Amitriptyline HCL (Elavil)

Generic name: Amitriptyline hydrochloride
Brands: Elavil, Endep, Levate
Class: Tricyclic antidepressants

Amitriptyline is an old tertiary amine tricyclic antidepressant which is used to treat symptoms of depression. It elevates mood by raising the level of neurotransmitters in the brain.

Amitriptyline is very sedating. Therefore it may be helpful for insomnia, nervousness, agitation, anxiety and eating disorders. Also, amitriptyline is widely used in the management of chronic pain syndromes such as migraines, headaches, vulvodynia, fibromyalgia, and irritable bowel syndrome.

Do NOT use Amitriptyline (Elavil) if:

you are currently taking or have taken a monoamine oxidase inhibitor (MAOI) (eg, phenelzine, selegiline) within the last 14 days.
you are taking antihistamines (eg, diphenhydramine), cisapride, droperidol, mibefradil, or pimozide.
you are recovering from myocardial infarction.
you have had a QTc interval prolongation or cardiac arrhythmia.

Important things to know:

Amitriptyline is associated with a higher likelihood of weight gain than other antidepressants.
It is dangerous in overdose.
Amitriptyline carries a risk of cardiotoxicity. It may cause arrhythmias, sinus tachycardia, and prolongation of the conduction time.
It should be used with caution in people with glaucoma, seizures, urinary retention, poor liver function, seizures, manic-depressive illness, or heart disease.

Description	Quantity	Pharmacy	Price
Amitriptyline 25 mg	30 tablets	MPLLC	$62
Amitriptyline 25 mg	60 tablets	MPLLC	$68
Amitriptyline 25 mg	90 tablets	MPLLC	$72
Amitriptyline 50 mg	30 tablets	MPLLC	$64
Amitriptyline 50 mg	60 tablets	MPLLC	$69
Amitriptyline 50 mg	90 tablets	MPLLC	$73
Amitriptyline 75 mg	30 tablets	MPLLC	$65
Amitriptyline 75 mg	60 tablets	MPLLC	$71
Amitriptyline 75 mg	90 tablets	MPLLC	$74

More Information

Precautions

Amitriptyline may cause dry mouth. Sucking a hard candy, chewing gum, or melting bits of ice in your mouth can provide relief.
Avoid drinking alcohol or taking other sedatives and tranquilizers that cause drowsiness while taking Amitriptyline.
The most common side effects include dry mouth, drowsiness, constipation, sedation, and dizziness or lightheadedness when standing. The dizziness is usually caused by a drop in blood pressure when changing position.

Amitriptyline (Elavil) dosage

Depression: the usual starting dosage is 75 mg daily in divided doses or 50-100 mg once daily at bedtime. Dosage may be gradually adjusted to the level that produces maximal therapeutic effect with minimal toxicity and may range from 150 to 300 mg daily.

Usual maintenance dosage: 50-100 mg taken once daily, preferably at bedtime. For some patients, 25-40 mg daily may be sufficient.

Pain management: initially 25 mg at bedtime, the dose may be increased to 100 mg per day.

Prophylaxis of chronic headache: 10 to 75 mg one to two hours before bedtim.

Elderly: for older adults the usual dose is 10 mg taken 3 times a day, with 20 mg taken at bedtime.

Tricyclic antidepressants are not recommended for children under 12 years of age.

Amitriptyline may not work right away. You may see some benefit within a week. However, it may take up to 4 weeks before you feel the full effect.

Amitriptyline (Elavil) alternatives

Nortriptyline (Pamelor) is a tricyclic antidepressant, which has pharmacologic effects similar to amitriptyline. Nortriptyline is less sedating, and less likely to cause hypotension or anticholinergic effects than amitriptyline.

The body converts amitriptyline to its active metabolite - nortriptyline. In other words, if you take amitriptyline you end up with nortriptyline in the blood as well. Nortriptyline accounts for most of the norepinephrine-reuptake inhibition after amitriptyline intake.