Amitriptyline

[Brynsiriol]

Hello, I’m 83 and have AF and a monitor in my chest linked to the hospital Cardiac department and take Apixaban to control this. I’ve been prescribed Amitriptyline for neurological pain after Varicose vein surgery at a 10mg dose. The doctor didn’t discuss my AF and I’m worried this new drug might be a dangerous combination.

[jeanjeannie50]

That's a low dose of Amitriptyline and a few people on this forum take it at that rate with no side effects. High doses are a no-no with AF. Why don't you speak to your pharmacist to put your mind at rest?

Jean

[Brynsiriol in reply to jeanjeannie50]

Thank you Jean, I’ll do that today.

[Hidden]

Hiya,

I have very, very highly controlled paroxysmal AF ( nothing this year so far) and my GP prescribed 10mg Amitriptyline for controlling acute arthritic pain in both shoulders. I abandoned it as it gave me quite dramatic diahorrea. Just went back to my 30/500 Cocodomol tablets.

Have you read the bit of paper in the packet. Quite alarming when you read it in the context of heart conditions. Only goes to show that in terms of knowing medication GP's are pretty well down the food chain. I support what Jean said about consulting a pharmacist. Take the bit of paper in the packet and challenge the pharmacist why it is being prescribed.

It seems to me to be more of an antidepressant than anything else.

John

[Brynsiriol in reply to Hidden]

Thank you for replying John .I felt I was rushed through my doctors appointment without mentioning all my problems and thought he had everything on the screen in front of him . A new doctor to me as well. I am trying to get in touch with my Cardiologist as well but having problems even getting through to the the secretary! I’m supposed to use the Amitriptyline for nerve damage to my leg after surgery as apparently it’s beneficial for that. I’m not going to start them until I’m absolutely sure about them.

[Hidden in reply to Brynsiriol]

Hiya Brynsiriol,

Another thought is to seek totally independant Pharmacist advice, say, a pharmacy close to where you live or where is convenient. The useless NHS are very busy encouraging patients to use other healthcare medical services which include Pharmacists you might get better results doing so.

My personal take on your decision not to take the meds until you are totally sure. I think the day has now arrived where it is up to the patient to be as demanding as possible on challenging the healthcare professionals decisions/ advice. Make them jump through hoops !

In any event, I do wish you well in your journey.

John

[Brynsiriol in reply to Hidden]

Thank you John, I’m going to the pharmacy tomorrow armed with my list of meds I take including Apixaban . I’ve also got a follow up appointment next week with the doctor who prescribed the tablets to see how they are helping or not as the case may be ! I’ll keep you up date as to how it goes . Brian

[Eddie49]

I agree with Carneuny. I have had so many different opinions from GPs, pharmacists etc. regarding medication for pain control over the years. I have been offered amitriptyline quite a few times but never managed to stay on it for any length of time. Also, as far as I can see the dose starts low and can take up to six weeks to begin to have an effect, if indeed it does help at all. You should also be monitored by the GP and the dose increased if not controlling the pain. Each time I was just given a month's supply, not even on repeat, no monitoring, ring up if you need more. I have also been to see a specialist at a pain clinic and told that there is some evidence to say that I could take the amitriptyline 'as needed', which is totally not the case. The same specialist also asked me if I am a 'Warrior or a Worrier'. I paid him £150 for that pep talk.

[Brynsiriol in reply to Eddie49]

Thank you Eddie, I’m not hearing much good news about it and it seems it might be easier to put up with the nerve discomfort instead ! I’ll let you know what my pharmacist has to say . Brian

[Gumbie_Cat]

I was on amytriptiline for about a month last year, just before Iwas diagnosed with A fib. It did take the edge of the back pain, but it’s when I increased it to 20mg, on advice, that I went into AFib.

They still didn’t reckon that the dose would be high enough to have set it off, and also seemed to think that I should be ok on the lower dose still. I just wasn’t confident about taking it any more though.

I must admit that managing pain with A Fib, plus anticoagulants, is difficult.

[Brynsiriol in reply to Gumbie_Cat]

Thank you for your reply. I’m not going to rush into taking Amitriptyline now , after people’s replies. I waited years for the vascular surgery and didn’t realise how common nerve damage is with the procedure. I’m due to have the other leg done soon but I’m not risking that either !

[Gumbie_Cat in reply to Brynsiriol]

Sometimes it feels like most interventions & medications come with a side order of a different problem!

[Brynsiriol in reply to Gumbie_Cat]

Very True , sadly !

[LKUK]

Amitriptyline is what pushed me into a very debilitating and long run of AF which was only solved through cardio version. I took a small dose for two days for osteoarthritis in my knee and bang that was it - AF with a heart rate above 170. I would not take it again.

[Linkj]

as a retired physio who was trained in pain management, Amitriptyline is an old fashioned anti depressant that can be very effective for pain relief at low doses (too low to work as an antidepressant). It needs to be taken with caution with AF but may be worth trying, see what the pharmacist says.

[PollyDoodle]

At a consultation with a cardiologist some while ago, I said I was taking amitriptyline for insomnia, (not every night) and his reaction was "well, if you must" not very keen on me taking it at all. Since then I have kept away from it, despite being offered for severe sciatica and back pain. The Doctors always seem surprised at the cardiologist s comments when I tell them

The other downside, for every pill I took, I put on a pound!

[KaliBill]

It's so interesting the way we react so differently. I was prescribed Amitriptyline for shoulder pain, 10mg. I was assured such a low dose wouldn't be detrimental to my afib, I take 2 5mg bisoprolol daily and increase it if I have an episode. I have found (fingers crossed at this point) that I've had less episodes. Whether it's to do with the reduction in heart rate the amytriptiline causes, whether it's because it was originally used for anxiety, and although the gp says such a small dose wouldn't help with that, it may be I'm slightly less stressed. I will add, it's done nothing for the pain in my shoulder!!

[MKG50]

I am on Edoxaban and Flecainide. I was also worried about taking Nortriptyline (the same thing as Amitripyline) for a chronic pain condition. There is an alert about combining those drugs but my GP said it is a small dose and the benefits outweigh the risks. I started on 10mg Nortriptyline and for a couple of days felt a bit spacey but then that disappeared and I was fine. I'm now on 20mg with no ill effects.Good luck.

[OldJane]

I was offered amitriptyline several times for chronic nerve pain. Our surgery has their own pharmacist who is a lot better than our local ones. He said it should be fine at a low dose (and I know friends on a low dose no problems including two with AF) but it made me feel too drugged. I would say it depends on how bad the nerve pain is. Mine was excruciating at first for months and a lot more debilitating than my AF - now it is a background draining hurt. A recent study showed effectiveness for amitriptyline for nerve pain (nothing else touches nerve pain) but it isn’t high effectiveness and there are side effects. Pain relief is so poor with AF to consider! And nerve pain is awful. Good luck deciding!

[nakuru8]

Hi I am 70 and had AF until a successful ablation in Sept 22. I took amitriptyline for 3 years together with bisoprolol and edoxaban without any problems. You should be OK.

[Nerja2012]

I suffer really badly with neuropathic pain in my arm and hand and after 8 years the cause still can't be found. Amitriptoline at 10mg was the only medication that helped, but unfortunately my heart didn't agree so like Carneuny I have to rely on Codamol, pain medication with AF is a tricky one. Hope you get some relief.

[Ppiman]

From what I have read. low doses of amitriptyline are generally safe as their effect on the heart is minimal, but this is something which, for me. I would want to double check and discuss with your GP and dispensing pharmacist.

Steve

[George22]

same here it upset my heart too at 10mgs

[Stumpy47]

Here's a link to a drug interactions web site you can check it on. reference.medscape.com/drug...

[Crystalbowl]

I have taken 30 mg Amatriptyline fir the last 4 years. It was prescribed for PHN (post herpetic neuralgia) pain following shingles in 2019. I don’t think it has done much to help the pain but it has helped me to sleep. I am in permanent AF, HF with CRT pacemaker implanted. The Cardiac GP I saw for a while was not happy about me being on Amatriptyline but allowed it. However, more recently I have been weaning myself off it, am now down to 10mg and hope to be off it completely by the end of this month. I do still have the PHN pain, btw.

[Qualipop]

Amitriptylene is an anti depressant but in very low doses like that it's been found to help with neuropathic pain and is very regularly prescribed. Personally I've tried it at least 10 times and it just makes me like a zombie.

[ozziebob]

drugs.com ...

is good for researching various medications and their interactions.

Here's the result for the 2 you mentioned ...

drugs.com/interactions-chec...

Be well.

[Brynsiriol in reply to ozziebob]

thank you, that’s useful