► Amitriptylinum VP (Amitriptyline) - Practical Medicine

Amitriptylinum VP (amitriptyline) - coated tablets

The name of the preparation Character; dose; package Manufacturer Price 100% Price after refund In which pharmacy?
Amitriptylinum VP coated tablets; 10 mg; 60 tables PharmaSwiss / Valeant 6.62 5.76
Amitriptylinum VP coated tablets; 25 mg; 60 tables PharmaSwiss / Valeant 11.17 9.01

Note: reimbursed drug prices are in line with the regulations in force from July 1, 2018.

The preparation contains the substance:amitriptyline

The drug is available on prescription

What is Amitriptylinum VP?

A preparation with antidepressant effect, belonging to the group of tricyclic antidepressants.

What does Amitriptylinum VP contain and how does it work?

Amitriptyline is a medicine from the group of tricyclic antidepressants that has a calming and anxiolytic effect. The full therapeutic effect is observed after a dozen or so days of use. The mechanism of action consists in inhibiting the uptake of norepinephrine and serotonin by neurons of the central nervous system. Amitriptyline has a balanced effect on the uptake of both compounds. It has a strong cholinolytic effect both in the central nervous system and in the periphery (in other tissues and organs). The effects of cholinolytic treatment include, among others: mydriasis, bronchiectasis, slowing of intestinal motility, reduction of gland secretion, increase of body temperature, stimulation of the central nervous system.

When should I use Amitriptylinum VP?

The preparation is indicated for the treatment of depressive symptoms, especially in those conditions when the patient needs calming.

When not to use this preparation?

Unfortunately, even if there are indications to use the preparation, it can not always be used. You can not use the preparation if you are allergic (you are hypersensitive) to any of the ingredients of the preparation or benzodiazepines.
Contraindications to the use of the preparation are also:
· Recent myocardial infarction, atrial conduction abnormalities, arrhythmias, angina
· Manic arousal
· Severe liver failure
· porphyria
· Breastfeeding period
· Under 16 years of age
· Parallel or up to 14 days after discontinuation, use with monoamine oxidase inhibitors (eg selegiline, moclobemide).

Take special care with Amitriptylinum VP?

Certain diseases and other circumstances may constitute a contraindication to use or indication to change the dosage of the preparation. In some situations it may be necessary to carry out specific check-ups.
The effects of using the product may occur only after a few weeks of treatment, sometimes this time is longer. Patients should be under strict medical supervision until they recover.Other psychiatric disorders in which amitriptyline is prescribed may also be associated with an increased risk of suicidal behavior. In addition, these conditions can co-exist with severe depressive disorders. People treated with this preparation because of other than depression, as well as people who have attempted suicide, and those who have a significant degree of suicidal tendency before starting treatment should be closely monitored by a doctor.
The group of special risk are people under 25 years of age. Also, during the change of dosage, the patient should be covered by special medical care. Patients and those around them should pay attention to any clinical sign of disease severity, suicidal behavior or thoughts or abnormal changes in behavior, and contact their physician immediately if they occur.

In people with bipolar disorder, the manic phase may be exacerbated by the use of the preparation; in people with schizophrenia, amitriptyline may increase the symptoms of the disease; it is also possible to intensify paranoid symptoms.

Because of the cholinolytic effect, the following persons should be careful when using it:
· With overgrowth of the prostate gland (possibility of increased difficulty in passing urine)
· With closed-angle glaucoma (possible increase in intraocular pressure)
· With a slow gastrointestinal passage.

In people with epilepsy under the influence of amitriptyline, symptoms may increase. Your doctor will probably recommend increasing the doses of antiepileptic drugs.

If high doses are used, special care should be taken as it may lead to arrhythmia, tachycardia and decreases in blood pressure. People with heart disease are particularly at risk, who may experience this effect even after using normal doses of the drug.

Caution should be exercised in people with impaired liver function due to the possibility of drug accumulation in the blood and possible symptoms of overdose.

In patients with hyperthyroidism and those treated with thyroid preparations, the drug may be more potent, caution should be exercised, the doctor will probably recommend appropriate modification of the dosage.

After consultation with a doctor, the preparation should be discontinued days before the planned surgery.

The use of electroconvulsive therapy during treatment with this preparation is not recommended.

Abrupt discontinuation of treatment, especially after prolonged use, can lead to numerous side effects; Dosage should be reduced gradually, in consultation with the physician.

In the following cases, the preparation can only be used if your doctor thinks that the risk is lower than the potential benefits:
· Alcoholism (possibility of intensifying the central nervous system inhibitory effect)
· Blood composition disorders
· asthma
·\turinary retention.

Does this preparation affect the ability to drive vehicles?
The preparation may impair your ability to drive or use machines. Be careful when using it!

Dosage of Amitriptylinum VP

The preparation is in the form of coated tablets. It is intended for oral use. Use the preparation as recommended. Do not exceed the recommended doses because it will not increase the effectiveness of the drug and may harm your health and life. If you have any doubts regarding the use of the preparation, consult a physician.
Adults and children over 16:
Initially 50-100 mg / day in divided doses or 1 / day / night. The doctor will then advise you to gradually increase the dose until you reach the optimal therapeutic dose (in outpatient settings up to 200 mg / day).
After a clinical improvement, maintenance treatment is given, usually 50-100 mg / day in 2-4 divided doses or 1 / day / night,
In the elderly, initially 25-75 mg / day. The dose should be increased with caution. In most cases, the therapeutic effect is achieved after applying 1/2 of the usual dose.
The recommended duration of treatment is 3-6 months. The drug should be discontinued gradually.
The preparation should be used orally, regardless of meals.

Can Amitriptylinum VP be used during pregnancy and breastfeeding?

During pregnancy, do not use any medicine without consulting your doctor!
It is very important that before using any medicine during pregnancy or breastfeeding, consult a physician and explain beyond any doubt the potential risks and benefits associated with the use of the drug.
Due to the lack of appropriate tests, it is not recommended to use during pregnancy, especially in the first and third trimester. Only use this medicine if, in the physician's opinion, the benefit of treatment outweighs the potential risk to the fetus.
The use of the preparation during breast-feeding is contraindicated.

Can I use other preparations in parallel?

Tell your doctor about all medicines you have recently taken, including those that are over the counter.
Amitriptyline reduces sympatholytic activity, increases the effect of sympathomimetics. Simultaneous use with sympathomimetics may lead to a significant rise in blood pressure (even at low doses, for example, for local anesthetics).
Drugs that inhibit CYP2D6 activity (eg cimetidine, chinaid) and CYP2D6-mediated metabolites (eg, phenothiazine derivatives, serotonin reuptake inhibitors, class Ic antiarrhythmics) may increase the amount of amitriptyline in the blood.
By inhibiting intestinal peristalsis, amitriptyline can cause malabsorption of other concomitantly administered drugs.
Amitriptyline weakens the effect of antihypertensive drugs (clonidine and methylmethyl).
Administration of MAO inhibitors with amitriptyline may cause hypertension, convulsions and hyperthermia, which is why it is contraindicated.
Drugs with depressant effects on the central nervous system (barbiturates, benzodiazepines, opioids and non-opioid analgesics, phenothiazine derivatives, antihistamines, alcohol) may potentiate the sedative effect of amitriptyline.
There have been reports of delirium following concurrent use with disulfiram.
Ritonavir increases the amount of amitriptyline in the blood.
Caution should be exercised when using with cholinolytic medicinal products or thyroid hormones in parallel because of possible side effects.
Alcohol increases the concentration of amitriptyline in the blood and increases the depressant effect of the drug on the central nervous system.

What side effects can occur?

Like all medicines, Amitriptylinum VP can cause side effects, although they will not occur in all patients who use this medicine. Remember that the expected benefits of using the drug are usually greater than the damage resulting from the occurrence of side effects.
The following may occur: nausea, vomiting, epigastric pain, inflammation of the mouth, dark tongue, unpleasant taste in the mouth, dry mouth, increased propensity to caries, constipation, paralytic ileus, loose stools, swollen salivary glands, excessive sweating , alopecia, skin eruptions, urticaria, photosensitivity, visual disturbances, mydriasis, accommodation disorders, increased intraocular pressure, difficulty in passing urine, frequent urinary urgency, hypotension or hypertension, weight gain or loss, glucose impairment serum, abnormal EEG, orthostatic hypotension, tachycardia, palpitations, myocardial infarction, arrhythmia, atrioventricular disturbances, ischemic stroke, impaired concentration, drowsiness, psychomotor agitation, numbness, tingling and paresthesia within limb neuropathy, ataxia, muscular tremors, generalized seizures, coma, involuntary movements, tardive dyskinesias, speech disorders, headaches, dizziness, confusion, confusion, hallucinations, mild manic state, insomnia, anxiety, anxiety, nightmares , tinnitus, tiredness, weakness, swelling of the face and tongue, agranulocytosis, leukopenia, eosinophilia, thrombocytopenia, hematuric purpura, hepatitis, cholestatic jaundice, testicles swelling, gynecomastia, menstrual disorders, breast engorgement and milkweed in women, weakness or intensification of libido sexual dysfunction, impotence, disorders of secretion of antidiuretic hormone, appetite disorders.The likelihood of side effects associated with the drug's cholinolytic action is greater in the elderly, due to the weakening of the parasympathetic system.
There have been reports of thoughts and / or suicide attempts during the use of the drug or shortly after its discontinuation.
Abrupt discontinuation of treatment, especially prolonged, may cause withdrawal symptoms: insomnia, irritability, nausea, headache, excessive sweating, occasionally symptoms of hypomania or mania in the first weeks after discontinuation of treatment.