Medication Profile - Amitriptyline Off-Label for Migraine

Patient Expert

There's a wide variety of medications used for Migraine, most of which are prescribed off-label. If amitriptyline has been prescribed for you, or if you and your doctor have been considering it, here's some information that should be helpful.

Type of medication:

Amitriptyline is a tricyclic antidepressant that has also been prescribed off-label as a Migraine and headache preventive for many years. It was, in fact, among the first medications recognized as a potential preventive.


  • It is very important that your doctor check your progress at regular visits to allow dosage adjustments and to help reduce side effects.

  • This medicine will add to the effects of alcohol and other CNS depressants.

  • This medicine may cause drowsiness. If this occurs, do not drive, use machines, or do anything else that could be dangerous if you are not alert.

  • Tricyclic antidepressants may cause your skin to be more sensitive to sunlight than it is normally.

  • For diabetic patients: This medicine may affect blood sugar levels. If you notice a change in the results of your blood sugar tests, check with your doctor.

  • Do not stop taking this medicine without first checking with your doctor

  • The effects of this medicine may last for 3 to 7 days after you have stopped taking it.

Pregnancy and Breastfeeding:

  • FDA Pregnancy Category D. May harm an unborn baby. Do not take without talking to your doctor if you are pregnant.
  • Passes into breast milk and may affect a nursing baby. Do not take without talking to your doctor if you are breast-feeding a baby.

Other medical conditions:

Be sure to let your doctor know of other medical problems you may have, especially:

  • alcohol abuse (or history of)
  • asthma, bipolar disorder
  • blood disorders
  • convulsions (seizures)
  • difficult urination
  • enlarged prostate
  • glaucoma
  • heart disease
  • high blood pressure
  • schizophrenia
  • kidney disease
  • liver disease
  • overactive thyroid
  • stomach or intestinal problems

Other medications:

Be sure to let your doctor know of ALL medications you are taking, especially

  • amphetamines
  • appetite suppressants
  • ephedrine
  • epinephrine
  • isoproterenol
  • medications for asthma or other breathing problems
  • phenylephrine
  • antipsychotic medications
  • Clonidine
  • thyroid medications
  • cimetidine (Tagamet)
  • metoclopramide (Reglan)
  • pomethazine (Phenergan)
  • monoamine oxidase (MAO) inhibitors

Potential side effects:

  • Stop using this medicine and check with your doctor immediately if any of the following side effects occur:
    • allergic reaction (swelling of the lips, face, or tongue; difficulty breathing)
    • seizures
    • fast or irregular heartbeat
    • symptoms of high blood pressure (blurred vision, headache)
    • difficulty urinating
    • fever with increased sweating, muscle stiffness, or severe muscle weakness
  • Continue medication and talk to your doctor if you experience:
    • drowsiness or dizziness
    • dry mouth and eyes
    • constipation
    • mild tremor
    • sweating
    • mild agitation, weakness, or headache
    • ringing in the ears
    • nausea
    • loss of weight or appetite

Brand Names:* ** U.S.:** Elavil (discontinued), Endep

  • Canada:Apo-Amitriptyline, Elavil (discontinued), Levate, Novotriptyn
  • U.K.: Levate, Novotriptyn
  • Australia: Tryptanol, Elavil, Endep, Amitrol

Related Information:* _Migraine preventive medications - too many options to give up! _



Wolters Kluwer. Amitriptyline. Last revised March 4, 2012.

Cerner Multum, Inc. Amitriptyline. Last revised March 4, 2012.

Material on this page is for informational purposes only, and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications.

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