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Amitriptyline should not be used with monoamine oxidase inhibitors (MAOIs). High fever, convulsions and even death can occur when these two types of drugs are used together.

Epinephrine should not be used with amitriptyline, since together they can cause severe high blood pressure.

Alcohol blocks the antidepressant action of amitriptyline but increases its sedative effect. Cimetidine (Tagamet) can increase blood levels of amitriptyline and its side effects by preventing the elimination of amitriptyline.

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Serious side effects have been reported with amitriptyline. See “Drug Precautions” section.

Common side effects of amitriptyline include:

• nausea
• vomiting
• weakness
• drowsiness
• dizziness
• dry mouth
• headache
• blurred vision
• change in appetite and weight
• constipation
• trouble urinating
• pain or tingling in the hands or feet
• changes in sex drive
• excessive sweating
• confusion
• orthostatic hypotension
• tachycardia (fast heart beat)

This is not a complete list of amitriptyline side effects. Ask your doctor or pharmacist for more information.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• monoamine oxide (MAO) inhibitors such as selegiline (Emsam) and phenelzine (Nardil)
• cimetidine (Tagamet)
• disulfiram (Antabuse)
• cisapride (Propulsid)
• quinidine (Quinidex)
• anti-arrhythmic drugs such as flecainide (Tambocor) and propafenone (Rythmol)
• barbiturates such as phenobarbital (Donnatal)
• selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa) and fluoxetine (Prozac)
• epinephrine
• pseudoephedrine (Sudafed)
• guanethidine (Ismelin)
• alcohol

This is not a complete list of amitriptyline drug interactions. Ask your doctor or pharmacist for more information.

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of amitriptyline, there are no specific foods that you must exclude from your diet when receiving amitriptyline.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Amitriptyline falls into category C. It is not known if amitriptyline will harm your unborn baby. This medication may be given to a pregnant woman if her healthcare provider believes that its benefits to the pregnant woman outweigh any possible risks to her unborn baby.

Tell your doctor if you are breastfeeding or plan to breastfeed.

You should not take amitriptyline if you are breastfeeding. It can be excreted in your breast milk and may harm your nursing child.

Take amitriptyline exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

Your doctor will prescribe the appropriate dose and schedule of amitriptyline depending on your condition, age, and response to the medication. Doses of amitriptyline may range from 10 to 150 mg a day. The maximum daily dose of amitriptyline in the hospital setting is 300 mg a day.

Store amitriptyline at room temperature.

Keep in a tight, light-resistant container.

Keep this and all medicines out of the reach of children.