Amitriptyline

What is amitriptyline?

Amitriptyline is a medicine that raises chemicals in the brain. It is used to treat long-term pain problems such as nerve pain. It can also be used to treat other medical conditions such as depression, anxiety and migraine headaches.

You may hear amitriptyline called by its brand name, Elavil. Amitriptyline comes as a tablet.

Before giving amitriptyline to your child

Tell your child's health care provider if your child is:

• allergic to amitriptyline or other medicines
• taking thioridazine or other medicines in the monoamine oxidase inhibitor (MAOI) drug class
• recovering from acute heart failure

Talk to your child's health care provider if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child has:

• mental health issues such as thoughts of suicide, bipolar disorder or schizophrenia
• heart problems
• increased pressure in the eye
• hyperthyroidism
• liver disease
• a history of seizures
• difficulty passing urine

How should you give your child amitriptyline?

Follow these instructions when giving your child amitriptyline:

• Give your child this medicine exactly as your child's health care provider has instructed, even if your child seems better. Talk to your child's doctor before you stop giving this medicine for any reason. Your child may have side effects if they stop taking this medicine suddenly.
• Do not increase or decrease the amount of medicine without speaking with your child's prescriber first.
• Give amitriptyline one hour before bedtime or as instructed by your child's health care provider.
• Amitriptyline can be given with or without food. Give it with food if it causes an upset stomach.
• If your child has trouble swallowing the tablet whole, you may crush the tablet and mix it with a small amount of food, water or juice.

What should you do if your child misses a dose of amitriptyline?

• Give the missed dose as soon as you remember.
• If it is almost time for the next dose, skip the missed dose. Give the next dose at the regular time.
• Do not give your child two doses to make up for one missed dose.

How long does amitriptyline take to work?

• Your child may start feeling better a few weeks after starting this drug, but it may take up to six weeks to see the full effect.
• Sometimes it is necessary to increase the dose to have an effect. Discuss with your child's health care provider.

What are the possible side effects of amitriptyline?

Your child may have some of these side effects while they take amitriptyline. Check with your child's health care provider if your child continues to have any of these side effects, if they do not go away, or if they bother your child:

• drowsiness
• dizziness
• blurry vision
• trouble having a bowel movement
• dry mouth
• weight gain

Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child's doctor right away or take your child to the nearest emergency department if your child experiences any of these side effects:

• Sudden trouble in swallowing or breathing, including shortness of breath.
• Swelling of the face, tongue or lips.
• Unusual behaviour, such as increased agitation, hostility or thoughts of self-harm or harm to others. If this happens, call your child's doctor immediately, but do not stop amitriptyline on your own.
• Any changes in heartbeat, such as fast, slow or irregular heartbeat.
• Seizures.
• Yellow eyes or skin.

What safety measures should you taken when your child is using amitriptyline?

• Amitriptyline can make some existing heart rhythm problems worse. Your child's doctor may order an electrocardiogram (ECG) to check your child's heart rhythm.
• There are some medicines that should not be taken together with amitriptyline; the dose of amitriptyline or the other medicine may need to be adjusted. It is important to tell your child's health care providers if your child takes any other medications (prescription, over the counter or herbal). These may include MAOIs, cisapride, linezolid, fluconazole, erythromycin, anti-retrovirals, diazepam, SSRIs and migraine medications.
• This medicine may cause your child to be less alert. Watch your child's activities closely until you see how amitriptyline affects them. You may also have your child avoid tasks that require alertness, such as riding a bicycle, driving or contact sports.
• Your child may get sunburned more easily. Avoid lots of sun, sunlamps and tanning beds. Use sunscreen, dress your child in protective clothing and encourage them to wear sunglasses.
• Do not stop giving your child amitriptyline suddenly, talk to your child's doctor first. The doctor may want to slowly decrease the dose of amitriptyline before stopping it to prevent withdrawal symptoms such as nausea, restlessness, headache and tiredness.
• Keep your appointments with the doctor to have your child checked regularly.

What other information should you know about amitriptyline?

• Keep a list of all medications your child is on and show the list to the doctor or pharmacist.
• Do not share your child's medicine with others and do not give anyone else's medicine to your child.
• Make sure you always have enough amitriptyline to last through weekends, holidays and vacations. Call your pharmacy at least two days before your child runs out of medicine to order refills.
• Keep amitriptyline tablets at room temperature in a cool, dry place away from sunlight. Do NOT store it in the bathroom or kitchen.
• Do not keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines.
  

Keep amitriptyline out of your child’s sight and reach and locked up in a safe place. If your child takes too much amitriptyline, call your local Poison Information Centre at one of these numbers. These calls are free. 

• Call 1-844 POISON-X, or 1-844-764-7669, from anywhere in Canada except Quebec.
• Call 1-800-463-5060 if you live in Quebec.