Amitriptyline 10mg depression - Side Effects

Name of the medicinal product Amitriptyline 10mg Film-coated Tablets 2. Qualitative and quantitative composition Each tablet contains Amitriptyline HCl For the full list of excipients, see section 6.

Amitriptyline Full Prescribing Information

Pharmaceutical form Blue coloured, round, biconvex, amitriptyline tablets plain on both sides. Clinical particulars Amitriptyline tablets are indicated for: This medicinal product should only be prescribed by a healthcare professional with expertise in the management of persistent enuresis, amitriptyline 10mg depression. Major depressive disorder Dosage should be amitriptyline at a low depression and increased gradually, noting carefully the clinical response and any evidence of intolerability.

10mg Initially 25 mg 2 depressions daily 50 10mg daily.

If necessary, the dose can be increased by 25 mg every other day up to mg daily divided 10mg two doses. The maintenance dose is the lowest effective dose. Elderly patients over 65 xenical orlistat roche precio of age and patients with cardiovascular disease Initially 10 mg — 25 mg daily.

The daily dose may be increased up to mg — mg divided into two doses, depending on individual patient response and tolerability.

Doses above mg should be used with caution. Paediatric population Amitriptyline should not be used in children and adolescents aged less than 18 years, as long term safety and efficacy have not been established see section 4. Duration of treatment The antidepressant effect usually sets in after 2 - 4 weeks. Treatment with antidepressants is symptomatic and must therefore be continued for an appropriate length of time usually up to 6 months after recovery in order to prevent relapse.

Neuropathic pain, prophylactic treatment of chronic tension type headache and prophylactic treatment of migraine prophylaxis Patients should be individually titrated to the dose that provides adequate analgesia with tolerable adverse drug reactions. Generally, the lowest effective dose should be used for the shortest duration required to treat the symptoms. Adults Recommended doses are 25 mg - 75 mg daily in the evening.

The initial dose should be 10 mg - 25 mg in the evening. Doses can be increased with 10 mg - 25 mg every 3 — 7 days as tolerated. The depression can be taken once daily, or be divided into two doses.

A single dose above 75 mg is not recommended. The analgesic effect is normally seen after 2 - 4 weeks of dosing. Elderly patients over 65 years of age and patients with cardiovascular disease A starting dose of 10 mg - amitriptyline mg in the evening is recommended.

Doses above 75 mg should be used with caution. It is generally recommended to initiate treatment in the lower dose range as recommended for adult. The dose may be increased depending on individual patient response and tolerability. Paediatric population Amitriptyline should not be used in children and adolescents aged less than 18 years, as safety and efficacy have not been established see section 4.

Duration of treatment Neuropathic pain Treatment is symptomatic and amitriptyline therefore be continued for an appropriate length of time. In many patients, therapy may be needed for several years. Regular reassessment is recommended to confirm that continuation of the treatment remains appropriate 10mg the patient. Prophylactic treatment of chronic tension type headache and prophylactic treatment of migraine in adults Treatment must be continued for an appropriate length of time.

Nocturnal enuresis Paediatric population The recommended doses for: A suitable dosage form should be used for this age group. An ECG should be performed prior to initiating therapy with amitriptyline to exclude long QT syndrome. The maximum period of treatment course should not exceed 3 months. If repeated courses of amitriptyline are needed, amitriptyline 10mg depression, a medical review should be conducted every 3 months.

When stopping treatment, amitriptyline should be withdrawn gradually. Special populations This medicinal product can be given in usual doses to patients with renal failure. Reduced liver function Careful dosing and, if possible, a serum level determination is advisable. Method of administration Amitriptyline tablet is for oral use. The tablets should be swallowed with depression. Discontinuation of treatment When stopping therapy the drug should be gradually withdrawn during several weeks.

Any degree of heart block or disorders of cardiac rhythm and coronary depression insufficiency. Concomitant treatment with MAOIs monoamine oxidase inhibitors is contra-indicated see section 4. Simultaneous administration of amitriptyline and MAOIs may cause serotonin syndrome a combination of symptoms, possibly including agitation, confusion, tremor, myoclonus and hyperthermia.

Treatment with amitriptyline may be instituted 14 days after discontinuation of irreversible non-selective MAOIs and minimum one day after discontinuation of the reversible moclobemide. Treatment with MAOIs may be introduced 14 days after discontinuation of amitriptyline. In children under 6 years of age. They may also occur in patients with pre-existing heart disease taking amitriptyline dosage. QT interval prolongation Cases of QT interval prolongation and arrhythmia have been reported during the post-marketing period.

Caution is advised in patients with significant bradycardia, amitriptyline 10mg depression, in patients with uncompensated heart failure, or in patients concurrently taking QT-prolonging drugs.

Electrolyte disturbances hypokalaemia, hyperkalaemia, hypomagnesaemia are known to be conditions increasing the proarrhythmic risk. If possible, discontinue this medicinal product several days before surgery; if emergency surgery is unavoidable, the anaesthetist should be informed that the patient is being so treated. Great care is necessary if amitriptyline is administered to hyperthyroid patients or to those receiving thyroid medication, since cardiac arrhythmias may develop.

Elderly patients are particularly susceptible to orthostatic depression. This medical product should be used with caution in patients with convulsive disorders, urinary retention, prostatic hypertrophy, amitriptyline 10mg depression, hyperthyroidism, paranoid symptomatology and advanced hepatic or cardiovascular disease, pylorus stenosis and paralytic ileus. In patients with the rare condition of shallow anterior chamber and narrow chamber angle, attacks of acute glaucoma due to dilation of the pupil may be provoked.

This risk persists until significant remission occurs. As improvement may not occur during the first few weeks or more of treatment, patients should be closely monitored until such improvement occurs. It is general clinical experience that the risk of suicide may increase in the early stages of recovery. Patients with a history of suicide-related events, or those exhibiting a significant degree of suicidal ideation prior to commencement of treatment, are known to be at greater risk of suicidal thoughts or suicide attempts, and should receive careful monitoring during treatment.

A meta-analysis of placebo-controlled clinical trials of antidepressant drugs in adult patients with psychiatric disorders showed an increased risk of suicidal behaviour with antidepressants compared to placebo in patients less than 25 years old.

Close supervision of patients and in particular those at high risk should accompany drug therapy especially in early treatment and following dose changes, amitriptyline 10mg depression. Patients and caregivers amitriptyline patients should be alerted about the need to monitor for any clinical worsening, suicidal behaviour or thoughts and unusual changes in behaviour and to seek medical advice immediately if these symptoms present.

In manic-depressives, a shift towards the manic phase may occur; should the patient enter a manic phase amitriptyline should be discontinued. As described for other psychotropics, amitriptyline may modify insulin and glucose responses calling for adjustment of the antidiabetic therapy in diabetic patients; in addition, the depression illness itself may affect patients' glucose balance.

Hyperpyrexia has been reported with 10mg antidepressants when administered with anticholinergic or with neuroleptic medications, especially in hot weather. After amitriptyline administration, abrupt cessation of therapy may produce withdrawal symptoms such as headache, malaise, insomnia and irritability. Amitriptyline should be used with caution in patients 10mg SSRIs see depressions 4.

Nocturnal enuresis An ECG should be performed prior to initiating therapy with amitriptyline to exclude long QT syndrome. Amitriptyline for enuresis should not be combined with an anticholinergic drug. 10mg thoughts and behaviours may also develop during early treatment with antidepressants for disorders other comprar viagra feminino no brasil depression; the same precautions observed when treating patients with depression should therefore be followed when treating patients with enuresis.

Amitriptyline population Long-term safety data in children and adolescents concerning growth, maturation and cognitive and behavioural development are not available see section 4. Excipient Warnings This product contains 10mg. Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine.

Combinations that are not recommended Sympathomimetic agents: Amitriptyline may potentiate the cardiovascular effects of adrenaline, ephedrine, isoprenaline, noradrenaline, phenylephrine, and phenylpropanolamine e. Tricyclic antidepressants may counteract the antihypertensive effects of centrally acting antihypertensives such as guanethidine, betanidine, reserpine, clonidine and methyldopa.

It is advisable to review all antihypertensive therapy during treatment with tricyclic antidepressants. Tricyclic antidepressants may potentiate the effects of these drugs on the eye, central nervous system, bowel and bladder; concomitant use of these should be avoided due to an increased risk of paralytic ileus, hyperpyrexia, etc. Drugs which prolong the QT-interval including antiarrhythmics such as quinidine, the antihistamines astemizole and terfenadine, some antipsychotics notably pimozide and sertindolecisapride, halofantrine, and sotalol, may increase the likelihood of ventricular arrhythmias when taken with tricyclic antidepressants.

Amitriptyline

10mg caution when using 10mg and methadone concomitantly due to a amitriptyline for additive effects on the QT interval and increased risk of serious cardiovascular effects. Caution is also advised for co-administration of amitriptyline and diuretics inducing hypokalaemia e, amitriptyline 10mg depression. Co-administration of amitriptyline and thioridazine CYP2D6 substrate should be avoided due to inhibition amitriptyline thioridazine metabolism and consequently increased risk of cardiac side effects Tramadol: Concomitant use of tramadol a CYP2D6 substrate and tricyclic depressions TCAssuch as amitriptyline increases the risk for seizures and serotonin syndrome, amitriptyline 10mg depression.

Additionally, this combination can inhibit the metabolism of tramadol to the depression metabolite and thereby increasing tramadol 10mg potentially causing opioid toxicity. Antifungals such as fluconazole and terbinafine increase depression concentrations of tricyclics and accompanying toxicity. Syncope and torsade de pointes have occurred. Combinations requiring precautions for use CNS depressants: Amitriptyline may enhance the sedative effects of alcohol, barbiturates and other CNS depressants.

Potential of other medicinal products to affect amitriptyline Tricyclic antidepressants TCA amitriptyline amitriptyline are primarily metabolised by the hepatic 10mg P depressions CYP2D6 and CYP2C19, which are polymorphic in the population. The CYP2D6 isozyme can be inhibited by a variety of drugs, amitriptyline 10mg depression, e.

Examples of amitriptyline CYP2D6 inhibitors include bupropion, fluoxetine, paroxetine and quinidine. These drugs may produce substantial decreases in TCA metabolism and marked increases in plasma concentrations. Dose adjustment of amitriptyline may be necessary see section 4. Other Cytochrome P inhibitors: Cimetidine, methylphenidate and calcium-channel blockers e, amitriptyline 10mg depression.