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How and when to take amitriptyline for pain and migraine

Always follow the instructions from a pharmacist or doctor or the leaflet in the medicine packet.

Dosage

Amitriptyline comes in 3 different strengths. It comes as:

  • tablets containing 10mg, 25mg or 50mg
  • liquid containing 10mg, 25mg or 50mg in a 5ml spoonful

The usual starting dose for adults and children aged 12 to 17 years old is 10mg a day. Your doctor can increase this dose if you need better pain relief.

The starting dose for children aged 11 years old and under depends on their weight and symptoms. The doctor will tell you how much to give them.

The maximum dose of amitriptyline for treating pain is 75mg a day. Your doctor may give you a higher dose if you're taking it to prevent migraine.

How to take it

You'll usually take amitriptyline once a day. It's best to take it before you go to bed because it can make you sleepy. If you still feel drowsy in the morning you could try taking it earlier in the evening.

Amitriptyline does not usually upset your stomach. You can take it with or without food.

Swallow the tablets whole with a drink of water. If you chew them they taste bitter.

The liquid amitriptyline will come with a plastic syringe or spoon to help you measure out the right dose. If you do not have a syringe or spoon, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not measure the right amount.

How long to take it for

Once you're feeling better, you'll probably continue to take amitriptyline for as long as it's working for you as a painkiller or to help prevent migraines.

Some people take it for many months and even for years but it should be reviewed regularly with your doctor.

If you forget to take it

If you forget a dose of amitriptyline, take it as soon as you remember, unless it's nearly time for your next dose. In this case, skip the missed dose and take your next dose at the usual time.

Never take 2 doses at the same time. Never have an extra dose to make up for a forgotten one.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

If you take too much

Taking too much amitriptyline can cause serious side effects such as a change in your heartbeat, seizures or fits.

Urgent advice: Contact 111 for advice now if:

  • you take more than your prescribed dose of amitriptyline

Go to 111 online or call 111. Call 111 if you're asking about a child under 5 years old.

Information:

If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the amitriptyline packet or leaflet inside it, any remaining medicine, and any other medicines you take.

Stopping amitriptyline

You may get extra side effects when you stop taking amitriptyline. This is more likely if you stop taking it suddenly.

You may get flu-like symptoms like feeling sick, muscle pain and feeling tired or restless.

To help prevent these side effects, your doctor will probably recommend reducing your dose gradually over several weeks, or longer if you've been taking amitriptyline for a long time.

Important

Do not stop taking amitriptyline suddenly without talking to your doctor.

Page last reviewed: 14 August 2023
Next review due: 14 August 2026