Elavil/Amitriptyline IS USED FOR:

The relief of depression. It may also be used to treat chronic pain and other conditions as determined by your doctor.

Amitriptyline/Elavil is a tricyclic antidepressant. How tricyclic antidepressants improve depression symptoms is not fully understood. They are thought to increase the activity of certain chemicals in the brain (norepinephrine, serotonin), which help improve mood.

BEFORE USING Elavil/Amitriptyline :

Some medical conditions may interact with Amitriptyline/Elavil . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you have allergies to medicines, foods, or other substances
• if you have a history of mental illness (eg, bipolar disorder, mania, manic-depression), or have considered or attempted suicide
• if you have a history of seizures, epilepsy, or porphyria
• if you have alcoholism or regularly consume 3 or more alcoholic beverages per day
• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you have glaucoma, an irregular heartbeat, heart disease, chest pain, liver disease, prostate problems, thyroid disease, or are unable to urinate (urinary retention)
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement

Some MEDICINES MAY INTERACT with Amitriptyline/Elavil . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Warfarin/Coumadin because side effects such as serious bleeding may be increased by Amitriptyline/Elavil
• Antihistamines (eg, diphenhydramine), cisapride, dofetilide, droperidol, fluoroquinolones (eg, ciprofloxacin/Cipro), ketolides (eg, telithromycin), macrolides (eg, erythromycin/Ilosone), mibefradil, pimozide, or streptogramins (eg, quinupristin/dalfopristin) because serious side effects on the heart (eg, racing heartbeat, dizziness, fainting, life-threatening abnormal heartbeat leading to unconsciousness, and lack of heartbeat, may be increased by Amitriptyline/Elavil
• Carbamazepine/Carbatrol, thyroid medicines (eg, levothyroxine/Levothroid), or stimulants (eg, albuterol/Albuterol sulfate , pseudoephedrine) because their side effects may be increased by Amitriptyline/Elavil
• MAO inhibitors (eg, phenelzine, selegiline/Eldepryl) because they can cause serious, sometimes life-threatening, reactions. Do NOT take MAO inhibitors with, or within 2 weeks of taking, Amitriptyline/Elavil
• Anticholinergics (eg, scopolamine), bupropion/Zyban sr, cimetidine, fluconazole/Diflucan, phenothiazines (eg, chlorpromazine/Thorazine), SSRIs (eg, fluoxetine/Rapiflux), terbinafine/Lamisil, or valproic acid because side effects such as blurred vision, difficult urination, drowsiness or sedation, dry mouth, or lightheadedness may occur
• Clonidine, guanethidine, or guanfacine because the effectiveness of these medicines may be decreased

This may not be a complete list of all interactions that may occur. Ask your health care provider if Amitriptyline/Elavil may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

HOW TO USE Elavil/Amitriptyline :

Use Amitriptyline/Elavil as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• If you miss a dose of Amitriptyline/Elavil , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
• Amitriptyline/Elavil may be taken with food or on an empty stomach.
• Amitriptyline/Elavil comes with an additional patient information sheet called a Medication Guide. Read it carefully and reread it each time you get Amitriptyline/Elavil refilled.
• Amitriptyline/Elavil may take up to 30 days to control symptoms of depression. Continue to use Amitriptyline/Elavil even if you feel well. Do not miss any doses.
• Avoid eating or drinking grapefruit juice while taking Amitriptyline/Elavil .

Ask your health care provider any questions you may have about how to use Amitriptyline/Elavil .

DO NOT USE Elavil/Amitriptyline IF:

• you are allergic to any ingredient in Amitriptyline/Elavil
• you are currently taking or have taken a monoamine oxidase (MAO) inhibitor (eg, phenelzine, selegiline/Eldepryl) within the last 14 days
• you are taking antihistamines (eg, diphenhydramine), cisapride, dofetilide, droperidol, fluoroquinolones (eg, ciprofloxacin/Cipro), ketolides (eg, telithromycin) macrolides (eg, erythromycin/Ilosone), mibefradil, or pimozide
• you are recovering from a heart attack

Contact your doctor or health care provider right away if any of these apply to you.

POSSIBLE SIDE EFFECTS OF Elavil/Amitriptyline :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Abnormal skin sensations; anxiety; bad taste in mouth; black tongue; blurred vision; clumsiness; constipation; diarrhea; difficulty speaking or swallowing; dilation of the urinary tract; disturbed concentration; dizziness; drowsiness; dry mouth; excitement; fever; hair loss; headache; heartburn; hives; incoordination; increased pressure in the eye; inflammation of the tongue; irritability; itching; loss of appetite; mood swings; nausea; nightmares; numbness; rash; restlessness; ringing in the ears; sensitivity to sunlight; sleeplessness; sweating; swelling; swelling of the face and tongue; sore throat; tearing; tingling; tiredness; upset stomach; urinary retention; vomiting; weakness; weight gain.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); confusion; delusions; disorientation; fast heartbeat; fainting; hallucinations; involuntary movements of tongue, face, mouth, or jaw (eg, protrusion of tongue, puffing of cheeks, puckering of mouth, chewing movements), sometimes accompanied by involuntary movements of the arms and legs; lightheadedness; pounding in the chest; seizures; tremors; unusual bleeding or bruising; yellowing of the skin or eyes.

IMPORTANT SAFETY INFORMATION:

• Avoid drinking alcohol or taking other medicines that cause drowsiness (eg, sedatives, tranquilizers) while taking Amitriptyline/Elavil . Amitriptyline/Elavil will add to the effects of alcohol and other depressants. Ask your pharmacist if you have questions about which medicines are depressants.
• Amitriptyline/Elavil may cause dizziness, drowsiness, or blurred vision. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Amitriptyline/Elavil . Using Amitriptyline/Elavil alone, with other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.
• Do not become overheated in hot weather or during exercise or other activities since heatstroke may occur.
• Involuntary and uncontrollable movements may develop in patients taking Amitriptyline/Elavil . Occurrence is highest among the elderly, especially women. The risk of developing these involuntary movements and the likelihood they will become permanent are increased with long-term use and with high doses. However, it is possible to develop these symptoms after short-term use at low doses. Contact your health care provider at once if any of the following occur: involuntary movements of the tongue, face, mouth, or jaw (eg, protrusion of tongue, puffing of cheeks, puckering of mouth, chewing movements), sometimes accompanied by involuntary movements of the arms and legs.
• Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Amitriptyline/Elavil .
• PREGNANCY and BREAST-FEEDING: Amitriptyline/Elavil has been shown to cause harm to the human fetus. If you plan on becoming pregnant, discuss with your doctor the benefits and risks of using this medicine during pregnancy. Amitriptyline/Elavil is excreted in the breast milk. Do not breast-feed while taking Amitriptyline/Elavil .
• Amitriptyline/Elavil may cause sensitivity to sunlight. Avoid prolonged exposure to the sun and other ultraviolet light (eg, tanning beds). Use sunscreens and wear protective clothing until tolerance is determined.
• Use caution in the ELDERLY because they may be more sensitive to its effects, especially lightheadedness upon standing; rapid heartbeat; breathing problems; difficult urination; and constipation.
• Alcoholic beverages, hot weather, exercise, and fever can increase dizziness. To prevent dizziness or fainting, sit up or stand slowly, especially in the morning. Also, sit or lie down at the first sign of dizziness or weakness.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.