Endep (Amitriptyline Hydrochloride)
Complete patient guide for uses, dosage, side effects, and safety information
Prescription RequiredQuick Facts
What Is Endep Used For?
Endep contains amitriptyline hydrochloride and belongs to a group of medicines called tricyclic antidepressants (TCAs). It is primarily used to treat depression and can also help with bedwetting problems in certain cases.
Primary Uses
Endep is used to treat depression. It can also be used to treat bedwetting, provided that there is no physical cause for the problem (such as bladder problems). Endep is not approved for use in children and adolescents below 18 years of age for treating depression.
How It Works
TCA medicines work by correcting the imbalance of certain chemicals in the brain called amines, which are involved in controlling mood. By correcting this imbalance, TCAs can help relieve the symptoms of depression.
How to Take Endep
The dose of Endep varies from person to person, and your doctor will decide the right dose for you. Follow the instructions provided and take Endep until your doctor tells you to stop.
Dosage Instructions
For depression, the usual starting dose is 75 mg to 150 mg per day in divided doses. For people being treated in hospital for depression, the usual starting dose is 100 mg to 200 mg per day. For elderly patients, lower doses are recommended. For bedwetting, the doses are lower than those used for depression and depend on the person’s age and weight. Endep can be taken with or without food, as a single dose (at bedtime) or as divided doses (three times a day). Swallow the tablets whole with a glass of water.
What If You Miss a Dose?
If you take one dose a day at bedtime and forget to take it, do not take the missed dose if you wake up late at night or early morning without checking with your doctor first. If you take more than one dose a day and it’s almost time for your next dose, skip the missed dose and take your next dose when scheduled. Otherwise, take the missed dose as soon as you remember, then return to your normal schedule.
Important: Do not take a double dose to make up for the dose you missed.
Available Tablet Strengths
Side Effects
Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.
Common Side Effects
These side effects occur relatively frequently and usually don’t require emergency care:
- Dry mouth
- Altered sense of taste
- Nausea (feeling sick)
- Vomiting
- Diarrhea
- Constipation
- Blurred vision
- Difficulty focusing
- Drowsiness
- Tiredness
- Headache
- Dizziness
- Lightheadedness
- Increased sweating
- Weight gain or loss
- Changes in sex drive
Seek immediate medical attention if you experience:
- Fast or irregular heartbeats
- Larger breast than normal (in men and women)
- Tingling or numbness of hands or feet
- Uncontrolled movements, trembling, shaking
- Difficulty passing urine
- Signs of frequent infections (fever, chills, sore throat)
- Yellowing of eyes or skin (jaundice)
- Unusual bruising or bleeding
- Feeling anxious, restless or confused
- Abnormal ideas, hallucinations
- Sudden mood switch to excitement, overactivity
- Skin rash, itching, hives
- Swelling of face or tongue
- Severe sunburn, blistering or swelling of skin
- Fever, swollen lymph nodes
- Fainting or collapse
- Chest pain
- Seizures or fits
Important Warnings
There are several important warnings and precautions to be aware of before taking Endep.
Who Should Not Take Endep
Do not take Endep if you are allergic to amitriptyline or any ingredients in the medicine, if you have recently had a heart attack, if you are taking cisapride (a medicine for stomach reflux), or if you are taking or have taken within the last 14 days a monoamine oxidase inhibitor (MAOI) such as phenelzine, tranylcypromine, moclobemide, or selegiline.
Medical Conditions to Discuss
Check with your doctor if you have heart or blood vessel problems, liver problems, glaucoma, urinary problems, thyroid problems, seizures or fits, any mental illness other than depression (such as schizophrenia or manic depression), or a family history of suicide or mania. Tell your doctor if you plan to undergo surgery or electroshock therapy.
Pregnancy and Breastfeeding
Check with your doctor if you are pregnant or intend to become pregnant. There have been reports of some babies experiencing complications immediately after delivery. Do not take Endep if you are breastfeeding, as it passes into breast milk and may harm your baby.
Suicidal Thoughts: Tell your doctor immediately if you have any suicidal thoughts or other mental/mood changes. This is more likely to occur in children, adolescents and young adults under 25 years of age during the first one to two months of treatment.
Drug Interactions
Some medicines may interfere with Endep and affect how it works. Tell your doctor about all medicines you are taking.
- Cisapride (stomach reflux medicine)
- MAOIs like phenelzine, tranylcypromine, moclobemide, selegiline
- SSRIs like fluoxetine, sertraline, paroxetine
- Blood pressure medicines
- Anticholinergics (stomach cramps, travel sickness, allergies medicines)
- Medicines for mental disorders like schizophrenia
- Quinidine and flecainide (heart rhythm medicines)
- Cimetidine (reflux and ulcer medicine)
- Sleeping tablets/sedatives, anti-anxiety medicines
- Epilepsy medicines
- Thyroid medicines
- Disulfiram (alcohol deterrent)
- Tramadol (pain medicine)
- Valproic acid
Alcohol & Driving
Endep may reduce your alertness and cause drowsiness or dizziness. Be careful with alcohol consumption and avoid driving if affected.
Alcohol
Be careful drinking alcohol while taking Endep. Combining Endep with alcohol can make you more drowsy or dizzy. Your doctor may suggest you avoid alcohol while being treated for depression.
Driving and Operating Machinery
Do not drive or operate machinery until you know how Endep affects you. Endep may reduce your alertness, cause drowsiness or dizziness. Children should not ride a bike, climb trees or do anything else that could be dangerous if they are drowsy.
Temperature Regulation
Anticholinergic medicines taken with Endep could result in high fever, particularly during hot weather.
Storage
Keep your tablets where the temperature stays below 25°C. Store in a cool dry place away from moisture, heat or sunlight. Do not store in the bathroom, near a sink, in the car or on window sills. Keep where young children cannot reach it – a locked cupboard at least one-and-a-half metres above the ground is recommended.
Overdose Information
Taking too much Endep at once can be dangerous and may cause death. If you think you have taken too much, immediately phone the Poisons Information Centre (Australia telephone 13 11 26), contact your doctor, or go to the Emergency Department at your nearest hospital. Symptoms may include drowsiness, feeling cold, dizziness, fast or irregular heartbeat, fits, difficulty breathing, or loss of consciousness. Children are much more sensitive to overdose than adults.
Frequently Asked Questions
Most medicines for depression take time to work, so don’t be discouraged if you don’t feel better right away. Some people notice improvement in their depressive symptoms after 3 or 4 days, but it may take up to 4 weeks to feel the full benefits of Endep.
Yes, Endep can be taken with or without food. Your doctor will advise whether to take it as a single dose (such as at bedtime) or as divided doses throughout the day.
Do not stop taking Endep or lower the dose without checking with your doctor. Stopping Endep suddenly may make you feel sick (nauseous), have headaches or feel generally unwell. Your doctor will tell you how to gradually reduce the amount before stopping completely.
Be careful drinking alcohol while taking Endep. Combining Endep with alcohol can make you more drowsy or dizzy. Your doctor may suggest you avoid alcohol while being treated for depression.
Weight gain or loss is listed as a possible side effect of Endep. If you notice significant weight changes that worry you, speak to your doctor.
For elderly patients, lower doses are recommended as Endep may not be well tolerated in this age group. Your doctor will determine the appropriate dose based on your individual circumstances.
If you take one dose daily at bedtime and forget, don’t take the missed dose if you wake up late at night or early morning without checking with your doctor first. If you take multiple doses daily and it’s almost time for your next dose, skip the missed dose. Never take a double dose to make up for a missed one.
Important Disclaimer
This information is intended for general educational purposes only and should not be considered medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.
If you think you may have a medical emergency, call your doctor or emergency services immediately.