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Drug Guide    A   Amitriptyline-Chlordiazepoxide

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This product contains 2 medicines (amitriptyline, chlordiazepoxide) and is used to treat mental/mood disorders such as depression with symptoms of anxiety. It may help improve mood and feelings of well-being, relieve anxiety and tension, help you sleep better, and increase your energy level. Amitriptyline belongs to a class of medications called tricyclic antidepressants. It works by affecting the balance of certain natural chemicals (neurotransmitters) in the brain. Chlordiazepoxide belongs to a class of drugs called benzodiazepines. It works by decreasing the symptoms of anxiety that may be experienced with depression and acts sooner than amitriptyline.

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OverviewPhotosHow To UseSide EffectsPrecautionsMissed DoseDrug Interactions

This product contains 2 medicines (amitriptyline, chlordiazepoxide) and is used to treat mental/mood disorders such as depression with symptoms of anxiety. It may help improve mood and feelings of well-being, relieve anxiety and tension, help you sleep better, and increase your energy level. Amitriptyline belongs to a class of medications called tricyclic antidepressants. It works by affecting the balance of certain natural chemicals (neurotransmitters) in the brain. Chlordiazepoxide belongs to a class of drugs called benzodiazepines. It works by decreasing the symptoms of anxiety that may be experienced with depression and acts sooner than amitriptyline.
  • Do not share this medication with others.Laboratory and/or medical tests (e.g., kidney function, liver function, amitriptyline blood level) may be performed from time to time to monitor your progress or check for side effects.
  • Keep all medical appointments.
  • Consult your doctor for more details.

  • Store at room temperature at 77 degrees F (25 degrees C) away from light and moisture.
  • Brief storage between 59-86 degrees F (15-30 degrees C) is permitted.
  • Do not store in the bathroom.
  • Keep all medicines away from children and pets.

  • Symptoms of overdose may include: severe dizziness, hallucinations, irregular heartbeat, fainting, widened pupils, muscle stiffness, seizures.

How To Use
  • Read the Medication Guide available from your pharmacist.
  • Consult your doctor or pharmacist if you have any questions.Take this medication by mouth, usually 2-4 times daily or as directed by your doctor.
  • The larger portion of the total daily dose may be taken at bedtime to help reduce daytime sleepiness.
  • The dosage is based on your age, medical condition, and response to therapy.
  • To reduce side effects, your doctor may start you at a low dose and gradually increase your dose over several weeks.
  • Follow your doctor's instructions carefully.This medication does not work right away.
  • It may take up to 2 to 3 weeks before you experience the full benefits.Use this medication regularly in order to get the most benefit from it.
  • To help you remember, take it at the same times each day.It is important to continue taking this medication even if you feel well.
  • Do not suddenly stop taking this medication without consulting your doctor.
  • Some conditions may become worse when the drug is abruptly stopped.
  • Muscle aches, headaches, and worsening anxiety may also occur.
  • Your dose may need to be gradually decreased.Tell your doctor if your condition persists or worsens (e.g., your feelings of sadness get worse, or you have thoughts of suicide).

Side Effects
  • See also Warning section.Drowsiness, dizziness, dry mouth, blurred vision, constipation, fast heartbeat, nausea, vomiting, bloating, loss of appetite, changes in taste, weight gain, tiredness, strange dreams, shakiness, confusion, stuffy nose, decreased sexual ability/interest, or trouble urinating may occur.
  • If any of these effects persist or worsen, notify your doctor or pharmacist promptly.To relieve dry mouth, suck on (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water, or use a saliva substitute.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects.
  • Many people using this medication do not have serious side effects.Tell your doctor immediately if any of these unlikely but serious side effects occur: unusual elevated mood (feeling "high"), persistent heartburn, confusion, mental/mood changes (e.g., agitation, excitement, hallucinations), loss of coordination, shaking, restlessness, uncontrollable movements of the mouth/face/hands, fast/irregular heartbeat, numbness/tingling of the hands/feet, enlarged/painful breasts or testicles, ringing in the ears, nervousness, sweating, unusual hunger, increased thirst/urination, fainting, muscle weakness/spasms, severe vomiting, severe constipation, swelling of the hands/feet, staggering walk, numbness/tingling of arms/legs, diarrhea, black tongue.Tell your doctor immediately if any of these rare but very serious side effects occur: seizures, easy bruising/bleeding, fever, persistent sore throat, yellowing eyes/skin, severe stomach/abdominal pain, dark urine, persistent nausea/vomiting, pain/redness/swelling of arms or legs, weakness on one side of the body, slurred speech, vision changes, chest pain.A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs.
  • Symptoms of a serious allergic reaction may include: rash, itching, swelling, severe dizziness, trouble breathing.If you notice other effects not listed above, contact your doctor or pharmacist.

  • See also Warning section.Before taking amitriptyline/chlordiazepoxide, tell your doctor or pharmacist if you are allergic to it, or to other benzodiazepines (e.g., diazepam, lorazepam, alprazolam), or to other tricyclic antidepressants (e.g., nortriptyline), or if you have any other allergies.This medication should not be used if you have certain medical conditions.
  • Before using this medicine, consult your doctor or pharmacist if you have: a certain eye problem (untreated narrow-angle glaucoma), a heart attack in the last 30 days.Before using this medication, tell your doctor or pharmacist your medical history, especially of: diabetes, kidney problems, liver problems, heart problems, problems urinating (e.g., due to enlarged prostate), persistent constipation, eating disorders (e.g., bulimia), overactive thyroid (hyperthyroidism), long-term lung problems (e.g., pulmonary insufficiency), a certain eye problem (open-angle glaucoma), personal or family history of mental/mood conditions (e.g., bipolar disorder, psychosis), family history of suicide, seizures, conditions that may increase your risk of seizures (e.g., other brain disease, alcohol withdrawal).This drug may make you drowsy or dizzy or cause blurred vision.
  • Use caution engaging in activities requiring alertness or clear vision such as driving or using machinery.
  • Limit alcoholic beverages.To minimize dizziness and the risk of fainting, get up slowly when rising from a sitting or lying position.Before having surgery, tell your doctor or dentist that you are taking this medication.This medication may cause dependence, especially if it has been used regularly for an extended time or if it has been used in high doses.
  • In such cases, withdrawal reactions (e.g., shakiness, seizures, stomach cramps, muscle cramps, vomiting, sweating) may occur if you suddenly stop this drug.
  • To prevent withdrawal reactions when stopping extended, regular treatment with this drug, gradually reduce the dosage as directed.
  • Consult your doctor or pharmacist for more details, and report any withdrawal reactions immediately.This medication may make you more sensitive to the sun.
  • Avoid prolonged sun exposure, tanning booths, and sunlamps.
  • Wear sunblock (SPF 30 or greater) and a hat when outdoors.If you have diabetes, this drug may increase your blood sugar levels.
  • Check your blood sugar levels regularly as directed by your doctor.
  • Tell your doctor immediately if you have symptoms of low blood sugar such as increased thirst/urination, shakiness, unusual sweating, or hunger.
  • Your anti-diabetic medication or diet may need to be adjusted.Depression can lead to thoughts/attempts of suicide.
  • Tell your doctor immediately if you have any suicidal thoughts, worsening depression, or any other mental/mood changes (including new or worsening anxiety, agitation, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, rapid speech).
  • Keep all medical appointments so your doctor can monitor your progress closely and adjust your medication if needed.Caution is advised when using this drug in the elderly because they may be more sensitive to its side effects, especially dizziness, drowsiness, confusion, and difficulty urinating.Caution is advised when using this drug in children.
  • (See also Warning section.)This drug is not recommended for use during pregnancy.
  • Consult your doctor for more details.This medication passes into breast milk and may have undesirable effects on a nursing infant.
  • Breast-feeding while using this drug is not recommended.
  • Consult your doctor before breast-feeding.

Missed Dose
  • If you miss a dose, take it as soon as you remember.
  • If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule.
  • Do not double the dose to catch up.

Drug Interactions
  • Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them.
  • Do not start, stop, or change the dosage of any medicine before checking with them first.This drug should not be used with the following medications because very serious (possibly fatal) interactions may occur: arbutamine, sibutramine, iomeprol, lumefantrine, MAO inhibitors (e.g., furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, selegiline, tranylcypromine).Avoid taking MAO inhibitors within 2 weeks before and after treatment with this medication.If you are currently using any of these medications listed above, tell your doctor or pharmacist before starting amitriptyline/chlordiazepoxide.Other drugs besides amitriptyline that may affect the heart rhythm (QT prolongation in the EKG) include pimozide, cisapride, halofantrine, disopyramide, grepafloxacin and sparfloxacin, among others.
  • Before using this drug, report all medications you are currently using to your doctor or pharmacist.
  • QT prolongation can infrequently result in serious (rarely fatal) fast/irregular heartbeat and other symptoms (e.g., severe dizziness, fainting) that require immediate medical attention.
  • Ask your doctor or pharmacist for more details and for instructions on how you may reduce the risk of this effect.Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: alcohol, amprenavir/fosamprenavir, duloxetine, clonidine, ethchlorvynol, guanadrel, guanethidine, levodopa, warfarin, barbiturates (e.g., phenobarbital), cimetidine, drugs for heart rhythm (e.g., flecainide, propafenone, quinidine), phenothiazines (e.g., chlorpromazine), SSRI antidepressants (e.g., citalopram, fluvoxamine, sertraline, fluoxetine), stimulants (e.g., amphetamines, methylphenidate), certain sympathomimetics (e.g., albuterol, epinephrine, phenylephrine), St John's wort, terbinafine, reserpine, thyroid supplements, disulfiram.If you have been taking fluoxetine, wait at least 5 weeks before starting amitriptyline/chlordiazepoxide.Cigarette smoking decreases blood levels of this medication.
  • Tell your doctor if you smoke or if you have recently stopped smoking.Tell your doctor or pharmacist if you also take drugs that cause drowsiness such as: certain antihistamines (e.g., diphenhydramine), anti-seizure drugs (e.g., phenytoin, carbamazepine), medicine for sleep or anxiety (e.g., alprazolam, diazepam, zolpidem), muscle relaxants, narcotic pain relievers (e.g., codeine), psychiatric medicines (e.g., fluphenazine, risperidone, trazodone).Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain drowsiness-causing ingredients.
  • Ask your pharmacist about the safe use of those products.Also report the use of drugs which might increase seizure risk (decrease seizure threshold) when combined with amitriptyline such as bupropion, isoniazid (INH), theophylline, or tramadol, among others.
  • Consult your doctor or pharmacist for details.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgement of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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