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Pregnancy, breastfeeding and fertility while taking amitriptyline for pain and migraine

Amitriptyline and pregnancy

Amitriptyline can be taken during pregnancy and is not thought to be harmful to your baby.

Although amitriptyline is safe to use, paracetamol is usually the first choice of painkiller during pregnancy. However, amitriptyline may be recommended if other painkillers, like paracetamol or codeine, are not effective in treating your condition.

Speak to your doctor or specialist about taking amitriptyline during pregnancy. They can discuss with you the benefits and risks and help you to choose the best treatment for you and your baby.

Amitriptyline and breastfeeding

If your doctor or health visitor says your baby is healthy, you can take amitriptyline while breastfeeding.

Although other medicines might be preferred for pain and migraine while you're breastfeeding, it's important you take the medicine that works for you. Talk to your doctor or pharmacist to help you decide.

Amitriptyline passes into breast milk in very small amounts and has only been linked with side effects in very few breastfed babies.

It's important not to share a bed with your baby while you're taking amitriptyline.

Talk to your health visitor, midwife, pharmacist or doctor as soon as possible if you have any concerns, including if your baby:

  • is not feeding as well as usual or putting on weight as you would expect
  • seems unusually sleepy
  • seems restless or irritable
  • is constipated
  • is not peeing as much (not producing as many wet nappies)

Amitriptyline and fertility

There's no evidence that amitriptyline affects fertility in either men or women.

Non-urgent advice: Tell your doctor if you're:

  • trying to get pregnant
  • pregnant
  • breastfeeding

Page last reviewed: 14 August 2023
Next review due: 14 August 2026