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Any patient receiving amitriptyline and fluoxetine concurrently should be observed closely for adverse effects and consideration should be given to monitoring the plasma levels of the tricyclic antidepressant with dosage reduction where necessary.

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If you are pregnant, planning to become pregnant, or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances including peanuts if you have a history of heart problems, eg, fast or irregular heartbeat, chest pain, low blood output , blood vessel problems, high blood pressure, or low blood potassium levels if you have a history of other lung or breathing problems eg, asthma, hyperactive airway if you have a history of an overactive thyroid, diabetes, seizures, liver or kidney problems, or an adrenal gland tumor pheochromocytoma if you have a history of an enlarged prostate, blockage or narrowing of the bladder, or glaucoma if you have had an unusual reaction to other sympathomimetic medicines eg, pseudoephedrine if you are taking a monoamine oxidase inhibitor maoi eg, phenelzine or tricyclic antidepressant eg, amitriptyline , or you have taken either of these medicines within the last 14 days.

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Its oral bioavailability is estimated at 66 – 21 , suggesting that retains greater bioavailability as a secondary amine than its parent drug amitriptyline, a tertiary amine.

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