Uses:
Amitriptyline is used to relieve symptoms of depression such as feelings of sadness, worthlessness, or guilt; loss of interest in daily activities; changes in appetite; tiredness; sleeping too much; insomnia; and thoughts of death or suicide. Elavil is also sometimes used to treat certain types of pain.

How To Take This Medication:
Amitriptyline comes as a tablet to take by mouth. It is usually taken one to four times a day and may be taken with or without food. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take amitriptyline exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Continue to take amitriptyline even if you feel well. Do not stop taking amitriptyline without talking to your doctor, especially if you have taken large doses for a long time. Your doctor probably will want to decrease your dose gradually. This drug must be taken regularly for a few weeks before its full effect is felt.

Side Effects:

Side effects that may go away during treatment include:

• upset stomach
• drowsiness
• weakness or tiredness
• excitement or anxiety
• insomnia
• nightmares
• dry mouth
• skin more sensitive to sunlight than usual
• changes in appetite or weight

Tell your doctor if any of these symptoms are severe or do not go away:

• constipation
• difficulty urinating
• frequent urination
• blurred vision
• changes in sex drive or ability
• excessive sweating

If you experience any of the following symptoms, call your doctor immediately:

• jaw, neck, and back muscle spasms
• slow or difficult speech
• shuffling walk
• persistent fine tremor or inability to sit still
• fever
• difficulty breathing or swallowing
• severe skin rash
• yellowing of the skin or eyes
• irregular heartbeat

Cautions:
Use caution when driving, operating machinery, or performing other hazardous activities. Elavil may cause drowsiness or dizziness. If you experience drowsiness or dizziness, avoid these activities.

Dizziness is likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall.

Drug Interactions:
Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking Elavil (Amitriptyline).

Before taking amitriptyline,

• tell your doctor and pharmacist if you are allergic to amitriptyline or any other drugs.
• tell your doctor and pharmacist what prescription and nonprescription drugs you are taking or have taken within the last 2 weeks, especially anticoagulants [warfarin (Coumadin)]; antihistamines; cimetidine(Tagamet); estrogens; fluoxetine (Prozac); cisapride (Propulsid); levodopa (Sinemet, Larodopa); lithium (Eskalith, Lithobid); MAO inhibitors [phenelzine (Nardil), tranylcypromine (Parnate)]; medication for high blood pressure, seizures, Parkinson's disease, diabetes, asthma, colds, or allergies; methylphenidate (Ritalin); muscle relaxants; oral contraceptives; sedatives; sleeping pills; thyroid medications; tranquilizers; and vitamins.
• tell your doctor if you have or have ever had glaucoma, an enlarged prostate, difficulty urinating, seizures, an overactive thyroid gland, or liver, kidney, or heart disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking amitriptyline, call your doctor immediately.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking amitriptyline.
• you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.
• remember that alcohol can add to the drowsiness caused by this drug.
• tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of this drug.

Notes:
If overdose is suspected, contact your local poison control center or emergency room immediately.

Missed Dosage:
If you take several doses per day, take the missed dose as soon as you remember it and take any remaining doses for that day at evenly spaced intervals. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule.

If you take amitriptyline once a day at bedtime and do not remember to take it until the next morning, skip the missed dose. Do not take a double dose to make up for a missed one.

Storage: Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.