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Amitriptyline

Amitriptyline is a medicine used for treating certain types of pain. 

It's available on prescription and comes as tablets and as a liquid.

You can take it:

  • to treat nerve pain (neuralgia)
  • to help prevent migraine attacks
  • to prevent chronic tension headache

Your GP may also prescribe it for back pain. This is known as 'off-label use'. Talk to your GP or pharmacist about off-label use.

Get emergency help

Get emergency help if you take too many tablets, have a serious allergic reaction or have serious side effects.

Serious allergic reaction

You might need to go to hospital if you have signs of a serious allergic reaction (anaphylaxis).

Emergency action required: Call 999 or 112 or go to an emergency department (ED) if:

  • you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
  • you're wheezing
  • you get tightness in the chest or throat
  • you have trouble breathing or talking
  • your mouth, face, lips, tongue or throat start swelling

If you take too much

Emergency action required: Call your GP immediately or go to your nearest emergency department (ED) if:

  • you take too much amitriptyline

Do this even if you feel well.

Do not drive yourself. Get someone else to drive you or call 999 or 112 for an ambulance.

Take the amitriptyline packet or the leaflet inside it, and any remaining medicine with you.

If you take too much amitriptyline you may also:

  • be sick (vomit)
  • feel drowsy
  • have a change in your heartbeat
  • have fits (seizures)

These are only some of the possible symptoms of an overdose. Read the patient information leaflet for a full list of symptoms.

Non-urgent advice: Find your patient information leaflet

Your patient information leaflet is the leaflet that comes with your medicine. You can find a digital version of the leaflet online.

Serious side effects

Serious side effects are rare.

Emergency action required: Call 999 or 112 or go to an emergency department (ED) if:

  • you’ve had a seizure or fit

Urgent advice: Speak to your GP immediately if you get:

  • a fast or irregular heartbeat
  • yellow skin, or the whites of your eyes go yellow
  • bruising, bleeding or a sore throat and fever
  • constant headaches, long lasting confusion or weakness, frequent muscle cramps
  • thoughts about harming yourself or ending your life
  • eye pain, a change in your eyesight, swelling or redness in or around the eye
  • blurred vision
  • constipation, a swollen stomach, fever and vomiting

When you start taking amitriptyline

Take amitriptyline in the evening or before you go to bed, because it can make you feel sleepy. 

You might start to feel better within a few weeks. But it can take 6 weeks for amitriptyline to reduce the amount of pain you feel.

Talk to your GP if you're thinking of stopping taking amitriptyline. It can cause extra side effects if you stop taking it suddenly. 

It's best to stop drinking alcohol while you're taking amitriptyline. Drinking alcohol with amitriptyline can make you sleepy and more unsteady on your feet.

Check if you can take amitriptyline

Check with a GP or pharmacist before starting to take amitriptyline if you:

  • already have a medical condition, including any problems with your heart or liver
  • are taking any other medicines or have taken any in the last 14 days
  • have had an allergic reaction to medicine in the past
  • have thoughts about harming yourself or ending your life
  • are trying to get pregnant, already pregnant or breastfeeding 

Do not give amitriptyline to children or anyone aged 18 or under unless your GP advises it.

Pregnant and amitriptyline

Talk to your GP before taking amitriptyline if you are pregnant, think you may be pregnant or trying for to get pregnant.

Amitriptyline is not recommended during pregnancy unless your GP thinks its benefits outweigh the risks.

It has been linked with a small risk of problems for the unborn baby if you take it in early or late pregnancy.

Breastfeeding and amitriptyline

Talk to your GP before taking amitriptyline if you're breastfeeding.

Amitriptyline passes into breast milk. It's been linked with side effects like sleepiness in breastfed infants. 

Your GP may prescribe other painkillers you can take instead.

Diabetes

Amitriptyline may change your blood sugar level if you have diabetes.

Monitor your blood sugar more often for the first few weeks of taking amitriptyline. Talk to a GP about your results. They may make changes to your diabetes treatment if needed.

Talk to your doctor if you’re worried about your blood sugar levels.

How and when to take amitriptyline

Always take amitriptyline exactly as you have been told. Follow the instructions on the medicine label or ask your GP, a pharmacist or a nurse if you're unsure.

Swallow the tablets with a drink of water. Do not chew them.

Most people take amitriptyline once a day before bedtime because it can make you feel sleepy.

If you find that you’re still feeling drowsy in the morning, you could try taking it earlier in the evening.

Amitriptyline does not usually upset your stomach so you can take it with or without food.

If amitriptyline makes you sleepy or dizzy, do not drive or use tools or machinery.

If you forget to take it 

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten dose.

If you forget a dose, leave out the missed dose and take your next dose as normal.

Side effects

Some of the side effects of amitriptyline will gradually improve as your body gets used to it.

Keep taking the medicine but talk to your GP, a pharmacist or nurse if side effects bother you or do not go away.

Side effects include:

  • constipation
  • dizziness
  • dry mouth
  • feeling sleepy
  • difficulty peeing
  • headache

See the patient information leaflet that comes with your medicine for a full list of side effects.

Non-urgent advice: Find your patient information leaflet

Your patient information leaflet is the leaflet that comes with your medicine. You can find a digital version of the leaflet online.

Report side effects

You can report any suspected side effects to the the Health Products Regulatory Authority (HPRA): report an issue - hrpa.ie

Taking amitriptyline with other medicines

Some medicines interfere with amitriptyline and can increase the chance of you having side effects. This includes herbal remedies, vitamins or supplements.

Make sure that your GP or pharmacist knows that you're taking amitriptyline before you start or stop any other medicine.

Tell your GP or pharmacist before taking amitriptyline if you are on any other medicine or have taken any other medicines in the last 14 days.

If you are going to have a general or local anaesthetic as part of surgery or dental treatment, tell your doctor or dentist that you are taking amitriptyline.

Fact check

This content was fact checked by a pharmacist, a GP, the National Medication Safety Programme (Safermeds) and the Health Products Regulatory Authority (HPRA).

Page last reviewed: 24 September 2021
Next review due: 24 September 2024

This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.