Introduction
Amilin 25 is used in the
treatment of depression. It is also used to treat and prevent chronic nerve-related
(neuropathic) pain, migraine, tension-type headache and nighttime bedwetting
(nocturnal enuresis) by older children (6 years and above) at different doses.
Amilin 25 is known as a tricyclic antidepressant. It is normally taken before
bedtime because it can make you feel sleepy. It can be taken with or without
food. The dose and how often you need to take it will be decided by your doctor
so that you get the right amount to control your symptoms. It may be increased
gradually. This medicine may not work straight away and it could be several
weeks before you get the full effects. How long you need to use it will depend
on what you are taking it for, but it is important to continue taking this
medication even if you feel well. Do not suddenly stop taking it without
consulting your doctor as it may make your condition worse. Your dose may be
modified or gradually decreased before stopping the medication. The most common
side effects of this medicine include increased heart rate, constipation, dizziness,
feeling thirsty or tired, dry mouth and difficulty urinating. It may also make
you aggressive or confused and can lead to weight gain in some people. This
medicine is not addictive, but you can experience additional side effects
(withdrawal symptoms) if you stop taking it suddenly. Most of the common side
effects tend to be mild. Your doctor may be able to suggest ways of preventing
or reducing side effects if they bother you or do not go away. Serious side
effects associated with this medicine are rare.
Uses of Amilin 25
Depression
Neuropathic pain
Migraine
Side effects of Amilin 25
Common
Constipation
Difficulty in urination
Dryness in mouth
Increased heart rate
Orthostatic hypotension (sudden
lowering of blood pressure on standing)
Weight gain
Aggressive behavior
Agitation
Nasal congestion (stuffy nose)
How to use Amilin 25
Take this medicine in the dose
and duration as advised by your doctor. Swallow it as a whole. Do not chew,
crush or break it. Amilin 25 may be taken with or without food, but it is
better to take it at a fixed time.
How Amilin 25 works
Amilin 25 is a tricyclic
antidepressant. It works by increasing the levels of chemical messengers in the
brain that help in regulating mood and treat depression. It also stops the
transmission of pain signals from nerves to the brain thereby relieving
neuropathic pain (pain from damaged nerves).
What if you forget to take Amilin
25?
If you miss a dose of Amilin 25,
take it as soon as possible. However, if it is almost time for your next dose,
skip the missed dose and go back to your regular schedule. Do not double the
dose.
Quick Tips
It may take 4 to 6 weeks for
Amilin 25 to start working. Keep taking it as prescribed.
It may cause sleepiness. Take it
at bedtime and do not drive or do anything requiring concentration until you
know how it affects you.
Avoid consuming alcohol when
taking Amilin 25 as it may cause excessive sleepiness.
Monitor your weight during the
treatment as this medicine can cause weight gain and increased appetite.
It may cause sudden drop in your
blood pressure. Rise slowly if you have been sitting or lying down.
Talk to your doctor if you notice
sudden mood changes or develop suicidal thoughts.
Brief Description
Indication
Adult: PO Depression
Initial:50-75 mg/day; up to 150 mg/day if needed. Max: 300 mg/day in severe
cases. Neuropathic pain Initial: 10-25 mg/day at night, up to 75 mg/day if
needed. Migraine prophylaxis Initial: 10 mg/day at night. Maintenance: 50-75
mg/day at night. Elderly: Initially, 25-50 mg/day as a single dose (at bedtime)
or in divided doses.
Administration
Increased risk of serotonin
syndrome w/ SSRIs, TCAs, triptans, fentanyl, lithium, tramadol. May reduce
plasma levels w/ barbiturates, rifampicin and other anticonvulsants. May increase
plasma levels w/ methylphenidate, cimetidine, antipsychotics, Ca channel
blockers. May precipitate cardiac arrhythmias w/ thyroid hormones. May reduce
antihypertensive effects of debrisoquine, guanethidine and clonidine. May
increase pressor effect of epinephrine and norepinephrine. May increase the
risk of ventricular arrhythmias w/ antiarrhythmics (e.g. amiodarone or
quinidine), antihistamines astemizole, terfenadine, some antipsychotics
(pimozide, sertindole, and thioridazine), sotalol, cisapride and halofantrine.
Potentially Fatal: Increased risk of serotonin syndrome w/ MAOIs, linezolid and
methylene blue.
Adult Dose
Bipolar illness, pregnancy,
lactation elderly, CVS disease, renal or liver impairment, epilepsy, thyroid
dysfunction, DM. Avoid abrupt withdrawal; urinary retention, prostatic
hyperplasia; chronic constipation; angle-closure glaucoma; phaeochromocytoma.
Monitor for signs of clinical worsening, suicidality or behavioural changes.
May increase risks associated with electro-convulsive therapy. May affect
ability to drive or operate machinery. Lactation: Distributed in breast milk;
do not nurse (AAP states effect on nursing infants is unknown but may be of
concern)
Renal Dose
Amitriptyline is a
dibenzocycloheptadiene tricyclic antidepressant. It increases synaptic
concentration of serotonin and/or norepinephrine in the CNS by blocking the
neuronal reuptake of norepinephrine and serotonin.
Contraindication
PO Depression Child: Adolescent:
Initially, 25-50 mg/day as a single dose (at bedtime) or in divided doses.
Nocturnal enuresis Child: 6-10 yr 10-20 mg/day; 11-16 yr 25-50 mg/day. All
doses to be given at bedtime. Max duration: 3 mth.
Mode of Action
May be taken with or without
food.
Precaution
Migraine headache, Depression,
Neuropathic pain, Post-herpetic neuralgia, Nocturnal enuresis
Pregnancy Category Note
Postural hypotension,
tachycardia, conduction disturbances. Dry mouth, wt gain, sour or metallic
taste, stomatitis, constipation; blurring of vision, urinary retention,
fatigue, dizziness, weakness, tremors, headache, confusion and delirium in
elderly, sexual disturbances; peripheral neuropathy; urticaria, angioedema,
sweating. Potentially Fatal: Cardiac arrhythmias.
Interaction
Hypersensitivity, use of MAO
inhibitors within the last 14 days; acute recovery phase post-MI. Concurrent
usage with cisapride.
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