When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use if you had an allergic reaction to amitriptyline.

How to Use This Medicine:
Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine with cisapride. Do not use this medicine and an MAO inhibitor (MAOI) within 14 days of each other.
• Some medicines and foods can affect how amitriptyline works. Tell your doctor if you are using cimetidine, disulfiram, or guanethidine. Tell your doctor if you are using other medicine for depression (such as fluoxetine, paroxetine, sertraline), a phenothiazine medicine (such as promethazine, chlorpromazine), medicine for heart rhythm problems (such as flecainide, propafenone, quinidine), or thyroid medicine.
• Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have liver disease, heart disease, diabetes, narrow-angle glaucoma, a seizure disorder, a thyroid problem, or trouble urinating.
• For some children, teenagers, and young adults, this medicine may increase mental or emotional problems. This may lead to thoughts of suicide and violence. Talk with your doctor right away if you have any thoughts or behavior changes that concern you. Tell your doctor if you or anyone in your family has a history of bipolar disorder or suicide attempts.
• This medicine may cause the following problems:
  
  • Heart rhythm problems
  • High or low blood sugar levels
• This medicine may make you dizzy or drowsy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Anxiety, restlessness, seeing or hearing things that are not there
• Chest pain, trouble breathing
• Fast, pounding, or uneven heartbeat
• Feeling more excited or energetic than usual, racing thoughts, trouble sleeping
• Lightheadedness, dizziness, or fainting
• Seizures
• Thoughts of hurting yourself or others, unusual behavior
• Unusual bleeding or bruising

If you notice these less serious side effects, talk with your doctor:

• Blurred vision, dry mouth, fever
• Change in how much or how often you urinate
• Constipation, diarrhea, nausea, vomiting
• Drowsiness, sleepiness
• Sexual problems

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088