Amitriptyline Tablets for Pain

10mg in the evening increased weekly up to 50mg in the evening

This information is to help you take the medication the doctor has prescribed for you.

In the past higher doses (i.e. over 75mg) of Amitriptyline were used as an anti depressant.  Research studies have shown us that by using much lower doses Amitriptyline can help long-term or ‘chronic’ pain.

The main side effect of Amitriptyline is to make you feel sleepy; therefore the best time to take it is in the evening.  The other most noticeable side effect that people find is a dry mouth.  A glass of water beside the bed at night will help and during the day sucking a sweet occasionally can help. These side effects wear off in the majority of people after a short period of time.

Amitriptyline works best if taken regularly and not on an ‘as required’ basis.  This is because slowly, over time, it alters chemicals in the brain that are involved in registering pain messages.

We suggest that you avoid driving for at least two days after starting or changing the dose of this medication.

Take the tablets as shown in the chart below:

If the pain is improved before getting to the higher doses stay on the dose that helps.

Other points to remember:

• If the side effects are too much when you increase the dose, stay on the lower dose for a further week, then try again.
• If you need to take longer between changing doses, then do – there is not a set time for reaching a certain dose.
• If you get to the highest dose (50mg) and the pain is better, the five tablets can be changed to one 50mg tablet.
• Do not take Amitriptyline in conjunction with St John’s Wort.
• If you feel that there is no improvement in your pain after 4-6 weeks at the highest tolerated dose then this medication may not be the right one for you.  Your doctor may want to try different ways of managing your pain.

If you are in any doubt about these tablets, or any other medication, contact your doctor for advice.

Leaflet first published August 2012. Review date August 2016.