amitriptyline hydrochloride at a glance
Medicine class
Tricyclic antidepressant with analgesic, anticholinergic and sedative properties
Food
Tablets and liquid may be taken with or without food
Alertness
May cause sleepiness, dizziness and reduced concentration; avoid driving or machinery if affected
What is amitriptyline hydrochloride used for?
Selected products are licensed for:
Major depressive disorder in adults.
Neuropathic pain in adults.
Prevention of chronic tension-type headache and migraine in adults.
Persistent nocturnal enuresis in children aged 6 years and over, after organic causes have been excluded and other treatments have failed; prescribing must be by an experienced clinician.
It is also sometimes used for pain associated with irritable bowel syndrome outside its licence.
How does amitriptyline hydrochloride work?
It reduces reuptake of serotonin and noradrenaline at nerve endings, supporting antidepressant effects and altering pain processing. Anticholinergic and antihistamine-like actions help explain dry mouth, constipation and sleepiness.
amitriptyline hydrochloride preparations and strengths
Oral solution
Route: Oral
Strengths: 10 mg/5 mL, 25 mg/5 mL, 50 mg/5 mL
Tablet
Route: Oral
Strengths: 10 mg, 25 mg, 50 mg
How to take amitriptyline hydrochloride
Follow the prescription and pack leaflet. It may be taken with or without food.
Swallow film-coated tablets whole with water.
Measure oral solution using the supplied oral syringe or medicine spoon, not a kitchen teaspoon.
Do not stop suddenly; discuss gradual withdrawal with the prescriber.
Alcohol can increase sleepiness and impaired concentration.
amitriptyline hydrochloride side effects
Common or expected effects
- Sleepiness or tiredness
- Dizziness, particularly on standing
- Dry mouth
- Constipation or nausea
- Headache or tremor
- Sweating
- Difficulty passing urine
- Palpitations
- Weight gain
Get urgent medical advice
- Fast or irregular heartbeat, fainting or severe chest pain
- Seizure
- Thoughts of self-harm or suicide
- Severe allergic swelling or breathing difficulty
- Eye pain with redness or altered vision
- Inability to pass urine or symptoms of bowel obstruction
- Jaundice or dark urine
- Widespread rash, blistering, fever or facial swelling
amitriptyline hydrochloride in pregnancy
It can be used when recommended by a specialist and is not known to harm the developing baby. Treatment should be reviewed rather than stopped abruptly. Use near delivery can cause temporary newborn feeding, sleeping or withdrawal symptoms, so the maternity team should know about its use.
amitriptyline hydrochloride while breastfeeding
It passes into breast milk in very small amounts and may be used cautiously when the infant is full-term and healthy. Monitor for unusual sleepiness, poor feeding, inadequate weight gain, irritability, constipation or fewer wet nappies.
amitriptyline hydrochloride interactions
Check prescribed, pharmacy and herbal products with a pharmacist or prescriber. Important interactions include:
Monoamine oxidase inhibitors
The combination is contraindicated because it can cause serious serotonin toxicity and cardiovascular effects.
Opioids, including tramadol
Sedation and breathing problems may increase. Tramadol also increases risks of seizures, serotonin syndrome and opioid toxicity.
SSRIs and CYP2D6 inhibitors, including fluoxetine, paroxetine and bupropion
They may increase exposure or serotonergic adverse effects.
Common questions about amitriptyline hydrochloride
Answers are fully visible for fast scanning and source review.
Can it be taken with food?
Yes. It can be taken with or without food.
Can I drive while taking it?
Do not drive, cycle or operate machinery if it causes sleepiness, dizziness, blurred vision or reduced concentration.
Can I stop it suddenly?
No. Discuss a gradual withdrawal plan with the prescriber.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.