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Dependence or withdrawal symptoms can occur with misuse

doi: 10.3389/fimmu.2017.00023

Drug metabolism in microorganisms

G., McGonigle, D

The post-opening discard period exists because: Sterility can no longer be fully guaranteed after first puncture Preservatives slow microbial growth but do not eliminate contamination risk Risk of contamination increases with repeated vial access For this reason, healthcare and laboratory settings typically follow a fixed discard timeframe (commonly 28 days), unless otherwise specified by the manufacturer

Amitriptyline, Nortriptyline (Pamelor), Doxepin, Imipramine (Norpramin), and Clomipramine are common TCAs