Amitriptine        Tablets

Amitriptyline  50mg

Usage and indications:

Amitriptine is indicated for depressive disorders

Dosage and administration: 

Initial Dose:

Adult Patients

The initial dose is to begin with 50 to100 mg then it may be increased if necessary to a total of 150 mg daily.

  • Hospitalized patients may initially require 100 mg daily, then it may be increased gradually if necessary to 200 mg daily, a small number of hospitalized patients may need as much as 300 mg daily.

Adolescent and Elderly Patients

  • In general, lower doses are recommended for them or as directed by the physician.  

Maintenance dose:

The usual maintenance dose is 50 to100 mg daily.

Undesirable effects:

The following adverse reactions may be observed:

Cardiovascular:

Myocardial infarction, stroke, nonspecific ECG changes, heart block, arrhythmias, hypotensionsyncope, hypertension, tachycardia and palpitation.

CNS and Neuromuscular:

Coma, seizures, hallucinations, delusions, confusion, ataxia, tremors, peripheral neuropathy, numbness, tingling, paresthesias of the extremities, dysarthria, disturbed concentration, excitement,  anxiety, insomnia, nightmares, drowsiness, dizziness, weakness, fatigue, headache, syndrome of inappropriate ADH (antidiuretic hormone) secretion and tinnitus.

Anticholinergic:

 Paralytic ileus, hyperpyrexia, urinary retention, dilatation of the urinary tract, constipation, blurred vision, disturbance of accommodation, increased ocular pressure, mydriasis and dry mouth.

Allergic:

Urticaria, photosensitization and edema of face and tongue.

Hematologic:

Bone marrow depression including agranulocytosis, leukopenia, thrombocytopenia, purpura and eosinophilia.

Gastrointestinal:

Nausea, vomiting, anorexia, stomatitis, peculiar taste, diarrhea, parotid swelling and rarely hepatitis (including altered liver function and jaundice).

Endocrine:

Testicular swelling and gynecomastia in males, breast enlargement and galactorrhea in females, increased or decreased libido, impotence, elevation and lowering of blood sugar levels.

Other:

Alopecia, edema, weight gain or loss, urinary frequency and increased perspiration.

Withdrawal Symptoms:   Abrupt cessation after prolonged administration of Amitriptine may produce nausea, headache and malaise. Gradual dosage reduction has been reported to produce, within two weeks, transient symptoms including irritability, restlessness, and sleep disturbance. These symptoms are not indicative of addiction.

Warnings and precautions:

  • Caution is advised with cardiac diseases particularly with arrhythmias, acute recovery phase following myocardial infarction, hepatic impairment (avoid if severe), pheochromocytoma, thyroid disease, history of seizures, psychoses, bipolar depression, urinary retention and angle-closure glaucoma.
  • All patients being treated with antidepressants for any indication should be monitored appropriately and observed closely for clinical worsening, unusual changes in behavior and suicidal ideation especially during the initial few months of a course of  Amitriptine therapy or at times of dose changes either increases or decreases.
  • The safety and the effectiveness of Amitriptyline have not been determined with individuals below 12 years of age, therefore it is not recommended at the present time for them.

Pack: box of 10 or 20 tablets

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