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Non-Opioid Pain Medicines

Amitriptyline

(Elavil®) tablets

Amitriptyline (Elavil ®) is a medicine prescribed by doctors that is used for many different conditions and can be used to help with nerve pain from cancer.

How do I take this medicine?

Take with a glass of water or other liquid. You can take this medicine with or without food. If you are taking this once a day, it is best to take it at bedtime because it causes sleepiness.

Continue taking this medicine, even if your pain is under control. Medicines like amitriptyline should be taken every day, on a schedule. Do not stop taking this medicine, unless your care team tells you to do so.

What are the side effects?

The most common side effects of amitriptyline are dizziness, sleepiness, dry mouth, and weight gain. 

 

Rarely this medicine can cause an abnormal heart rhythm, blurry vision, low blood pressure, or stomach upset. While side effects can be tough, there are ways to manage them. Talk to your care team if any of these side effects are interfering with your life.

How can I be safe when taking this medicine?
  • Always follow the instructions on your prescription bottle.
    Never take a higher dose of your opioids, or take them more often than prescribed. Instructions on medicine bottles can be confusing. Short-acting opioids are often prescribed with a range of doses you can take. For example: “Take 1-2 tablets every 3 hours as needed for pain.” This means it’s OK to take up to 2 tablets within a 3-hour time window. You can also choose to take less than this, or not take it at all (if your pain is controlled). Take them with a sip of water, with or without food.
  • Take them when you have pain and need quick relief.
    These take about 30 minutes to start working and 1 ½ hour to get the most relief, so take them early on when you feel your pain creeping up.
  • If you don’t have pain, don’t take them.
    If your pain is manageable and you don’t expect it to get worse, you shouldn’t take this medicine. It should be used “as needed” when you have pain.
  • Take them before your pain gets severe.
    Try to “stay ahead” of your pain by taking your short-acting opioid early on when you notice your pain getting worse. If you wait until your pain is severe, it often takes more medication and a longer time to get your pain under control. Pay attention to your body as you learn about your pain and how you react to opioids. Most people start recognizing their body’s signals about when they need to take their short-acting opioid for breakthrough pain.
  • Choose the dose that matches your pain level.
    Most short-acting opioid prescriptions have a range of doses you can choose to take within a given time-period. A common example is take 1-2 tablets every 3 hours as needed. If your pain is severe, start with the higher dose (for example: 2 tablets). If your pain is less severe, you can start with the lower dose (for example: 1 tablet). If your pain isn’t significantly better after 30 minutes to an hour, you can take the rest of the dose.
  • Take them about 30 minutes before painful activities.
    Some people know they will have pain with certain activities, like walking or taking a long car ride. Think of activities that usually worsen your pain. To help you be more active, you may want to take your short-acting opioid 30 minutes beforehand.
  • If your short-acting opioid is not working well, talk to your care team.
    Every person is different and it can take some time to find the right medicines and right doses for you. Your care team might decide to increase the dose of your opioid or change to a different medication. The important thing is to let them know how you are doing.
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