Amitriptyline

Amitriptyline is a prescription medication used to treat mental/mood problems such as Depression. 

• Amitriptyline is available under the following different brand names: Elavil, Levate

Adult and pediatric dosage

Tablet

• 10mg
• 25mg
• 50mg
• 75mg
• 100mg
• 150mg

Depression

Adults

• Outpatient: 25-50 mg orally every evening initially; increased by 25 mg every 5-7 days to 100-200 mg/day (may divide doses throughout day or give at bedtime); if needed, may increase to 300 mg/day
• Inpatient: 100-300 mg orally each day

Adolescents

• Initial: 25-50 mg/day orally in divided doses
• Increased gradually to 100 mg/day in divided doses

Dosage Considerations – Should be Given as Follows: 

• See "Dosages."

Common side effects of Amitriptyline include:

• drowsiness, 
• dizziness, 
• dry mouth, 
• blurred vision, 
• constipation, 
• weight gain, and
• trouble urinating

Serious side effects of Amitriptyline include:

• easy bruising, 
• unusual bleeding, 
• persistent heartburn, 
• shaking, 
• mask-like facial expressions, 
• muscle spasms, 
• severe stomach pain, 
• decreased sexual ability or desire, 
• enlarge or painful breasts, 
• black stools, 
• vomit that looks like coffee grounds, 
• severe dizziness, 
• fainting, 
• seizures, 
• eye pain, swelling, or redness, 
• vision changes, 
• seeing halos around lights, 
• fever, 
• muscle stiffness, 
• severe confusion, 
• sweating, 
• fast or irregular heartbeat, 
• rash, 
• itching, 
• swelling of the face, tongue, or throat, and
• trouble breathing 

Rare side effects of Amitriptyline include:

• none 

This is not a complete list of side effects and other serious side effects or health problems may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them.  Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first

• Amitriptyline has severe interactions with at least 16 other drugs.
• Amitriptyline has serious interactions with at least 133 other drugs.
• Amitriptyline has moderate interactions with at least 377 other drugs.
• Amitriptyline has minor interactions with at least 105 other drugs.  

This information does not contain all possible interactions or adverse effects.  Visit the RxList Drug Interaction Checker for any drugs interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use.  Keep a list of all your medications with you, and share this information with your doctor and pharmacist.  Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns.

Contraindications

• Hypersensitivity
• Acute recovery phase following MI
• Concurrent use with cisapride
• Contraindicated within 14 days of MAOIs; if linezolid or IV methylene blue (MAOIs) must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity; may resume 24 hours after last linezolid or methylene blue dose, or after 2 weeks of monitoring, whichever comes first

Effects of drug abuse

• None

Short-Term Effects

• See "What are Side Effects Associated with Using Amitriptyline?"

Long-Term Effects

• See "What Are Side Effects Associated with Using Amitriptyline?"

Cautions

• Bone marrow suppression reported
• Avoid use in narrow-angle glaucoma
• May cause sedation and impair mental and physical abilities
• Avoid use with any drugs or conditions that prolong QT interval
• May cause orthostatic hypotension
• Use caution in patients with cardiovascular disease, diabetes, mania, hepatic and renal impairment, thyroid dysfunction, and seizure disorder
• May worsen mania symptoms or precipitate mania in patients with bipolar disorder
• Clinical worsening and suicidal ideation may occur despite medication in adolescents and young adults (18-24 years)
• Risk of anticholinergic side effects; may cause constipation, urinary retention, blurred vision, and xerostomia
• Use caution in patients with urinary retention, open-angle glaucoma, BPH, decreased gastrointestinal motility, or paralytic ileus
• Possibility of EPS and neuroleptic malignant syndrome
• Abrupt discontinuation of therapy not recommended in patients receiving high doses for prolonged periods
• Fractures reported with therapy

Pregnancy and Lactation

• Use with caution if benefits outweigh risks during pregnancy.  
• Distributed in breast milk; do not nurse (AAP states effect on nursing infants is unknown but may be of concern).