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
- 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.