Amotril tablet

Generic Name(s): Clonazepam

Why it's used

Amotril tablet is a prescription medicine that is used to treat various types of epileptic and seizure disorders such as akinetic and myoclonic seizures, absence seizures (petit mal) including atypical absence seizures, Lennox-Gastaut syndrome (petit mal variant), primary or secondarily generalized tonic-clonic seizures (grand mal), partial (focal) seizures, or various forms of myoclonic seizures, myoclonus and associated abnormal movements. This medicine works by reducing abnormal electrical activity in the brain. Amotril tablet is also used to treat panic disorder with or without fear in open public space (agoraphobia), and to treat symptoms of involuntary movement disorder and behavior or motor function abnormality (acute catatonic reactions).
Benzodiazepine
Amotril belongs to the Benzodiazepine class of medicines. Benzodiazepines are a class of drugs used to treat a range of conditions, including anxiety and insomnia. These medicines work by slowing down the activity of the central nervous system by relaxing the muscles and inducing sleep.

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How to use

Read the directions on the product label, patient guide, or medicine guide provided by the medicine company or your pharmacist before starting to use Amotril tablet. If you have any questions related to this medicine, ask your doctor or pharmacist. Eat this medicine as recommended by your doctor.
Amotril tablet is eaten with or without food. Swallow the whole tablet with water. Amotril is usually taken one to three times a day.

Typical Dosage

The typical dose of Amotril is 1 mg/day for panic disorder (not more than 4 mg in one day). The maximum adult dose of Amotril is 20 mg/day for seizure disorder and 4 mg/day for panic disorder in a day. Although this medicine helps people, it may sometimes cause addiction. You may be at higher risk if you have a substance use disorder, such as an addiction to drugs, or to alcohol. To reduce your risk of addiction, take this medicine exactly as prescribed by your doctor.
This medicine is to be used for longer periods of time. You should continue to use this medicine as directed by the doctor even if you feel well.
If using the orally-disintegrating form of this medicine, make sure you do not consume any food or fluid 5 minutes before or after taking this medicine. Before taking the medicine out of the package, wash your hands thoroughly. Place the medicine on the tongue. Make sure you do not chew or swallow the medicine. You do not need to drink water after consuming the medicine. In certain cases, the medicine can taste slightly bitter. Also, ensure that you do not break or split the medicine.

Talk to Your Doctor

Talk to your doctor if your condition persists or worsens or if you develop new symptoms. Tell your doctor if suicide thoughts, feeling agitated or restless, panic attacks, insomnia, new or worse depression, anxiety or irritability, acting aggressive, being angry, or violent, an extreme increase in activity and talking, unusual behavior or mood changes, attempt to commit suicide, and acting on dangerous impulses. If you have any kidney disease, the dose of Amotril should be reduced in patients with abnormal functioning of the kidney. If you have issues with the health of your liver, the lowest effective dose should be considered in patients with abnormal functioning of the liver. You should consult with your doctor before stopping the use of Amotril.
Your doctor may recommend a lower initial dose of this medicine to see the impact of this medicine on the body. Please follow your doctor's directions. Taking a higher dose of this medicine may increase the risk of side-effects. Older patients may see an increase in the incidence of side-effects with this medicine. As a result, a lower dose may be recommended for older patients.
When stopping this medicine, you may experience withdrawal symptoms such as state of unease or dissatisfaction, insomnia, tremor, sweating, agitation, sleep disturbances, anxiety, headaches, muscle pain, anxiety, tension, restlessness, confusion, irritability, derealisation, feeling unreal, hearing disorder, numbness, tingling, allergic reaction to light, hallucinations, convulsions, psychosis behavioral disorder, and abdominal cramps. You may need to gradually decrease the dose of this medicine before stopping.

Use in Children

If you are giving Amotril tablet to a child, be sure to use a product that is meant for children. Before giving this medicine to a child, use the child's weight or age to find the right dose from the product package. You can also read the dosage section of this page to know the correct dose for your child. Else, consult with your doctor and follow their recommendation.

Avoid Alcohol

Avoid the consumption of alcohol with Amotril. Avoid grapefruit and grapefruit juice while using Amotril. Consult with the doctor about drinking grapefruit juice and eating grapefruit while taking Amotril therapy.

Storage

You should store Amotril tablet 15° to 30°C (59° to 86°F), and away from moisture. Store the medicine away from the reach of children and pets.
Medicines may be prescribed for uses other than those listed in the medicine guide. Do not use Amotril tablet for conditions for which it was not prescribed. Do not give Amotril tablet to other people who might have the same conditions or symptoms that you have. Self-medication may harm them.

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How to take Amotril

Your dose and how often you take Amotril will depend on the following factors:
  • age
  • weight
  • patient's health
  • the health of the patient's liver
  • the health of the patient's kidneys
  • medicines recommended by the doctor
  • any other medicines being used
  • herbal supplements in use
  • response to the medicine

Amotril Dosage

Dosage for seizure disorders

Adult
  • Initial: 0.5-1 mg every three days or dosage should not be increased by 1.5 mg/day divided into three doses, and maintenance dosage falls within the range 4-8 mg/day
  • Maximum: 20 mg/day
Children (infants and small children)
  • Initial: 0.25 mg/day and maintenance dosage falls within the ranges 1-3 mg/day (1-5 years), 0.5-1 mg/day (0-1 year) or 3-6 mg/day (5-12 years)
Children (infants and children (up to 10 years or 30 kg (66.1lb) of body weight))
  • Initial: 0.01 and 0.03 mg/kg (0.0045-0.013 mg/lb)/day but doses should not to exceed 0.05 mg/kg (0.023 mg/lb)/day given in two or three divided doses and dosage can be increased to 0.25 to 0.5 mg every 3 days until a daily maintenance dose of 0.1 to 0.2 mg/kg (0.045-0.09 mg/lb) of body weight has been reached
Older Adults
  • Initial: 0.5 mg/day

Dosage for panic disorder

Adult (panic disorder with or without fear in open public space (agoraphobia))
  • Recommended: 1 mg/day
  • Initial: 0.25 mg twice daily which can be increased to the target dose of 1 mg/day may be made after three days and Amotril therapy should be stopped gradually, with a decreased dose of 0.125 mg twice every three days, until the drug is completely withdrawn
  • Maximum: 4 mg/day

Dosage calculation for children

To calculate the dosage for children please use the weight based dose calculator to calculate the appropriate dosage as per the weight of your child.

Forms

Tablet
Strength: 0.5 mg, 1.0 mg, 2 mg
Orally disintegrating tablet
Strength: 0.125 mg, 0.25 mg, 0.5 mg, 1 mg, 2 mg
Wafer
Strength: 0.125 mg, 0.25 mg, 0.5 mg, 1 mg, 2 mg

Missed Dose

A missed dose should be taken as early as you remember it. However, if the time for the next dose is almost there, then the missed dose should be skipped, and the regular dosing schedule should be continued. Avoid taking a repeated dose to make up for a missed dose.

Overdose

What to do if you overdose on Amotril?
In case of overdose, pulse rate, respiration, and blood pressure should be monitored. Immediate stomach emptying and general supportive measures should be performed. Maintain proper breathing and fluids should be given through the vein. The use of levarterenol or metaraminol may combat low blood pressure. Flumazenil should be given for the reversal of sleeping effects due to Amotril overdose. It should be given with proper monitoring of respiratory insufficiency, re-sedation and other remaining benzodiazepine effects for some period after the treatment. Flumazenil is not used in patients with epilepsy who are using benzodiazepines. The opposite effect of the Amotril effect in such patients may cause seizures. If the overdose has happened within the last 1-2 hours, the harmful effect can be reduced by taking activated charcoal and treatment according to the symptoms should be considered for heart and respiratory or central nervous system effects.
Symptoms of an overdose of Amotril
If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:
If you think you have overdosed on Amotril tablet, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Amotril

Before you use Amotril, tell your doctor of your medical and health history including the following:
  • angle-closure glaucoma
  • excessive production of saliva
  • history of drug abuse or alcoholism
  • history of mental disorders such as mood problems, depression, or suicidal thoughts or behavior
  • kidney problems
  • liver disease
  • liver disease
  • long-term respiratory problems
  • patients with the build-up of chemicals (porphyria)
  • reduced or absent activity of lactase and abnormal absorption of glucose and galactose in the body
  • seizures disorders
  • sensitive to benzodiazepines
  • swelling in the brain or spinal
  • taking codeine, hydrocodone, fentanyl, hydromorphone, meperidine, methadone, morphine, oxycodone, tramadol, amiodarone, antibiotics, antidepressants, antifungal, antihistamines, calcium channel blockers, HIV protease inhibitors, medicines used to treat anxiety, allergies, or cold, mental illness, antiepileptics drugs, sedatives, selective serotonin reuptake inhibitors and tranquilizers
  • taking other central nervous system depressant drugs
Patients with a history of mental disorders may experience behavior effects such as confusion, hallucination and sleeplessness when using Amotril. Amotril may cause worsening of the seizure when used in patients with seizures disorders. Patients with abnormality in the functioning of the kidney may experience increased accumulation of Amotril. Amotril may cause convulsions in patients with build-up of chemicals (porphyria). Physical and mental dependence can occur in patients with alcoholism or drug abuse when using Amotril.
Before you use Amotril tablet, tell your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information. Tell your doctor if you are allergic to alprazolam, lorazepam, chlordiazepoxide, diazepam, clorazepate, estazolam, flurazepam, oxazepam, temazepam, midazolam, or triazolam.
Before having any surgery when using Amotril, tell your doctor and dentist about all the medicinal products you use including prescription and non-prescription medicines, and any herbal supplements.
The use of this medicine may change body weight. Amotril may cause either increase or decrease in body weight.

Alcohol

Avoid the consumption of alcohol with Amotril tablet. Drinking alcohol may cause increased sleepiness, increased dizziness, increased sedation, slow and ineffective breathing, worsening of heart disease, and inability to operate machinery or drive a vehicle.

Use in Pregnancy

Amotril tablet should be used in pregnancy only when required. Amotril should be used during pregnancy after evaluating the potential benefits and risks to the fetus. This medicine may cause increased birth defects, irregularities in the heartbeat, reduced muscle strength (hypotonia), weakness or reduced muscle tone (neonatal flaccidity), low body temperature, and feeding and respiratory difficulties. Infants born to mothers who have consumed this medicine during later stages of pregnancy are at risk of developing physical dependence and associated withdrawal symptoms. Pregnancy can also worsen epilepsy.

Use while Breastfeeding

Amotril is not safe for use in women who are breastfeeding. If you are breastfeeding, discuss with your doctor if you should either discontinue breastfeeding or stop using this medicine while breastfeeding. Amotril may pass into breast milk.

Impact on Fertility

Consult with your doctor on the use of Amotril tablet, if you are trying to conceive. Patients planning to become pregnant are advised to talk to their doctor about the desirability for stopping the use of Amotril.

Seizures

Amotril tablet can make you feel sleepy. Be careful while driving, using machinery, or doing any other activity that needs you to be alert. The consumption of alcohol with Amotril tablet can make you feel more sleepy. Amotril tablet may cause seizures in some people. Discuss with your doctor if you perform activities where a loss of consciousness may cause you or others harm.

Increased Risk

This medicine may increase your sensitivity to sunlight. If this happens, limit your time outdoors and prevent sunburns. Cover your skin or use a sunscreen.

Side-effects in Children

Amotril tablet may cause an increased risk of side-effects in younger patients. Children using this medicine may see an increased risk of increased saliva and bronchial secretion, and dropping saliva uncontrollably from the mouth (drooling).

Side-effects in Older Patients

Amotril tablet may increase side-effects in older patients. Elderly patients may see an increased risk of sedation, confusion, falls, and fracture.

Long Term Use

Patients using Amotril for long-term may experience a sudden occurrence of seizure which may last for longer than five minutes (status epilepticus). Also, these patients may experience dependence with withdrawal symptoms such as behavioral disorder, convulsions, hallucinations, tremor, psychosis, and abdominal or muscle cramps. Such patients may also experience speech disorder due to muscle weakness, rapid involuntary movements of the eyes (nystagmus), reduced coordination of movements and gait disorder and double vision (diplopia).

What precautions should be taken during Pregnancy and Nursing, and administering Amotril to Children or the Older Adults?

Pregnant Women

Only When Necessary
Warning: Amotril should be used during pregnancy after evaluating the potential benefits and risks to the fetus. This medicine may cause increased birth defects, irregularities in the heartbeat, reduced muscle strength (hypotonia), weakness or reduced muscle tone (neonatal flaccidity), low body temperature, and feeding and respiratory difficulties. Infants born to mothers who have consumed this medicine during later stages of pregnancy are at risk of developing physical dependence and associated withdrawal symptoms. Pregnancy can also worsen epilepsy.

Breastfeeding

Contraindicated or Not Recommended
Warning: Amotril may pass into breast milk

Younger Adults Population

Precaution
Warning: Amotril may cause secondary sex characteristics (incomplete precocious puberty), suicidal behavior, increased production of bronchial secretion and saliva with drooling in children and infants. Special attention should be given to maintenance of the airways. Long-term use of Amotril may cause side effects on mental or physical development, evaluation of the benefit-risk should be considered for long-term use in children with seizure disorder.

Older Adults Population

Precaution
Warning: Elderly patients with liver or kidney disease may experience decreased elimination or increased accumulation of Amotril respectively. They may experience falls, fracture, confusion, and over-sedation when using Amotril. A low dose of Amotril should be given to these patients. Precaution along with monitoring of the functioning of the kidney should be advised during dose selection and when giving this medicine in patients with an abnormality in the functioning of the kidney.

Amotril Side-effects

The following side-effects may commonly occur when using Amotril tablet. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
The following side-effects may commonly occur in older patients on the use of Amotril tablet. Discuss with your doctor if any of these side-effects last for a long time or are severe:
The following side-effects may commonly occur in children when using Amotril tablet. Discuss with your doctor if any of these side-effects last for a long time or are severe:
  • increased saliva or bronchial secretion with drooling
  • mental problems
  • reversible development of premature secondary sex (incomplete precocious puberty)
Rarely, the use of Amotril tablet may cause the following side-effects:
  • abnormal condition of the blood (blood dyscrasias)
  • abnormal dryness of the eye (xerophthalmia)
  • abnormal hunger
  • abnormal involuntary movement (choreiform movements)
  • abnormal liver function
  • abrasions
  • aggressiveness
  • alcohol poisoning
  • ankle and facial swelling
  • back pain
  • bacterial skin infection (cellulitis)
  • bladder dysfunction
  • breast pain
  • build-up of fluids and mucus in the lungs (chest congestion)
  • burning or prickling sensation
  • chest pain
  • coated tongue
  • coughing
  • decreased ejaculation
  • decreased muscle tone (muscular hypotonia)
  • decreased or aggressive reactions
  • dermal bleeding
  • difficult urination
  • disconnected or detached feeling (depersonalization)
  • double vision
  • dry mouth
  • earache
  • emotional lability
  • enlarged liver (hepatomegaly)
  • enlarged lymph nodes
  • erectile dysfunction
  • exaggerated or uncontrollable emotion or excitement (hysteria)
  • excess fluid trapped in the body
  • excessive dreaming
  • excessive sneezing
  • excessive urination at night (enuresis/nocturia)
  • excitability
  • excitement
  • extreme dryness of the skin (xeroderma)
  • eye irritation
  • eye twitching
  • falling
  • feeling mad
  • feeling of discomfort
  • flare acne
  • flatulence
  • flushing
  • foot or eye swelling
  • frequent bowel movements
  • frequent urination (micturition frequency)
  • fungal infection (mycotic infection)
  • fungal infection on the skin or mucous membranes (moniliasis)
  • glassy-eyed appearance
  • headache
  • heartburn (pyrosis)
  • heavy head feeling
  • hives
  • hoarseness
  • hyperactivity
  • hypersecretion in upper respiratory passages
  • illusion
  • impotence
  • inability to perform rapidly alternating movements
  • inability to speak (aphonia)
  • increase in the number of eosinophils in the blood (eosinophilia)
  • increased appetite
  • increased production of bronchial secretion and saliva with drooling
  • increased risk for falls and fractures
  • increased saliva
  • indigestion
  • infection of the lungs (pneumonia)
  • inflammation of a vein in the leg (leg thrombophlebitis)
  • inflammation of the inside of the nose (rhinitis)
  • inflammation of the lining of bronchial tubes (bronchitis)
  • inflammation of the skin (contact dermatitis)
  • inflammation of the tissue between the lungs and chest cavity (pleurisy)
  • inflammation of the vagina (colpitis)
  • inflammation or irritation of a tendon (tendinitis)
  • influenza
  • injury
  • insomnia
  • involuntary leaking of feces (encopresis)
  • irregular heartbeat
  • irregular menstrual
  • irritability
  • jaw pain
  • knee swelling
  • lack of attention
  • lack of interest (apathy)
  • leg pain
  • localized inflammation
  • loss of the ability to create new memories (anterograde amnesia)
  • lost or increased libido
  • low back pain (lumbago)
  • mental disorders
  • migraine
  • mononucleosis infectious
  • motion sickness
  • muscle or leg cramps
  • muscle pain
  • muscle weakness
  • nape, ankle, feet, knee, joint or shoulder pain
  • nausea
  • nervousness
  • nightmares
  • nosebleed
  • organic disinhibition
  • pain
  • painful lump near the edge of the eyelid (styes)
  • painful periods (dysmenorrhea)
  • partial paralysis or weakness
  • pelvic pain
  • pigmentation changes
  • piles (hemorrhoids)
  • poor focus
  • pus-filled bumps on the skin (pustular reaction)
  • reduced sense of touch or sensation (hypoesthesia)
  • restlessness
  • reversible development of premature secondary sex (incomplete precocious puberty)
  • runny nose (rhinorrhea)
  • severe itching
  • severe pain, redness and tenderness in joints (gout)
  • shivering
  • shortness of breath/asthmatic attack
  • skin burning
  • skin rash
  • sleep disturbances
  • slurred speech
  • sore gums
  • sprains and strains
  • stomach or intestinal (gastrointestinal) inflammation
  • stomach pain
  • stomach upset
  • streptococcal infection
  • suicide ideation
  • taste loss
  • thick tongue
  • thirst
  • tooth disorder
  • toothache
  • transient hair loss
  • traumatic fracture
  • tremor
  • twitching
  • uncontrolled leakage of urine (urinary incontinence)
  • unfriendliness (hostility)
  • unwanted hair growth (hirsutism)
  • urine discoloration
  • vertigo
  • viral infection
  • visual disturbance
  • visual field defect
  • vivid dreams
  • weakness on one side of the body (hemiparesis)
  • weight loss or gain
  • wound
  • yawning
The following severe side-effects may also occur when using Amotril tablet:
  • stomach and intestinal disorders
    Symptoms: eating disorder (anorexia), constipation, diarrhea, stomach inflammation (gastritis) dehydration
  • Symptoms: slow and ineffective breathing, upper respiratory tract infection, inflammation of the nasal sinus (sinusitis), inflammation of the pharynx (pharyngitis) breathing difficulty
  • heart disorder
    Symptoms: heart failure/arrest low blood pressure on quickly standing up
  • mental and neurological disorders
  • immune system disorders
    Symptoms: allergic reaction, life-threatening allergic reaction (anaphylaxis) swelling of the lower layer of the skin
  • Symptoms: decreased platelet count, low red blood cells, decrease in the number of leukocytes abnormally low levels of thrombocytes
  • urinary system disorders
    Symptoms: inability to completely or partially empty the bladder, urinary tract infection, inflammation of the bladder (cystitis) urinary tract bleeding
  • hearing and vision disorders
    Symptoms: blurred vision middle ear infection (otitis)
  • liver disorders
    Symptoms: increased liver enzymes (transaminases and alkaline phosphatase)
  • fever | herpes simplex infection |
Your doctor has prescribed this Amotril because they have judged that the benefits outweigh the risks posed by side-effects. Many people using this medicine do not have serious side-effects. This is not a complete list of possible side-effects for Amotril.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Side-effects and Allergic Reactions of Amotril by Severity and Frequency

Common Side-effects

Following are the common side-effects of this medicine:

Infrequent and Rare Side-effects

Following are the infrequent and rare side-effects of this medicine:

Severe Side-effects

Following are the severe side-effects of this medicine:

Side-effects in Older Adults

Following are the side-effects of this medicine in elderly patients:

Side-effects in Children

Following are the side-effects of this medicine in young patients:
  • incomplete precocious puberty
  • increased saliva or bronchial secretion with drooling
  • mental impairment

Side-effects differences in men and women

While using Amotril in women the common side effects observed are breast pain, dysmenorrhea, colpitis, and menstrual irregularity. In men, delayed ejaculation and impotence occur while using this medicine.

Mild Allergic Reactions

Following are the symptoms of mild allergic reactions to this medicine:

Serious Allergic Reactions

Following are the symptoms of serious allergic reactions to this medicine:
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Increased saliva and bronchial secretion

Infants and small children are at an increased risk when using this medicine. Use of Amotril in infant and small children may cause increased production of saliva and bronchial secretion. Special care must be given in patients to maintaining airways patency, and this should be considered before giving the Amotril to patients who are difficulty handling secretions.

Brain problems, depressants, drug/alcohol abuse

Patients with swelling in the brain and spinal, taking other drugs (central nervous system depressants) or alcohol, history of drug abuse or alcohol taking other drugs or drinking alcohol are at an increased risk when using Amotril. Such patients may experience an increased risk of dependence, clinical effects of Amotril such as sedation, slow and ineffective breathing, sleepiness, dizziness, and worsening of heart disease. Precaution should be taken in patients with swelling in the brain or spinal and history of alcohol or drug abuse. Patients should not drink alcohol when using Amotril.

Breastfeeding women taking Amotril

This medicine should not be used in women who are breatfeeding.

Worsening of seizures

Patients with different types of seizure are at increased risk when using Amotril. Such patients may experience increased occurrence or worsen of the seizure involving the entire body (generalized tonic-clonic seizures). Also combined use of valproic acid and Amotril may produce seizure involving the entire body which may last for hours and even last for days (absence status epilepticus). Suitable anticonvulsants or increased dosages of these medicines should be added in the therapy.

Dependence and withdrawal reactions

There is a risk of dependence/withdrawal reactions in patients taking Amotril for long-term or high-dose. This may occur in patients with a history of alcohol/drug abuse. Patients using Amotril may have a risk of physical/psychological dependence on Amotril. Long-term or high dose therapy may lead to speech or movement disorders, involuntary eye movement and double vision. Patients using benzodiazepines at therapeutic/high dosages may increase the frequency of seizures/risk of anterograde amnesia. This medicine also causes withdrawal symptoms including sweating, insomnia, agitation, etc. These may occur after abrupt discontinuation or withdrawal of Amotril. Dose reduction should be considered when discontinuing Amotril and another anticonvulsant can be used.

Interference with memory and movement performance

Patients taking Amotril are at an increased risk. Amotril may cause central nervous depression, which may lead to decrease mental alertness in driving a motor vehicle or operating machinery. Precaution should be taken in such patients. These patients should be warned about the combined use of other central nervous depressant or alcohol during Amotril therapy.

Pregnant women or child-bearing women

Children born to mother using Amotril are at an increased risk. Children are at risk of birth defects, feeding difficulties, or reduced muscle tone etc. They may experience physical dependence/withdrawal symptoms such as behavioral disorder, tremor, psychosis, and insomnia after birth. Discontinuation of anticonvulsants should not be made in patients whom therapy is needed. But discontinuation should be considered in patients whom removal of medicines does not possess a serious threat. The use of Amotril in women with childbearing potential should be considered only after evaluating the benefit to the children. Amotril should not be used in early pregnancy. Patients should be notified about the risk to the fetus.

kidney and liver problem or anticonvulsant agents

Patients with kidney and liver problem, undergoing treatment with other centrally acting medicines or anticonvulsant agents are at an increased risk when taking this medicine. Patients with abnormal functioning of the kidney may experience increased accumulation of Amotril. When Amotril is used with anticonvulsants, it may cause sedation, lack of interest (apathy), harmful effects, or epilepsy (absence status epilepticus). Also, it may increase the clearance of Amotril by decreasing the level of Amotril. Precaution should be taken in such patients. In these cases, the dose of the Amotril should be reduced.

depression and suicide attempts

Patients with a history of depression and suicide attempts are at an increased risk when taking this medicine. Such patients should be kept under close observation.

Suicidal behavior and ideation

Patients taking Amotril are at increased risk. Use of antiepileptic drugs including Amotril may increase the risk of suicidal thoughts or behavior. Patients treated with any antiepileptic drugs for any indication should be monitored for the suicidal thoughts or behavior, changes in mood and development or worsening of depression. Appropriate therapy should be considered in such patients. Patients, families and their caregivers should be instructed of the need to be alert for these sign and symptoms.

Build-up of natural chemicals (porphyrin) in the body

Patients with a build-up of natural chemicals in the body (porphyria) are at an increased risk when taking this medicine. Such patients may have an increased risk of convulsions. Amotril should be used with precaution in patients with porphyria.

Pulmonary insufficiency, elderly or weak patients

Patients with long-term pulmonary insufficiency, elderly or weak patients (debilitated) are at an increased risk when taking this medicine. Precaution should be taken in such patients. In these cases, the dose of the Amotril should be reduced.

Rare genetic problems

Patients with rare genetic problems of galactose intolerance, the Lapp lactase deficiency or disturbed absorption of glucose-galactose are at an increased risk when taking this medicine. This medicine should not be used in such patients.

Interactions with Amotril

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
This page does not contain all the possible interactions of Amotril tablet. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.
Amotril tablet interacts with anticonvulsants (hydantoins, phenobarbital, clonazepam, carbamazepine, phenytoin, and sodium valporate), which are used to treat epilepsy. When Amotril is used with anticonvulsants, it may cause sedation, lack of interest (apathy), harmful effects, or epilepsy (absence status epilepticus). Also, it may increase the clearance of Amotril by decreasing the level of Amotril. Precaution should be taken and the risk should be kept in mind when using these medicines together.
There may be an interaction of Amotril with propantheline, which is used for the treatment of excessive sweating. When propantheline is used with Amotril, it may decrease the level of Amotril in the body.
Amotril tablet may interact with ranitidine, which is used to decrease stomach acid. When Amotril is used with ranitidine, it may alter the activity of Amotril in the body.
Your doctor's guidelines may need to be followed while taking this medicine along with antianxiety, thioxanthene, and butyrophenones, which are used to treat anxiety, mental or emotional conditions, and schizophrenia respectively. When Amotril is used with antianxiety, thioxanthene, or butyrophenones,it may increase the calming effect (central nervous system depressant effect) of Amotril on brain.
Special instructions need to be followed while taking this medicine along with narcotics, non-barbiturate hypnotics, and barbiturates, which are used to treat pain, sleeplessness, and anxiety respectively. When Amotril is used with narcotics, non-barbiturate hypnotics, or barbiturates, it may increase the calming effect (central nervous system depressant effect) of Amotril on brain.
Your doctor's guidelines may need to be followed while taking this medicine along with rifampicin and levodopa, which is used to treat tuberculosis and symptoms of movement disorders (Parkinson-like symptoms) respectively. When Amotril is used with rifampicin, it may interfere in the metabolism of Amotril. Also using Amotril with levodopa may decrease the effect of Amotril.
Special instructions need to be followed while taking this medicine along with cimetidine, fluvoxamine, disulfiram, and ritonavir, which are used to treat heartburn, depression, alcoholism, and human immunodeficiency virus infection respectively. When Amotril is used with cimetidine, fluvoxamine, disulfiram, or ritonavir, it may increase the levels of Amotril in the blood.
Amotril tablet interacts with amprenavir, which is used in the treatment of human immunodeficiency virus infection. When Amotril is used with amprenavir, it may increase the risk of slow or ineffective breathing and sedation.
There may be an interaction of Amotril with primidone and theophylline, which are used to treat epilepsy and asthma. When Amotril is used with primidone or theophylline, it may decrease the levels of Amotril.
Amotril tablet may interact with phenothiazines, monoamine oxidase inhibitors, and tricyclic antidepressants, which are used to treat schizophrenia, anxiety, and depression respectively. When Amotril is used with phenothiazines, monoamine oxidase inhibitors, or tricyclic antidepressants, it may increase the calming effect (central nervous system depressant effect) of Amotril on brain.
Your doctor's guidelines may need to be followed while taking this medicine along with nabilone, tizanidine, and opioid analgesics, which are used to treat nausea and vomiting during cancer treatment, muscle cramps and pain respectively. Using Amotril with nabilone, tizanidine, or opioid analgesics may increase the sedative effects of Amotril.
Special instructions need to be followed while taking this medicine along with mirtazapine and lofexidine, which are used to treat depression and withdrawal symptoms caused during stopping opioids respectively. The sedative effects of Amotril are increased when this medicine is used with baclofen, mirtazapine, or lofexidine.
Amotril tablet interacts with antihistamines, baclofen, and general anesthetics, which are used to treat allergies, muscle spasms and during surgery respectively. When Amotril is used with general anesthetics, antihistamines, or baclofen, it may increase the sedative effects of Amotril.
There may be an interaction of Amotril with antihypertensive drugs (angiotensin-converting enzyme inhibitors, beta-blockers, adrenergic neuron blockers, hydralazine, angiotensin-II receptor antagonists, calcium channel blockers, clonidine, methyldopa, diazoxide, diuretics, minoxidil, nitrates or nitroprusside) which are used to treat high blood pressure. When Amotril is used with antihypertensive drugs, it may increase the blood pressure lowering effect of these medicines.
Amotril tablet may interact with moxonidine or alpha-blockers, which are used to treat high blood pressure. When Amotril is used with alpha-blockers or moxonidine, it may increase the blood pressure lowering and sedative effects.
Amotril tablet may interact with central nervous system depressants. When Amotril is used with central nervous system depressants, it may increase the risk of severe sedation, slow and ineffective breathing and worsen of heart disease. Patients should not use both medicines together.

Interactions of Amotril by Severity

Severe

The following medicines are usually not to be taken together without consulting with your doctor or pharmacist.

Moderate

The following medicines may interact when taken together and can increase your risk of harmful effects. Please consult with your doctor or pharmacist before taking these medicines together.

When should Amotril be not used?

Allergic to benzodiazepines

This medicine should not be used in patients who are allergic to benzodiazepines. These patients may have the following symptoms if they use this medicine:
  • life-threatening allergic reaction (anaphylaxis)
  • swelling of the lower layer of skin

Liver disease such as severe liver insufficiency

This medicine should not be used in patients with liver disease.

Optic nerve damage

This medicine should not be used in patients with acute narrow-angle glaucoma.

Patients in a coma

This medicine should not be used in patients in a coma.

Drugs abuse or alcohol

This medicine should not be used in patients known to be abusing drugs or alcohol. Such patients may experience an increased risk of sleepiness, dizziness, sedation, slow and ineffective breathing, worsening of heart disease, and inability to operate machinery or drive a vehicle.

Patients with respiratory problems

This medicine should not be used in patients with respiratory problems such as acute pulmonary insufficiency, severe respiratory insufficiency and breathing difficulty during sleep (sleep apnoea syndrome).

Patients with muscle weakness

This medicine should not be used in patients with muscle weakness.

Patients with lactose intolerance

This medicine should not be used in patients with rare problems of galactose intolerance, the Lapp lactase deficiency or disturbed absorption of glucose-galactose.

Use of central nervous system depressants

Patients should not use both medicines together. When Amotril is used with central nervous system depressants, it may increase the risk of severe sedation, slow and ineffective breathing and worsen of heart problems.

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Amotril is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.
This page provides information for Amotril tablet .
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