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 is for parents and carers about how to use this When should the medicine start working?
medicine in children. Our information sometimes differs from Pain caused by nerve damage can be difficult to treat. It may
that provided by the manufacturers, because their information take a few days, or even weeks, for amitriptyline to work
is usually aimed at adults. Please read this leaflet carefully. properly. Continue to give the medicine as you have been told
Keep it somewhere safe so that you can read it again. to by your doctor.

Do not stop giving amitriptyline suddenly, as your What if my child is sick (vomits)?
child may get withdrawal symptoms. •• 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
Name of drug a dose of amitriptyline, you do not need to give them
Amitriptyline (sometimes known as amitriptyline hydrochloride) another dose. Wait until the next normal dose.
If your child is sick again, seek advice from your GP,
Why is it important for my child to take this medicine? pharmacist or hospital. They will decide what to do based on
Amitriptyline will help your child to feel less pain. The pain your child’s condition and the specific medicine involved.
may be described as having a burning, shooting or scalding
sensation. What if I forget to give it?
If you usually give amitriptyline once a day
What is amitriptyline available as? •• If you forget to give amitriptyline, you do not need to
•• Tablets: 10 mg, 25 mg, 50 mg; these all contain small wake your child up to give the missed dose.
amounts of lactose •• You can give the missed dose in the morning, as long as
•• Liquid medicine: 25 mg or 50 mg in 5 mL this is 12 hours before the next dose is due. However, if
this is likely to make your child sleepy, it may be better
When should I give amitriptyline? to forget the missed dose altogether and give the next
•• Amitriptiyline is usually given once each day, this is evening dose as usual.
usually in the evening. If you usually give amitriptyline twice a day
•• However, you may have been told to give amitriptyline •• If you forget to give amitriptyline, do not give the missed
twice each day. This should be in the morning and in dose. Wait until the next normal dose.
the evening.
If you have forgotten to give more than one dose,
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 contact your doctor for advice.
you to remember. Never give a double dose of amitriptyline.

How much should I give? What if I give too much?

Your doctor will work out the amount of amitriptyline (the It may be dangerous to give too much amitriptyline. If
dose) that is right for your child. The dose will be shown on 999
your child has any, or all, of the following symptoms,
the medicine label. they may have had too much amitriptyline.
Your doctor may suggest that your child has a low dose to •• The pupils (the black circles in the centre of the eye)
start with. They may then increase the dose as your child may become very large.
gets used to the medicine and depending on how your child •• Your child may become very sleepy.
responds to it.
•• They may have difficulty breathing, or their breathing
It is important that you follow your doctor’s may be slow.
instructions about how much to give. •• Their heart may race.
How should I give amitriptyline? •• Your child’s skin feels hot to touch.
If there is any possibility that you may have given your child
Tablets should be swallowed with a glass of too much amitriptyline, take them to hospital or telephone for
water, milk or juice. Your child should not chew an ambulance straight away. Tell the doctor that your child may
the tablet. have had too much amitriptyline.
Liquid medicine: Measure out the right amount Take the medicine container or packet with you, even if it is
using a medicine spoon or oral syringe. You empty. This will be useful to the doctor. Have the packet with
can get these from your pharmacist. Do not use you if you telephone for advice.
a kitchen teaspoon as it will not give the right
5.0 ml
2.5 ml

amount.
Are there any possible side-effects? by bit to make sure that your child doesn’t get withdrawal
We use medicines to make our children better, but sometimes symptoms. Do not change the dose without talking to
they have other effects that we don’t want (side-effects). your doctor first.
Side-effects that you must do something about
•• If amitriptyline does not seem to be helping your child’s
pain, contact your doctor for advice. Remember that it
Your child may have an irregular heart beat – they may make take a few weeks for amitriptyline to work.
say that their heart is racing or they have a fluttery
feeling in their chest. If this happens, contact your doctor
•• Amitriptyline is also used to treat depression but this is
at a higher dose than used to treat neuropathic pain. The
straight away. drug works in different ways at different doses.
If your child has problems with their eyesight (e.g. •• If your child has liquid medicine, keep a note of which
blurred or double vision), contact your doctor straight strength they have, and make sure you are given the right
away. one.
Other side-effects you need to know about
General advice about medicines
•• Your child may feel sleepy for a few hours after having
a dose of amitriptyline. This is why it is best to give •• Try to give the medicine at about the same time(s) each
amitriptyline in the evening. day, to help you remember.
•• Your child may have a dry mouth. Eating citrus fruits •• Only give this medicine to your child. Never give it to
(e.g. oranges) and taking sips of water may help. anyone else, even if their condition appears to be the
same, as this could do harm.
•• When they first start taking amitriptyline, your child
may feel sweaty, feel sick (nausea), have constipation If you think someone else may have taken the medicine
(difficulty doing a poo) or find it difficult to pass urine by accident, contact your doctor straight away.
(do a wee). These symptoms should settle down after •• Make sure that you always have enough medicine. Order
a week or so as your child’s body gets used to the a new prescription at least 2 weeks before you will run
medicine. out.
•• If your child still has any of these symptoms after 2 •• Make sure that the medicine you have at home has
weeks, or you are worried, contact your doctor. not reached the ‘best before’ or ‘use by’ date on the
There may, sometimes, be other side-effects that are not listed packaging. Give old medicines to your pharmacist to
above. If you notice anything unusual and are concerned, dispose of.
contact your doctor. You can report any suspected side-effects
to a UK safety scheme at http://www.mhra.gov.uk/yellowcard. Where should I keep this medicine?
•• Keep the medicine in a cupboard, away from heat and
Can other medicines be given at the same time as direct sunlight. It does not need to be kept in the fridge.
amitriptyline ? •• Make sure that children cannot see or reach the
•• You can give your child medicines that contain medicine.
paracetamol or ibuprofen, unless your doctor has told you •• Keep the medicine in the container it came in.
not to.
•• Amitriptyline should not be taken with some common Who to contact for more information
drugs that you get on prescription. Tell your doctor and Your child’s doctor, pharmacist or nurse will be able to give
pharmacist about any medicines your child is taking you more information about amitriptyline and about other
before starting amitriptyline. medicines used to treat neuropathic pain.
•• Check with your doctor or pharmacist before giving You can also get useful information from:
other medicines to your child. This includes herbal or England: NHS 111
complementary medicines. Tel 111 - www.nhs.uk
Scotland: NHS 24
Is there anything else I need to know about Tel 111 - www.nhs24.scot
amitryptyline? Wales: NHS 111 Wales
If your child has ever had a problem with their heart, tell Tel 111 - www.111.wales.nhs.uk
your doctor before giving amitryptyline. Northern Ireland: NI Direct
Do not suddenly stop giving amitriptyline to your child, www.nidirect.gov.uk
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

www.medicinesforchildren.org.uk

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.