Amitriptyline for neuropathic pain
Amitriptyline for neuropathic pain
This leaflet is about the use of amitriptyline for the treatment of neuropathic pain (pain caused by nerve damage).
This leaflet has been written specifically for parents and carers about the use of this medicine in children. The information may differ from that provided by the manufacturer. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again.
Do not stop giving amitriptyline suddenly, as your child may get withdrawal symptoms.
Name of drug
Amitriptyline (sometimes known as amitriptyline hydrochloride)
Why is it important for my child to take this medicine?
Amitriptyline will help your child to feel less pain.
What is amitriptyline available as?
- Tablets: 10 mg, 25 mg, 50 mg; these all contain small amounts of lactose
- Liquid medicine: 25 mg or 50 mg in 5 mL
When should I give amitriptyline?
- Amitriptiyline is usually given once each day, this is usually in the evening.
- However, you may have been told to give amitriptyline twice each day. This should be in the morning and in the evening.
Give the medicine at about the same time(s) each day so that this becomes part of your child’s daily routine, which will help you to remember.
How much should I give?
Your doctor will work out the amount of amitriptyline (the dose) that is right for your child. The dose will be shown on the medicine label.
It is important that you follow your doctor’s instructions about how much to give.
How should I give amitriptyline?
Tablets should be swallowed with a glass of water, milk or juice. Your child should not chew the tablet.
Liquid medicine: Measure out the right amount using a medicine spoon or oral syringe. You can get these from your pharmacist. Do not use a kitchen teaspoon as it will not give the right amount.
When should the medicine start working?
Pain caused by nerve damage can be difficult to treat. It may take a few days, or even weeks, for amitriptyline to work properly. Continue to give the medicine as you have been told to by your doctor.
What if my child is sick (vomits)?
- If your child is sick less than 30 minutes after having a dose of amitriptyline, give them the same dose again.
- If your child is sick more than 30 minutes after having a dose of amitriptyline, you do not need to give them another dose. Wait until the next normal dose.
If your child is sick again, seek advice from your GP, pharmacist or hospital. They will decide what to do based on your child’s condition and the specific medicine involved.
What if I forget to give it?
If you usually give amitriptyline once a day
- If you forget to give amitriptyline, you do not need to wake your child up to give the missed dose.
- You can give the missed dose in the morning, as long as this is 12 hours before the evening dose is due. However, if this is likely to make your child sleepy, it maybe better to forget the missed dose altogether and give the next evening dose as usual.
If you usually give amitriptyline twice a day
- If you forget to give amitriptyline, do not give the missed dose. Wait until the next normal dose.
If you have forgotten to give more than one dose, contact your doctor for advice.
Never give a double dose of amitriptyline.
What if I give too much?
It may be dangerous to give too much amitriptyline. If your child has any, or all, of the following symptoms, they may have had too much amitriptyline.
- The pupils (the black circles in the centre of the eye) may become very large.
- Your child may become very sleepy.
- They may have difficulty breathing, or their breathing may be slow.
- Their heart may race.
If there is any possibility that you may have given your child too much amitriptyline, take them to hospital or telephone for an ambulance straight away. Tell the doctor that your child may have had too much amitriptyline.
Take the medicine container or packet with you, even if it is empty. This will be useful to the doctor. Have the packet with you if you telephone for advice.
Are there any possible side-effects?
We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects).
Side-effects that you must do something about
Your child may have an irregular heart beat – they may say that their heart is racing or they have a fluttery feeling in their chest. If this happens, contact your doctor straight away.
If your child has problems with their eyesight (e.g. blurred or double vision), contact your doctor straight away.
Other side-effects you need to know about
- Your child may feel sleepy for a few hours after having a dose of amitriptyline. This is why it is best to give amitriptyline in the evening.
- Your child may have a dry mouth. Eating citrus fruits (e.g. oranges) and taking sips of water may help.
- When they first start taking amitriptyline, your child may feel sweaty, feel sick (nausea), have constipation (difficulty doing a poo) or find it difficult to pass urine (do a wee). These symptoms should settle down after a week or so as your child’s body gets used to the medicine.
- If your child still has any of these symptoms after 2 weeks, or you are worried, contact your doctor.
There may, sometimes, be other side-effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side-effects to a UK safety scheme at http://www.mhra.gov.uk/yellowcard.
Can other medicines be given at the same time as amitriptyline ?
- You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.
- Amitriptyline should not be taken with some common drugs that you get on prescription. Tell your doctor and pharmacist about any medicines your child is taking before starting amitriptyline.
- Check with your doctor or pharmacist before giving other medicines to your child. This includes herbal or complementary medicines.
Is there anything else I need to know about amitryptyline?
If your child has ever had a problem with their heart, tell your doctor before giving amitryptyline.
Do not suddenly stop giving amitriptyline to your child, as they may get withdrawal symptoms.
- If your doctor decides to stop amitryptyline, they will discuss this with you. You will usually reduce the dose bit by bit to make sure that your child doesn’t get withdrawal symptoms. Do not change the dose without talking to your doctor first.
- If amitriptyline does not seem to be helping your child’s pain, contact your doctor for advice. Remember that it make take a few weeks for amitriptyline to work.
- Amitriptyline is also used to treat depression but this is at a higher dose than used to treat neuropathic pain. The drug works in different ways at different doses.
- If your child has liquid medicine, keep a note of which strength they have, and make sure you are given the right one.
General advice about medicines
- Try to give the medicine at about the same time(s) each day, to help you remember.
- Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.
If you think someone else may have taken the medicine by accident, contact your doctor straight away.
- Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.
- Make sure that the medicine you have at home has not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.
Where should I keep this medicine?
- Keep the medicine in a cupboard, away from heat and direct sunlight. It does not need to be kept in the fridge.
- Make sure that children cannot see or reach the medicine.
- Keep the medicine in the container it came in.
Who to contact for more information
Your child’s doctor, pharmacist or nurse will be able to give you more information about amitriptyline and about other medicines used to treat neuropathic pain.
Version 2, January 2014. © NPPG, RCPCH and WellChild 2011, all rights reserved. Reviewed by: January 2017.
The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk
We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and
editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.