Amitriptyline

• The dose of amitriptyline will be different for different people.
• Your doctor will usually start you on a low dose and increase this slowly. This allows your body to get used to the medicine and reduces side effects.
• Amitriptyline is usually prescribed as a single dose to be taken at bedtime, although your dose may be different.
• Always take your amitriptyline exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much amitriptyline to take, how often to take it, and any special instructions.
• If your tablets look different to your last supply, ask your doctor or pharmacist for advice.

• Timing: Take amitriptyline at the same times each day. It is usually taken as a single dose at bedtime, but your dose may be different. Swallow your amitriptyline tablets with a glass of water. You can take amitriptyline with or without food.
• Missed dose: If you forget to take your dose, take it as soon as you remember that day. But, if it is nearly time for your next dose, just take the next dose at the right time. Do not take double the dose.
• Avoid alcohol while you are taking amitriptyline. Drinking alcohol while taking amitriptyline can cause drowsiness and affect concentration, putting you at risk of falls and other accidents. It can also cause agitation, aggression and forgetfulness.  This is especially when you first start treatment. If you do drink alcohol, drink only small amounts and see how you feel. Do not stop taking your medication
• Keep taking amitriptyline every day. It may take a few weeks before you notice the full benefits of amitriptyline. If you think amitriptyline is not working for you, do not stop taking it suddenly; speak to your doctor or nurse before stopping.

Here are some things to know when you're taking amitriptyline. Other things may be important as well, so ask your healthcare provider what you should know about.

• Diabetes: if you have diabetes, you may need to check your blood glucose more often because amitriptyline can affect the levels of glucose in your blood. 
• Sun protection: amitriptyline can make your skin more sensitive to the sun. You may get a burning, tingling feeling on your skin when you are in the sun, or you may notice a darker tan or redness. When outside, protect your skin by using an SPF30+ sunscreen and clothing that protects you from the sun. Let your doctor know if you notice a rash when you first start taking amitriptyline. This could be an allergic reaction.
• Interactions: Amitriptyline interacts with many other medications and herbal supplements (such as St. John's Wort) so check with your doctor or pharmacist before starting amitriptyline or before starting any new medicines.

Like all medicines, amitriptyline can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Suicidal behaviour

The use of antidepressants has been linked with self-harm or suicidal thoughts and behaviour. Children, teenagers, young adults and people with a history of suicidal behaviour are most at risk. This is most likely during the first few weeks of starting treatment or if the dose is changed. It is important to look out for signs of suicidal behaviour such as suicidal thoughts, self-harm, worsening of low mood, agitation or aggression.

If you notice any of these signs, contact your doctor immediately. If you need urgent help or are concerned, phone:

• Lifeline 0800 543 354 (available 24/7), or
• Healthline 0800 611 116, who can give you the phone number for your local mental health crisis line.

Other side effects