Indications And Dose
Abdominal pain or discomfort (in patients who have not responded to laxatives, loperamide, or antispasmodics) ▶BY MOUTH ▶Adult: Initially 5–10 mg daily, to be taken at night; increased in steps of 10 mg at least every 2 weeks as required; maximum 30 mg per day Major depressive disorder [not recommended—increased risk of fatality in overdose] ▶BY MOUTH ▶Adult: Initially 50 mg daily in 2 divided doses, then increased in steps of 25 mg once daily on alternate days if required, maximum 150 mg daily in 2 divided doses ▶Elderly: Initially 10–25 mg daily, increased if necessary up to 100–150 mg daily in 2 divided doses, dose increases dependent on individual patient response and tolerability—doses above 100 mg should be used with caution Major depressive disorder in patients with cardiovascular disease [not recommended—increased risk of fatality in overdose] ▶BY MOUTH ▶Adult: Initially 10–25 mg daily, increased if necessary up to 100–150 mg daily in 2 divided doses, dose increases dependent on individual patient response and tolerability—doses above 100 mg should be used with caution Neuropathic pain | Migraine prophylaxis | Chronic tension- type headache prophylaxis ▶BY MOUTH ▶Adult: Initially 10–25 mg daily, dose to be taken in the evening, then increased, if tolerated, in steps of 10–25 mg every 3–7 days in 1–2 divided doses; usual dose 25–75 mg daily, dose to be taken in the evening, doses above 100 mg should be used with caution (doses above 75 mg should be used with caution in the elderly and in patients with cardiovascular disease); maximum per dose 75 mg Emotional lability in multiple sclerosis ▶BY MOUTH ▶Adult: Initially 10–25 mg daily; increased, if tolerated, in steps of 10–25 mg every 1–7 days; maximum 75 mg per day l UNLICENSED USE Not licensed for use in abdominal pain or discomfort in patients who have not responded to laxatives, loperamide, or antispasmodics. g Amitriptyline hydrochloride is used for emotional lability in multiple sclerosis, l but is not licensed for this indication.
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