyline
• Carbamazepine, thyroid medicines (eg, levothyroxine), or stimulants (eg, albuterol, pseudoephedrine) because their side effects may be increased by Amitriptyline
• Warfarin because side effects such as serious bleeding may be increased by Amitriptyline
• Clonidine, guanethidine, or guanfacine because the effectiveness of these medicines may be decreased

This may not be a complete list of all interactions that may occur. Ask your health care provider if Amitriptyline may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Amitriptyline :

Use Amitriptyline as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Amitriptyline comes with an additional patient information sheet called a Medication Guide. Read it carefully and reread it each time you get Amitriptyline refilled.
• Amitriptyline may be taken with food or on an empty stomach.
• Avoid eating or drinking grapefruit juice while taking Amitriptyline.
• Amitriptyline may take up to 30 days to control symptoms of depression. Continue to use Amitriptyline even if you feel well. Do not miss any doses.
• If you miss a dose of Amitriptyline , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Amitriptyline.

Important safety information:

• Amitriptyline may cause dizziness, drowsiness, or blurred vision. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Amitriptyline. Using Amitriptyline alone, with other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.
• Avoid drinking alcohol or taking other medicines that cause drowsiness (eg, sedatives, tranquilizers) while taking Amitriptyline. Amitriptyline will add to the effects of alcohol and other depressants. Ask your pharmacist if you have questions about which medicines are depressants.
• Alcoholic beverages, hot weather, exercise, and fever can increase dizziness. To prevent dizziness or fainting, sit up or stand slowly, especially in the morning. Also, sit or lie down at the first sign of dizziness or weakness.
• Involuntary and uncontrollable movements may develop in patients taking Amitriptyline. Occurrence is highest among the elderly, especially women. The risk of developing these involuntary movements and the likelihood they will become permanent are increased with long-term use and with high doses. However, it is possible to develop these symptoms after short-term use at low doses. Contact your health care provider at once if any of the following occur: involuntary movements of the tongue, face, mouth, or jaw (eg, protrusion of tongue, puffing of cheeks, puckering of mouth, chewing movements), sometimes accompanied by involuntary movements of the arms and legs.
• Amitriptyline may cause sensitivity to sunlight. Avoid prolonged exposure to the sun and other ultraviolet light (eg, tanning beds). Use sunscreens and wear protective clothing until tolerance is determined.
• Do not become overheated in hot weather or during exercise or other activities since heatstroke may occur.
• Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Amitriptyline.
• Use caution in the ELDERLY because they may be more sensitive to its effects, especially lightheadedness upon standing; rapid heartbeat; breathing problems; difficult urination; and constipation.
• PREGNANCY and BREAST-FEEDING: Amitriptyline has been shown to cause harm to the human fetus. If you plan on becoming pregnant, discuss with your doctor the benefits and risks of using this medicine during pregnancy. Amitriptyline is excreted in the breast milk. Do not breast-feed while taking Amitriptyline.

Possible side effects of Amitriptyline :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Abnormal skin sensations; anxiety; bad taste in mouth; black tongue; blurred vision; clumsiness; constipation; diarrhea; difficulty speaking or swallowing; dilation of the urinary tract; disturbed concentration; dizziness; drowsiness; dry mouth; excitement; fever; hair loss; headache; heartburn; hives; incoordination; increased pressure in the eye; inflammation of the tongue; irritability; itching; loss of appetite; mood swings; nausea; nightmares; numbness; rash; restlessness; ringing in the ears; sensitivity to sunlight; sleeplessness; sweating; swelling; swelling of the face and tongue; sore throat; tearing; tingling; tiredness; upset stomach; urinary retention; vomiting; weakness; weight gain.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); confusion; delusions; disorientation; fast heartbeat; fainting; hallucinations; involuntary movements of tongue, face, mouth, or jaw (eg, protrusion of tongue, puffing of cheeks, puckering of mouth, chewing movements), sometimes accompanied by involuntary movements of the arms and legs; lightheadedness; pounding in the chest; seizures; tremors; unusual bleeding or bruising; yellowing of the skin or eyes.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

Other Useful Information:

Calcium: A mineral found mainly in the hard part of bones, where it is stored. Calcium is added to bones by cells called osteoblasts and is removed from bones by cells called osteoclasts. Calcium is essential for healthy bones. It is also important for muscle contraction, heart action, nervous system maintenance, and normal blood clotting. Food sources of calcium include dairy foods, some leafy green vegetables such as broccoli and collards, canned salmon, clams, oysters, calcium-fortified foods, and tofu. According to the National Academy of Sciences, adequate intake of calcium is 1,200 milligrams a day (four glasses of milk) for men and women 51 and older, 1,000 milligrams a day for adults 19 through 50, and 1,300 milligrams a day for children 9 through 18. The upper limit for calcium intake is 2.5 grams daily.

Cavities: Holes in the two outer layers of a tooth called the enamel and the dentin. The enamel is the outermost white hard surface and the dentin is the yellow layer just beneath enamel. Both layers serve to protect the inner living tooth tissue called the pulp, where blood vessels and nerves reside. Small cavities may not cause pain, and may be unnoticed by the patient. Larger cavities can collect food, and the inner pulp of the affected tooth can become irritated by bacterial toxins, foods that are cold, hot, sour, or sweet - causing toothache.

Naturopathy: A system of therapy based on preventative care, and on the use of heat, water, light, air, and massage as primary therapies for disease. Some naturopaths use no medications, either pharmaceutical or herbal. Some recommend herbal remedies only. A few who are licensed to prescribe may recommend pharmaceuticals in those cases where they feel their use is warranted.

Naturopathy is an American healthcare profession. It was founded in the US as a formal healthcare system at the turn of the 20th century by medical practitioners from various natural therapeutic disciplines. By the early 1900s, more than 20 naturopathic medical schools existed, and naturopathic physicians were licensed in most States. Today there are more than 1,000 licensed naturopathic doctors in the US.

As practiced today, naturopathic medicine integrates traditional natural therapeutics -- including botanical medicine, clinical nutrition, homeopathy, acupuncture, traditional oriental medicine, hydrotherapy, and naturopathic manipulative therapy -- with modern scientific medical diagnostic science and standards of care. The medical research base of naturopathic practice consists of empirical documentation of treatments using case history observations, medical records, and summaries of practitioners' clinical experiences.

At present, the two accredited naturopathic medical schools in the US have active research departments. Naturopathic researchers have investigated the pharmacology and physiological effects of nutritional and natural therapeutic agents, and naturopathic physicians have been active in the investigation of new homeopathic remedies and in the natural treatment of women's health problems. The most recently completed naturopathic study in women's health tested the clinical and endocrine effects of a botanical formula as an alternative to estrogen replacement therapy.

Blood: The familiar red fluid in the body that contains white and red blood cells, platelets, proteins, and other elements. The blood is transported throughout the body by the circulatory system. Blood functions in two directions: arterial and venous. Arterial blood is the means by which oxygen and nutrients are transported to tissues while venous blood is the means by which carbon dioxide and metabolic by-products are transported to the lungs and kidneys, respectively, for removal from the body.

Blood pressure: The blood pressure is the pressure of the blood within the arteries. It is produced primarily by the contraction of the heart muscle. It's measurement is recorded by two numbers. The first (systolic pressure) is measured after the heart contracts and is highest. The second (diastolic pressure) is measured before the heart contracts and lowest. A blood pressure cuff is used to measure the pressure. Elevation of blood pressure is called "hypertension".

Brain: That part of the central nervous system that is located within the cranium (skull). The brain functions as the primary receiver, organizer and distributor of information for the body. It has two (right and left) halves called "hemispheres."

Disease: Illness or sickness often characterized by typical patient problems (symptoms) and physical findings (signs). Disruption sequence: The events that occur when a fetus that is developing normally is subjected to a destructive agent such as the rubella (German measles) virus.

Doctor: In a medical context, any medical professional with an MD, a PhD, or any other doctoral degree. The term doctor is quite nonspecific. A doctor may, for example, be a physician, psychologist, biomedical scientist, dentist, or veterinarian. In a nonmedical context, a professor of history might be addressed as doctor, an eminent theologian might be named a doctor of a church, and a person awarded an honorary doctorate by a college or university might also be called a doctor.

The word "doctor" comes from the Latin "docere" meaning to teach. A doctor was a teacher, especially a learned or authoritative one.