IMPORTANT NOTE: The following information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist or other healthcare professional. It should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. Consult your healthcare professional before using this drug.

TRICYCLIC ANTIDEPRESSANTS - ORAL, INJECTION

COMMON BRAND NAME(S): Adapin, Asendin, Aventyl, Elavil, Endep, Norpramin, Pamelor, Sinequan, Surmontil, Tofranil, Vivactil

USES: This medication is used to treat depression, obsessive- compulsive disorders, and bed-wetting in children over 6 years of age (enuresis).

ELAVIL: Amitriptyline is in a class of drugs called tricyclic antidepressants. Amitriptyline affects chemicals in the brain that may become unbalanced and cause depression. Amitriptyline is used to relieve symptoms of depression such as feelings of sadness, worthlessness, or guilt; loss of interest in daily activities; changes in appetite; tiredness; sleeping too much; insomnia; and thoughts of death or suicide. Amitriptyline is also sometimes used to treat certain types of pain. Elavil may also be used for purposes other than those listed in this medication guide.
 
OTHER USES: Elavil may also be used to treat nerve pain, sleeping problems (insomnia), and has other uses as determined by your doctor.

HOW TO USE: Use Elavil as prescribed. Try to use each dose at the same time(s) each day so you remember to routinely use it. It may take 2 to 3 weeks before the full benefit of this medication becomes apparent. Do not stop using this medication without your doctor's approval. Nausea, headache or fatigue can occur if the drug is suddenly stopped.

SIDE EFFECTS: May cause drowsiness, dizziness, increased sun sensitivity or blurred vision. May initially cause dizziness and lightheadedness when rising too quickly from a sitting or lying position. Other side effects include heartburn, loss of appetite, dry mouth, strange taste in mouth, anxiety, restlessness or sweating. If any side effects persist or worsen, notify your doctor. Report promptly: chest pain, rapid or irregular heartbeat, difficulty urinating, nightmares, ringing in the ears, excessive drowsiness, uncoordinated movements, fainting. Taking this medication at bedtime may help minimize side effects. Talk to your doctor about this. In the unlikely event you have an allergic reaction to Elavil, seek medical attention immediately. Symptoms of an allergic reaction include: rash, itching, swelling, dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist.

PRECAUTIONS: Before using this drug tell your doctor your medical history, especially of: glaucoma, prostate problems, decreased urine output, thyroid disease, breathing problems, seizure problems, alcohol use, heart disease, mental/emotional problems, liver or kidney disease, any drug allergies. Use caution when engaging in tasks requiring alertness such as driving or operating machinery. Limit alcohol consumption as it may increase the drowsiness and dizziness effects of this drug. Limit exposure to hot weather as it may lead to heat stroke. Caution is advised when using Elavil in the elderly, because they may be more sensitive to the effects of the drug (e.g., confusion may occur or worsen). This drug should be used during pregnancy only if clearly needed. Discuss the risks and benefits with your doctor. This drug may be excreted into breast milk. The effects on the infant are not known at this time. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: Inform your doctor about the medicines you take, especially if you take: clonidine, guanadrel, guanethidine, MAO inhibitors (e.g., furazolidone, linezolid, phenelzine, selegiline, tranylcypromine), cimetidine, SSRIs (e.g., fluoxetine, sertraline), warfarin, carbamazepine, certain diet pills (e.g., phentermine, fenfluramine), adrenaline-type drugs (e.g., dopamine, ephedrine, epinephrine, pseudoephedrine, phenylephrine, isoproterenol- some of which may be found in cough-and-cold or asthma products), narcotic pain medications (e.g., codeine), cisapride, St John's wort, any other prescription or nonprescription drugs you take. Do not start or stop any medicine without doctor or pharmacist approval.

OVERDOSE: If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms ofoverdose may include agitation, confusion, hallucinations, fever, irregular movement of the eyes, seizures, change in amount of urine, dry mouth or nose, constipation, large pupils, drowsiness, slow or shallow breathing, dizziness, unconsciousness, unusually fast or slow heartbeat, or flushing..

NOTES: Do not allow anyone else to use this medication.

MISSED DOSE: If you miss a dose of Elavil and are taking more than 1 daily: do not take it if it is almost time for the next dose, instead, skip the missed dose and resume your usual dosing schedule. If you take it once daily at bedtime, do not take it the following morning. Call your doctor. Do not double the dose to catch up.

STORAGE: Store at room temperature away from moisture and sunlight. Do not store in the bathroom. Do not freeze liquid forms of this medication.