Is Amitryptiline contra indicated with Pred?

[merril]

Sadly, Co-codamol only worked for two nights. Then I remembered that I had been prescribed Ami with Morphine Sulphate when I had a herniated disc. It was still in date and for the last two nights I took it at 8pm , as I had done before , light off at 12MD and slept through until 9am. That may not last, but I would be reassured that it was not contra-indicated with Pred. before I continue.

[DorsetLady PMRGCAuk volunteer]

This is what I found online - drugs.com -

Interactions between your drugs

No interactions were found between your selected drugs. This does not necessarily mean no interactions exist. Always consult your healthcare provider.

[merril in reply to DorsetLady]

Thanks DL...I will check on the 27th when I see my rheumy.

[PMRpro Ambassador]

Quite a lot of people on the forum are on both pred and amitryptiline - but not sure it is the version with morphine sulphate though.

[suzy1959]

I have been taking Amitriptyline, 35mgs, for about 5 years, prescribed by Prof. Dasgupta to help with the sleeplessness that the Pred. caused me. If I forget to take it, I always have a bad night. The main side effect I notice is a dry mouth.

[merril in reply to suzy1959]

Thanks suzy1959. As yet I have not had any side effects, but I am on 25mg tabs and that might make a difference.👍

[Maisiek in reply to merril]

Like Suzy, Prof Dasgupta

Prescribed Amit. When he was so concerned about my sleeplessness. I was on 6mg Pred. Good Luck.

[merril in reply to Maisiek]

Thank you Maisiek. 👍

[Kendrew]

Hi merril. Just to throw a spanner in the works, Prof Dasgupta prescribed it for me but clearly it didn't agree with me..... left me feeling 'fuzzy headed' in a morning and gave me awful headaches, which stopped when I stopped taking it. Lots of people take it alongside pred without any adverse effects, but just be aware that as with all meds, everyone is different and therefore can react differently.

[PMRpro Ambassador in reply to Kendrew]

Doesn't help the headaches but a lot of people have said that they need to take it early in the evening to avoid the morning hangover ...

[Kendrew in reply to PMRpro]

Neither the prof nor my GP mentioned that!! Just assumed it was something I'd have to put up with. Was told to take it two hours before I went to bed!

[PMRpro Ambassador in reply to Kendrew]

Something tells me that some people can't take it any later than 7.30pm - but don't quote me!!! Ask MrsNails - I'm sure she has mentioned it in the past. Somehow I don't envisage you being in bed at 9.30!

[Kendrew in reply to PMRpro]

Haha! Not 9.30....but not much later. Usually between 10 and 10.30pm, but I do read a bit before settling down. Yes!....9.30 would be a bit too early for me.

[merril in reply to PMRpro]

Yes, I am a night owl😀 but last night I put light out at midnight and I have read the resetting of Circadian Circle sent me by Mrs Nails. When I was a young nurse my great dread was that I might end up with poly pharmacy.!!!

[Sheilamac in reply to PMRpro]

I had to take it at 7pm to avoid still being asleep at 11am or feeling fuzzy and weird and that was just 10mg.

[S4ndy in reply to PMRpro]

Yes I have to take my 50mg of Amitriptyline at 7.00pm in order to avoid a morning hangover. I've been taking Amitriptyline for the whole of my time on Pred and don't seem to have a problem. Like others if I forget to take it I can't sleep as my nerve pain is too bad. I am currently on 5mg of Pred a day. I find Amitriptyline a very useful drug for nerve pain and getting some decent sleep. I have taken it for many years prior to having PMR but at a lower dose.

[merril in reply to Kendrew]

Hi Kendrew, I take your point but I have not been able to sleep for some time. Co-codamol only worked for two nights, so took one tab of Amitriptyline 25mgs last night. Had no ill effects in the am so will continue until I see rheumy next week.

[Kendrew in reply to merril]

That's a good outcome for you if it's working well. Thats how it should be.

[MrsNails]

Hi Merril

Do you actually ‘need’ the morphine sulphate or just the Amitriptyline? You obviously have pain if you are taking Co-Codamol?

MrsN

[merril in reply to MrsNails]

Hi Mrs Nails....I don't take Morphine Sulphate now, ( had it with Ami four years ago when I had a herniated disc). Ami will be discussed with rheumy next week.👍

[MrsNails in reply to merril]

Ah, l misunderstood l thought it was a combined tablet.

Amitriptyline is very good at relaxing the muscles, my recommendation is to take it by 7pm each evening, then you’ve slept off any side effects by morning. If l take mine late l certainly know about it!...

[Kendrew in reply to MrsNails]

Hi MrsNails. Been advised to consult you regarding your view/opinion on the benefit or recommendation to take amitriptyline no later than 7.30pm to avoid early morning 'hangover'?? Would be interested to hear any thoughts you might have on this please?

[PMRpro Ambassador in reply to Kendrew]

See above!!!!

[MrsNails in reply to Kendrew]

Absolutely! I take mine at 7pm so it’s well & truly out of my system by morning......

I had a friend who used to take it in bed at Midnight & was constantly tired 😴 it can give you a bit of a dry mouth but that’s pretty easily remedied. I don’t find that an issue as l probably take in enough fluid during the evening.

I’ve been known to take it late especially on holiday & it just ruins the next morning even after taking it for a long time & l’ve taken various doses over the years - it’s my shoulders best friend! 😉

[merril in reply to MrsNails]

That's great to hear, I am so pleased for you. This might help to reset my Circadian Circle by light out an hour earlier?

[Kendrew in reply to MrsNails]

Thankyou for that. I wish my rheumy or GP had told me that when I was taking the amitriptyline. Even when I resisted being put back on them by the prof, and told him why....he didn't suggest taking it earlier in the evening. Interesting!!Thankyou MrsNails.

[DorsetLady PMRGCAuk volunteer in reply to Kendrew]

TBH many doctors (however eminent they may be ) don't know the nuances of the tablets they prescribe...... a pharmacist usually does...,a fellow patient definitely does.

[merril in reply to DorsetLady]

So true DL !👍

[Kendrew in reply to DorsetLady]

I'm beginning to learn that!!😄 It's really not good is it, when the medical professionals don't know these small details that really could make such a huge difference to the well being of the patients!

[MrsNails in reply to Kendrew]

I received my advice from a Doctor l worked with.....

[Kendrew in reply to MrsNails]

Do you think it's something to do with the training doctors are given? There doesn't seem to be consistency with the degree of detail they're exposed to....some doctors are well clued up and others sadly lacking! Becomes a bit of a lottery as to how fortunate we are with the GPs in our own practices!

[MrsNails in reply to Kendrew]

My Recommendation is make a friend of your Pharmacist, always use the same one, ask their opinion & always ask them to double check any newly prescribed Meds & the best time to take them.

My previous GP & to be fair the New One too always double check in a BNF* when prescribing anything new.

As l keep saying we need to be our own advocate.....

I’ve worked in a Medical Setting most of my working life so have always had access to Specialist Knowledge when required but l think that makes me more inclined to Ask or Question......

* BNF - British National Formulary

[Kendrew in reply to MrsNails]

Thankyou. Yes....I'm quite fortunate in that we have a very competent village pharmacy and I do know the pharmacist quite well. I probably haven't taken full advantage of his knowledge and expertise though ....particularly with the increase in customers and demand for his time. I will definitely make that a much stronger consideration for the future though! Thanks again. Always such sound and sensible advice. 🙂

[PMRpro Ambassador in reply to Kendrew]

But also always ask on here - we have gathered a vast mass of that sort of information over the years or know where to find it.

[Kendrew in reply to PMRpro]

Of course. Thankyou......and I've already learnt so much from here that I'd never have otherwise known.

[SheffieldJane]

I found that 10 mgs of Amitriptyline, taken 1 hour before bed, allowed my body to feel comfortable enough to sleep in the early days of my PMR. I am sorry that you are still struggling merril. 🌼

[merril in reply to SheffieldJane]

Thanks again SJ, I am managing with all the help I get here, and I am learning to be patient.

[Mgt1234]

Hi, if you can take Amitriptyline it’s very good, I benefitted from it .. but I only used it as and when needed. However, 2 years ago I was diagnosed with SVTs and told I can no longer use it, so please check it out with your Pharmacy or GP if in doubt. ❤️

[Suet3942 in reply to Mgt1234]

I took 10mg for 4 years with no probs and then I got an awful palpitations so had to stop. I loved having a guaranteed sleep.

[merril in reply to Mgt1234]

MGT 1234, I will check this out tomorrow as I already have AF. Thanks for the info. 👍

[LemonZest11]

I take 5mgs when I take my 2am dose of pred. Helps get me back to sleep, no side-effects, mind you it's only 5mgs. Doc told me I could take up to 30mgs but she warned of the possibility of fogginess the next morning.

[BPlady]

I’ve been on Amitryptiline for years as I have Fibromyalgia as well as PMR with my current dose being 75mg, and no side effects!

[Suet3942 in reply to BPlady]

Wow I wouldn't wake up for a week on that dose. 😂

[BPlady in reply to Suet3942]

It gives me a great 8 hours sleep, and no drugged feeling on waking so I consider myself very lucky😊

[Helipad]

I take 40mg of amitriptyline with Pred and also 50mg of tramadol. I was already on amitriptyline and tramadol for CRPS prior to being diagnosed with PMR and GCA. it’s the only thing that helps with some of the pain and sleep.

[merril in reply to Helipad]

Hi Helipad, thanks for replying. I have been taking 25mgs at 8pm and no problems apart from sleeplng to 10am. Perhaps will ask GP about lower dose By the way my son who is 65 contracted CRPS 20 years ago after an accident. It is such a horrible syndrome and my thoughts are with you.

[MrsNails in reply to merril]

You can get 10mg tablets so you could reduce to 20mg easily.

[merril in reply to MrsNails]

Thanks, Mrs Nails, I appreciate your responding👍

[Helipad in reply to merril]

Thank you merril, it certainly is a horrible syndrome and I also developed it after an accident just over 3 years ago. I definitely feel for your son having had it for 20 years.