Amitriptyline Warnings and Precautions 

Some Amitriptyline Precautions and Warnings 

Some amitriptyline warnings and precautions to be aware of include: 

• Antidepressants (including amitriptyline) may increase the risk of suicidal thoughts or behaviors in children, teenagers,  and adults (see Antidepressants and Suicide for more information). Therefore, you should talk with your healthcare provider immediately  if you notice any changes in symptoms  or develop any new symptoms while taking amitriptyline. Some of these symptoms may include anxiety, hostility, agitation, panic, restlessness, hallucinations, extreme hyperactivity, and suicidal thoughts or behaviors. 
• People who have bipolar disorder or who have a family history of bipolar disorder should take special care before using antidepressants (including amitriptyline). 
• Amitriptyline can make schizophrenia worse. Discuss this with  your healthcare provider before  taking amitriptyline. 
• Because amitriptyline may affect a person's mental  or physical ability, use caution when driving, operating heavy machinery,  or performing other tasks that require concentration -- especially when first starting  the medication or when switching dosages. Make sure to understand how amitriptyline affects  you before performing any task  that requires mental or physical concentration.
• Amitriptyline can potentially interact with certain medications (see Amitriptyline Drug Interactions). 
• Amitriptyline may enhance the effects of alcohol, barbiturates,  and other medicines that can affect the brain. This may lead  to an increased risk  of drowsiness, dizziness, suicidal thoughts,  and other amitriptyline overdose symptoms. Make sure to talk with  your healthcare provider about drinking alcohol while  taking amitriptyline. 
• Amitriptyline is classified as a pregnancy Category C medicine by  the U.S. Food and Drug Administration (FDA). This means amitriptyline  may not be safe for use during pregnancy. Talk with your healthcare provider about  the benefits and the risks  of using amitriptyline during pregnancy (see Amitriptyline and Pregnancy  for more information). 
• Amitriptyline passes through breast milk and may cause harm to  your baby. Therefore, be sure to let your healthcare provider know (before taking amitriptyline)  if you are breastfeeding or plan to start breastfeeding. 
• If  you have a history of seizures, bladder problems, or glaucoma, you should  take special care when taking amitriptyline, as the medicine can make these conditions worse. 
• Talk with  your healthcare provider before taking amitriptyline  if you have any heart problems, as amitriptyline can affect the heart  and its electrical system. 
• Talk with your healthcare provider before taking amitriptyline  if you have hyperthyroidism (overactive thyroid)  or if you take  thyroid medication. 
• Taking amitriptyline while receiving electroshock  or electroconvulsive therapy (ECT) can increase your risk  of side effects. Talk with your healthcare provider about these risks. 
• If possible, amitriptyline should be stopped several days before surgery. 
• Amitriptyline may cause a dry mouth. Sucking hard candy, chewing gum,  or melting bits of ice in  your mouth can provide relief. 
• The elderly appear to be more sensitive to amitriptyline, which can increase their risk of side effects, such as delirium and confusion. In these particular situations, a healthcare provider will start people on lower doses of amitriptyline and monitor them more closely. 
• If you have diabetes, make sure to check your blood sugar levels more often when starting amitriptyline  or changing dosages. There have been reports of increased or decreased blood sugar levels in people who take  amitriptyline.
• For people taking amitriptyline, the skin may become more sensitive to the effects of the sun. Therefore, try and stay out of the sun whenever possible. When outside,  make sure that  you have adequate protection, such as protective clothing and sunscreen. 
• Do not treat yourself for the common cold,  a cough, or allergies without first talking with your healthcare provider. Some of these medicines can increase the risk of developing amitriptyline side effects. 
• Do not stop taking amitriptyline without first discussing it with your healthcare provider. Stopping the medicine abruptly may increase the risk of withdrawal symptoms. 
• Talk with your healthcare provider if  you have any liver problems, as the liver is important in clearing amitriptyline from the body. 

Who Should Not Take Amitriptyline? 

You should not take amitriptyline if you: 

• Are allergic  to amitriptyline, Elavil, or any inactive ingredient used to make amitriptyline. Your healthcare provider or pharmacist has a list of  the inactive ingredients used to make amitriptyline. 
• Have recently had a heart attack (known medically as a myocardial infarction). 
• Have used a monoamine oxidase inhibitor (MAOI) within the last 14 days. MAOIs include: 

1. Isocarboxazid (Marplan®) 
2. Phenelzine (Nardil®) 
3. Rasagiline (Azilect®) 
4. Selegiline (Eldepryl®, Emsam®, Zelapar®) 
5. Tranylcypromine (Parnate®). 

• Are taking cisapride (Propulsid®) due to an increased risk of  a dangerous change in heart rhythm. 

Amitriptyline Warnings and Precautions: Summary 

There are a number of situations in which amitriptyline should not be taken,  as well as several precautions and warnings people should be aware of with amitriptyline.  However, it is possible that not all of the precautions or warnings  for amitriptyline were discussed in this article. Therefore, you should talk with your healthcare provider about  the amitriptyline warnings  and precautions that may apply  to you.