October 21, 2014
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Drug Factsheets

 Health Home >> Medications 

Elavil

(amitriptyline)

DIN (Drug Identification Number)

00335053 ELAVIL TAB 10MG
00335061 ELAVIL TAB 25MG
00335088 ELAVIL TAB 50MG
00754129 ELAVIL TAB 75MG

What side effects are possible with Elavil?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • constipation
  • dizziness
  • drowsiness
  • dry mouth
  • flushing
  • headache
  • increased or decreased appetite
  • low blood pressure
  • nausea
  • tiredness or weakness (mild)
  • unpleasant taste
  • vision problems (e.g., blurred vision)
  • weight gain

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • agitation
  • anxiety
  • confusion
  • decreased or increased sexual ability
  • decreased or increased sweating
  • difficulty speaking
  • disorientation
  • eye pain
  • fast or irregular heartbeat
  • hallucinations
  • increased sensitivity to sunlight
  • irritability
  • loss of balance control
  • mask-like face
  • nervousness or restlessness
  • nightmares
  • numbing or tingling of the fingers or toes
  • problems urinating
  • ringing or buzzing in the ears
  • shuffling walk
  • skin rash or itching
  • tremors or shakiness
  • trouble sleeping
  • vomiting

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • seizures
  • symptoms of a severe allergic reaction (e.g., swelling of face and tongue, difficulty breathing, hives)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.





Are there any other precautions or warnings for Elavil?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Drowsiness/reduced alertness: Amitriptyline may reduce mental or physical abilities required for performance of hazardous tasks, such as operating machinery or driving a motor vehicle. Do not undertake such activities until you have determined that it does not have this effect on you.

Heart diseases: Tricyclic antidepressant medications such as amitriptyline can cause abnormal heart rhythms, particularly when taken in high doses. People with a history of heart disease and seniors should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Mania or hypomania: Amitriptyline may cause activation of mania or hypomania. People with a history of bipolar disorder should be closely monitored by their doctor while using this medication.

Medical conditions: People with the following conditions should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed:

  • benign prostatic hyperplasia (enlarged prostate)
  • certain blood disorders
  • increased eye pressure
  • reduced liver function
  • narrow-angle glaucoma
  • seizures
  • urinary retention

Suicidal or agitated behaviour: People taking antidepressants such as amitriptyline may feel agitated (restless, anxious, aggressive, emotional, trouble sleeping, and feeling not like themselves), or they may want to hurt themselves or others. If you notice any changes in mood, behaviours, thoughts, or feelings in yourself or someone who is taking this medication, contact a doctor immediately. Your doctor will monitor you closely for behaviour changes, especially at the start of treatment or when your dose is increased or decreased.

Surgery: Using amitriptyline before, during, and after surgery may increase the risk of developing abnormal heart rhythms. The risks and benefits of continuing amitriptyline during elective surgery should be discussed with your doctor. Your doctor may recommend to stop or reduce the dose of amitriptyline several days prior to the scheduled surgery.

Thyroid disease: Patients who have an overactive thyroid (hyperthyroidism) or are taking thyroid medication should be monitored closely by their doctor when taking amitriptyline.

Withdrawal: Stopping this medication abruptly after taking it for a long time may produce nausea, headache, and malaise. Gradual dosage reduction has been reported to produce (within 2 weeks) transient symptoms including irritability, restlessness, and dream and sleep disturbance. Experiencing these symptoms does not mean you are addicted. Do not suddenly stop taking this medication if you have been taking it for a while. If you are to stop taking this medication, contact your doctor, who will advise you on how to gradually stop this medication.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking amitriptyline, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children under 12 years of age.

What other drugs could interact with Elavil?

There may be an interaction between amitriptyline and any of the following:

  • acetylsalicylic acid (ASA)
  • alcohol
  • alfuzosin
  • altretamine
  • amiodarone
  • anticholinergic medications (e.g., atropine, oxybutynin)
  • antifungals (e.g., fluconazole, itraconazole, ketoconazole)
  • antihistamines
  • barbiturates (e.g., butalbital, phenobarbital)
  • beta-2 agonists (e.g., salmeterol, formoterol, fenoterol, terbutaline)
  • bupriopion
  • carbamazepine
  • chloroquine
  • cholinesterase inhibitors (e.g., donepezil, galantamine, rivastigmine)
  • cimetidine
  • cinacalcet
  • ciprofloxacin
  • clonidine
  • decongestant nasal sprays (e.g., oxymetazoline, phenylephrine, naphazoline)
  • delavirdine
  • desmopressin
  • divalproex
  • dronedarone
  • duloxetine
  • guanethidine
  • isoniazid
  • levofloxacin
  • lithium
  • MAO inhibitors (e.g., phenelzine, tranylcypromine)
  • methylphenidate
  • moxifloxacin
  • nilotinib
  • nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., celecoxib, diclofenac, ibuprofen, naproxen)
  • opioid analgesics (e.g., morphine)
  • other medications that can cause sedation (e.g., sedatives, sleeping pills, anaesthetics)
  • paroxetine
  • phenytoin
  • propafenone
  • propoxyphene
  • protease inhibitors for HIV (e.g., ritonavir, lopinavir, tipranavir)
  • quinidine
  • quinine
  • rifabutin
  • rifampin
  • selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, fluoxetine, fluvoxamine, sertraline)
  • St. John's wort
  • stimulant medications (e.g., appetite suppressants, epinephrine, norepinephrine)
  • terbinafine
  • tetrabenazine
  • thioridazine
  • tizanidine
  • tramadol
  • trazodone
  • valproic acid
  • warfarin
  • yohimbine
  • ziprasidone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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Depression Symptom Checker Tool

The Depression Symptom Checker tool can help you learn about depression. Use this tool to create a list of your symptoms and rate how much the symptoms impact your life on a daily basis. The checklist is divided into 6 symptom categories that are associated with depression. You can also learn more about symptoms of depression here.

For each statement choose a number from 0 to 4 that describes the impact on your daily life, where 4 has the highest impact and 0 has no impact:

  • 0 = no impact on daily life/no symptoms
  • 1 = mild impact on daily life
  • 2 = moderate impact on daily life
  • 3 = severe impact on daily life
  • 4 = debilitating impact on daily life

It is important to remember that this is not a “score” but a way to help you communicate how much you feel the symptom impacts your daily life. When you finish you will be able to print out your symptoms and share this information with your doctor. Use the Doctor Discussion Guide to prepare for your doctor’s visit.

Rate how much the following symptoms apply to you.

1. Emotions

Depression can affect anyone at any age, although it most commonly appears between 15 and 45 years of age.

0 1 2 3 4
0 1 2 3 4
0 1 2 3 4
0 1 2 3 4

Visit your doctor with these results, when booking your appointment inform your doctor that you may need extra time to discuss these matters. Getting help for your depression can change your life. Don’t wait- depression is an illness that can, and should be treated.

Thoughts about death or suicide are common in depression, and it’s important to take such thoughts seriously. If you feel like giving up or as if you might hurt yourself, get help immediately: call your doctor, go to the emergency room or call 911.

This tool is adapted with permission from similar content found on www.depressionhurts.ca.


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