I take amitriptyline 10 mg at bedtime for the management of vestibular migraines. Can I sometimes take Tylenol or Advil when I have menstrual cramps?

Amitriptyline (when effective) can reduce the frequency of migraines. However, it is not contraindicated to take an analgesic such as tylenol (acetaminophen) or advil (ibuprofen, motrin) for the relief of an onset migraine. Tylenol is safer than Advil. Given the possible interactions with Advil, ask your pharmacist to validate with your pharmacological file if it is safe for you to take Advil (always with food to reduce gastric irritation).

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You also say that you take 1 extra tablet of amitriptyline when your migraines are severe. Do you find this effective in decreasing the duration or intensity of your migraines compared to just 10 mg? In fact, an amitriptyline-type medication usually takes around 2 weeks to start working. The same is true for dose increases. Therefore, increasing the dose spontaneously, as you are doing, is unlikely to make a difference compared to taking only 10 mg. If you tolerate the 20 mg dose of amitriptyline well, you may want to ask your pharmacist to send a pharmaceutical opinion to your doctor suggesting that you increase the dose to 20 mg per day on a regular basis for better control of your migraines.

Also, remember that the total amount of pain medication (including Tylenol, Advil or other pain medication, excluding amitriptyline) should not exceed 15 doses per month. Exceeding this amount can lead to what is known as rebound or overuse headaches. This creates a kind of vicious circle by increasing the frequency of your migraines, forcing you to take more and more pain medication regularly. Try to avoid this!

Correction: I said not to exceed more than 15 doses per month. Actually, to be accurate, it is to not exceed more than 15 DAYS of painkiller use per month.

Advil or tylenol can also help with menstrual pain, but you should be careful not to exceed 15 days of painkillers per month.

Hello, thank you for the clarification.

Regarding amitriptyline, the "morning after" feeling and residual drowsiness that you experience when taking 20 mg instead of 10 mg is quite normal. When the dose of this type of medication is increased, the body must readapt to the new dose. It is therefore normal to experience the side effects you are experiencing. It usually takes several days and sometimes up to 2 weeks for the body to get used to the new dose (just like when you first started taking the medication). Usually, it is best to keep a fixed dose of amitriptyline and use another fast-acting medication for migraine relief as clinically determined by your doctor (e.g., a drug from the tryptan family, an anti-inflammatory drug, or other). You could ask your pharmacist to send an opinion to your doctor on this subject following his analysis of your file to see if a medication of this type could be prescribed to you.Regarding your menstrual pain, you can indeed take tylenol or advil for relief (check with your pharmacist for advil especially). Naproxen (another anti-inflammatory drug like advil) is also often prescribed for this purpose. It can be prescribed, but it can also be purchased over the counter at the pharmacy. You should therefore ask the pharmacist for it so that it can be put in your pharmaceutical file. If you have a regular menstrual cycle, one method is to start taking advil or naproxen (one or the other, NOT BOTH) 2 days before the first day of your period and continue during your period. The latter method can be tried when starting at the onset of pain is not enough.I hope I have answered your question better!Don't hesitate to contact me again if you need to. It's a pleasure for me!