See Supplemental Patient Information
- Amitriptyline increases the risk of suicidal tendencies and behavioral changes in children, adolescents, and young adults with major depressive disorder (MDD) or other psychiatric disorders [US Black Box Warnings]
- Closely monitor all the patients treated with antidepressants for any indication for clinical worsening, suicidality, and unusual changes in behavior, especially during the initial few months of a course of drug therapy, or at times of dose changes, either increases or decreases [US Black Box Warnings]
- A major depressive episode may be the initial presentation of bipolar disorder. Patients with depressive symptoms should be adequately screened to determine if they are at risk for bipolar disorder prior to initiating treatment with an antidepressant, as treating with an antidepressant alone may increase the likelihood of precipitation of a mixed/manic episode in patients at risk for bipolar disorder
- Amitriptyline hydrochloride can block the antihypertensive action of guanethidine or similarly acting compounds
- Use cautiously in patients with a history of urinary retention, angle-closure glaucoma or increased intraocular pressure as amitriptyline has atropine-like action and even average doses may precipitate an attack
- Arrhythmias, sinus tachycardia, prolongation of the conduction time, myocardial infarction and stroke have been reported with tricyclic antidepressant drugs, including amitriptyline, particularly when given in high doses, closely monitor patients with cardiovascular disorder
- Closely monitor hyperthyroid patients or those receiving thyroid medication when amitriptyline is administered
- Amitriptyline may enhance the response to alcohol and the effects of barbiturates and other CNS depressants thereby increasing the danger inherent in any suicide attempt or overdosage
- Amitriptyline causes delirium when coadministered with disulfiram
- There may be exaggeration of symptoms in patients with schizophrenia, paranoid symptomatology, manic-depressive illness. In these circumstances reduce the dose of amitriptyline or coadminister major tranquilizer such as perphenazine
- Concurrent administration of amitriptyline hydrochloride and electroshock therapy may increase the hazards in depressed patients, limit the use to patients for whom it is essential or discontinue the drug several days before elective surgery
Cautions: Use cautiously in
- Hepatic impairment
- Cardiovascular disorder
- Angle-closure glaucoma
- Increased IOP
- Urinary retention
- Prostatic hypertrophy
- History of seizure disorder
- Diabetes mellitus
- Susceptibility to angle closure glaucoma
- Electroconvulsive therapy
- Psychotic disorder
- Suicidal tendencies
- Alcohol abuse
- Thyroid disorder
Supplemental Patient Information
- Patient's families, and caregivers should be informed and instructed to be alert for the unusual changes in behavior, worsening of depression, and suicidal ideation, especially early during antidepressant treatment and when the dose is adjusted up or down and immediately report such symptoms to the health professional
- Patients should be advised to avoid excessive use or alcohol during the therapy
Pregnancy Category:C
Breastfeeding: Amitriptyline and its metabolites are excreted in breastmilk in small amounts. Immediate adverse events have not been reported and limited data on follow-up found no adverse events on growth and development. Usually not expected to cause any adverse effects in breastfed infants, especially if the infant is older than 2 months however other agents with fewer active metabolites may be preferred when larger doses are required; especially while nursing a newborn/preterm infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 17 February 2011). Because of the potential for possible serious adverse reactions in nursing infants a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Pricing data from www.DrugStore.com in U.S.A.
- Amitriptyline HCl 150 MG TABS [Bottle] (QUALITEST)
90 mg = $20.99
180 mg = $38.97 - Amitriptyline HCl 100 MG TABS [Bottle] (QUALITEST)
30 mg = $13.99
60 mg = $15.97 - Amitriptyline HCl 75 MG TABS [Bottle] (QUALITEST)
100 mg = $15.99
300 mg = $39.96
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
