Trade Names:Amitriptyline- Tablets 10 mg- Tablets 25 mg- Tablets 50 mg- Tablets 75 mg- Tablets 100 mg- Tablets 150 mgAPO-Amitriptyline (Canada)
Inhibits presynaptic reuptake of norepinephrine and serotonin in CNS.
Metabolized in the liver by N-demethylation and bridge hydroxylation. Nortriptyline is an intermediate active metabolite.
50% to 66% excreted in the urine within 24 h. Excreted as glucuronide or sulfate conjugate of metabolites. A small amount of unchanged drug excreted in the urine. T ½ is 31 to 46 h.
May have increased plasma levels. Dosage adjustment may be necessary.
Relief of depression. Endogenous depression is more likely to be alleviated than are other depressive states.
Management of chronic pain associated with migraine, tension headache, phantom limb pain, tic douloureux, diabetic neuropathy, peripheral neuropathy, cancer or arthritis; treatment of panic and eating disorders.
Hypersensitivity to any tricyclic antidepressant; use during acute recovery phase of MI; concomitant use with MAOIs, except under close medical supervision; may block the antihypertensive action of guanethidine or similarly active compounds.
Titrate dosage over 2 wk to 1 mo. Give maintenance dose 6 mo to 1 yr. Do not interrupt therapy abruptly; reduce over 2 wk period.Outpatients
PO 75 to 150 mg/day in divided doses; give in evening or at bedtime because of sedative effects.Hospitalized patients
PO 100 to 300 mg/day.Adolescents and elderly
PO 10 mg 3 times daily and 20 mg at bedtime.Maintenance
PO 40 to 100 mg/day.
Give drug with or immediately after food or fluid and in late afternoon or at bedtime because of sedative effect. Tablets may be crushed.
Store at room temperature and protect from light.
May cause decreased blood levels of amitriptyline.Cimetidine, fluoxetine
May cause increased blood levels of amitriptyline.Clonidine
Use with product may result in hypertensive crisis.CNS depressants
Depressant effects may be additive.MAOIs
May cause hyperpyretic crises, severe convulsions, and death when given with amitriptyline.
None well documented.
Orthostatic hypotension; hypertension; tachycardia; palpitations; arrhythmias; ECG changes.
Confusion; hallucinations; disturbed concentration; decreased memory; delusions; nervousness; restlessness; agitation; panic; insomnia; nightmares; mania; exacerbation of psychosis; drowsiness; dizziness; weakness; emotional lability; numbness; tremors; extrapyramidal symptoms (eg, pseudoparkinsonism, movement disorders, akathisia); seizures.
Rash; pruritus; photosensitivity reaction; dry skin; acne; itching.
Conjunctivitis; blurred vision; increased IOP; mydriasis; tinnitus; nasal congestion; peculiar taste in mouth.
Nausea; vomiting; anorexia; GI distress; diarrhea; flatulence; dry mouth; constipation.
Impotence; sexual dysfunction; menstrual irregularities; dysmenorrhea; nocturia; urinary frequency; UTI; vaginitis; cystitis; urinary retention and hesitancy.
Bone marrow depression, including agranulocytosis; eosinophilia; purpura; thrombocytopenia; leukopenia.
Elevation or depression of blood sugar levels.
Pharyngitis; rhinitis; sinusitis; cough.
Category D .
Excreted in breast milk.
Not recommended for children younger than 12 yr of age.
Caution is needed with history of seizures; urinary retention; urethral or ureteral spasm; angle-closure glaucoma or increased IOP; cardiovascular disorders; hyperthyroidism and patients receiving thyroid medication; hepatic or renal function impairment; schizophrenia; paranoia.
Waiting period of 7 to 10 days is necessary to prevent hypertensive crisis.
Some TCAs inhibit neuronal reuptake of serotonin and can increase synaptic serotonin levels.
Confusion, agitation, hallucinations, seizures, status epilepticus, clonus, choreoathetosis, hyperactive reflexes, positive Babinski's sign, coma, cardiac arrhythmias, renal failure, flushing, dry mouth, dilated pupils, hyperpyrexia.
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