What side effects can Amitriptyline have?
Below you will find the most important information about possible known side effects of amitriptyline.
These side effects do not occur, but you can. Because every person reacts differently to medication. Please also note that the type and frequency of side effects may vary depending on the drug formulation (eg tablet, syringe, ointment).
Very common side effects:
dry mouth, stuffy nose, tiredness, drowsiness, sweating, dizziness, low blood pressure, circulatory disorders, palpitations, cardiac arrhythmia, irritability, speech disorders, tremors, sharpness disorders, headache, constipation, weight gain, liver disease Enzyme increase in blood (mostly temporary).
Common side effects:
bladder dysfunction, restlessness, blood sodium deficiency, thirst, rash, taste disorders, movement disorders, pupil dilation, confusion, lack of concentration, libido loss, impotence, delirium (especially in elderly patients).
Uncommon side effects:
circulatory collapse, hypertension, fluid retention in the tissues (face, tongue), tinnitus, intestinal obstruction, diarrhea, urinary retention, white blood cell abnormalities, abnormal milk flow, liver dysfunction with bile-block, anxiety, paranoia, agitation, Cardiac arrhythmia, cardiac insufficiency, allergic skin reactions, allergic vasculitis, myocarditis.
Rare side effects:
hair loss, refusal of eating (anorexia), enlargement of the salivary gland, hypersensitivity, delusions, breast enlargement, body temperature increase.
Very rare side effects:
absence of granulocytes, brain cramps, facial movement disorders, generalized nervous disorders, glaucoma, allergic pulmonary alveoli (alveolitis, spoonbill syndrome), myocardial damage, special cardiac arrhythmias (Torsades de pointes).
Many of the unwanted side effects are most pronounced at the beginning of treatment and usually lessen as the body gets used to the drug.
Special risk groups such as epileptics, alcoholics or patients taking other psychotropic drugs at the same time may experience epileptic seizures.
In elderly or brain-damaged patients, the drug may induce delirium. Confusion states and other delirious symptoms such as disorientation or delusions are common, especially in the elderly and patients with Parkinson’s disease or Parkinson’s syndrome.
Acute overdose is characterized by over-excitability (including convulsions), impaired consciousness (even coma), cardiac arrhythmia and respiratory arrest. If you see signs of these symptoms, but also increased dry mouth or urinary problems and increased heart rate, this indicates a beginning of overdose. Talk to your doctor immediately.
Treatment with amitriptyline should not be stopped abruptly as it may cause side effects such as nausea, insomnia and anxiety. It is recommended to reduce the dose slowly (to escape).
In children, the treatment increases the risk of tooth decay (tooth decay). So you have to pay special attention to the daily dental care.
The widespread use of the drug has shown that ingestion may increase the risk of fractures.
What interactions does amitriptyline show?
Please note that the interactions may vary depending on the drug formulation of a drug (eg tablet, syringe, ointment).
Interactions of amitriptyline mainly consist of active ingredients that also counteract the effects of consciousness, such as sedatives and sleeping pills. With these remedies, but also with alcohol consumption, amitriptyline can increase the effectiveness of each other.
A mutual enhancement results with agents that have an anticholinergic effect like amitriptyline. These include, for example, phenothiazines (a group of psychotropic drugs), antiparkinsonian drugs such as biperiden, antihistamines (used as sleeping pills and against allergies) or atropine (for example, contained in eye drops).
Cimetidine (for gastric ulcers) and methylphenidate (used for example in hyperactive children) increase the effects and side effects of the drug amitriptyline.
Some vasoconstrictors (catecholamines), even if they only occur as an adjunct to local anesthetic, are potentiated by amitriptyline in its action on the nervous system.
Special medical attention is warranted when antidepressants of other classes of agents are or have been taken before or concurrently with amitriptyline. This applies in particular to the active substances fluoxetine and fluvoxamine, but also to other tricyclic antidepressants. Concurrent use of amitriptyline results in a mutual enhancement of the effect and an increase in the incidence of side effects. The dose of amitriptyline and / or the other antidepressants to be taken must therefore be adjusted by the doctor.
Antidepressants from the group of MAO inhibitors must not be taken together with amitriptyline because of serious side effects. The intake of MAO inhibitors must be stopped at least 14 days before taking amitriptyline. Even with a reverse change from amitriptyline to MAO inhibitors, this minimum interval of 14 days applies.
Neuroleptics, which also affect the psyche, strengthen amitriptyline in its action. This also applies to concomitant treatment with anticonvulsants such as benzodiazepines or barbiturates. Increased seizures of the central nervous system can occur here.
Amitriptyline may reduce or eliminate the effects of some drugs on high blood pressure such as guanethidine, reserpine, betanidine, clonidine. The same applies to the active ingredient alpha-methyldopa.
Special care should be taken with concomitant use of thyroid hormones, as unwanted cardiac-damaging effects can be exacerbated.
Anti-arrhythmic agents of the type of quinidine or amiodarone are potentiated by amitriptyline.
Drugs that accelerate the breakdown of amitriptyline in the liver, such as barbiturates, the epilepsy agents carbamazepine and phenytoin, such as nicotine or hormonal contraceptives, reduce the effects of amitriptyline. Carbamazepine and phenytoin are simultaneously enhanced in their action by amitriptyline.
Co-administration of coumarin-type coagulants such as phenprocoumon may result in changes in blood coagulation. The coagulation values must therefore be checked regularly by a doctor.