Amitriptyline hydrochloride
Amitriptyline hydrochloride (Elavil)
Amitriptyline hydrochloride
(ah-me- TRIP-tih-leen)
Pregnancy Category: C Apo-Amitriptyline Elavil Levate (Rx) Novo-Tryptin

Classification: Antidepressant, tricyclic

See Also: See also Antidepressants, Tricyclic.

Action/Kinetics: Amitriptyline is metabolized to an active metabolite, nortriptyline. Has significant anticholinergic and sedative effects with moderate orthostatic hypotension. Very high ability to block serotonin uptake and moderate activity with respect to norepinephrine uptake. Effective plasma levels of amitriptyline and nortriptyline: Approximately 110-250 ng/mL. Time to reach steady state: 4-10 days. t 1/2: 31-46 hr. Up to 1 month may be required for beneficial effects to be manifested.

Uses: Relief of symptoms of depression, including depression accompanied by anxiety and insomnia. Chronic pain due to cancer or other pain syndromes. Prophylaxis of cluster and migraine headaches. Investigational: Pathologic laughing and crying secondary to forebrain disease, bulimia nervosa, antiulcer agent, enuresis. Adjunct analgesic for phantom limb pain, migraine, chronic tension headaches, diabetic neuropathy, tic douloureux, cancer pain, peripheral neuropathy with pain, postherpetic neuralgia, arthritic pain. Dermatologic disorders (chronic urticaria and angioedema, nocturnal pruritus in atopic eczema).

Contraindications: Use in children less than 12 years of age.

Additional Drug Interactions: May block the antihypertensive effect of guanethidine and similar drugs.

How Supplied: Injection: 10 mg/mL; Tablet: 10 mg, 25 mg, 50 mg, 75 mg, 100 mg, 150 mg

Dosage
?Tablets Antidepressant.
Adults (outpatients): 75 mg/day in divided doses; may be increased to 150 mg/day. Alternate dosage: Initial, 50-100 mg at bedtime; then, increase by 25-50 mg, if necessary, up to 150 mg/day. Hospitalized clients: initial, 100 mg/day; may be increased to 200-300 mg/day. Maintenance: usual, 40-100 mg/day (may be given as a single dose at bedtime). Adolescent and geriatric: 10 mg t.i.d. and 20 mg at bedtime up to a maximum of 100 mg/day.
Chronic pain.
50-100 mg/day.
Enuresis.
Pediatric, over 6 years: 10 mg/day as a single dose at bedtime; dose may be increased up to a maximum of 25 mg. Less than 6 years: 10 mg/day as a single dose at bedtime.
Analgesic adjunct.
75-300 mg/day.
Dermatologic disorders.
10-50 mg/day.
?IM Only Antidepressant.
Adults: 20-30 mg q.i.d.; switch to PO therapy as soon as possible.