Medications and Drugs
Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: amitriptyline
BRAND NAME: Endep (Elavil: This brand name drug is no longer available in the U.S.)
DRUG CLASS AND MECHANISM: Amitriptyline is an antidepressant drug. Depression
is an all-pervasive sense of sadness and gloom. It is believed that in some
patients with depression, abnormal levels of neurotransmitters (chemicals that
nerves use to communicate with each other) may relate to their depression.
Amitriptyline elevates mood by raising the level of neurotransmitters in nerves
of the brain. Amitriptyline was approved by the FDA in May 1983.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 10, 25, 50, 75, 100, and 150mg.
STORAGE: Amitriptyline should be stored at room temperature in a tight, light
resistant container. Avoid storage at temperatures above 30°C (86°F).
PRESCRIBED FOR: Amitriptyline is used to elevate the mood of patients with
depression.
DOSING: Amitriptyline may be taken with or without food. The recommended
adult dose is 40-150 mg daily in divided doses. The lowest effective dose should
be used.
DRUG INTERACTIONS: Amitriptyline should not be used with monoamine oxidase
inhibiting drugs. High fever, convulsions and even death can occur when these
two drugs are used together. Epinephrine should not be used with amitriptyline,
since together they can cause severe high blood pressure. Alcohol blocks the
antidepressant action of amitriptyline but increases its sedative effect.
Cimetidine (Tagamet) can increase blood levels of amitriptyline and its side
effects.
PREGNANCY: Safety in pregnancy and children is not established.
NURSING MOTHERS: Amitriptyline is secreted in
human milk and potentially can
adversely affect the nursing infant.
SIDE EFFECTS: Sometimes troublesome side effects include fast heart rate,
blurred vision, urinary retention, dry mouth, constipation, weight gain or loss,
and low blood pressure on standing. Rash, hives,
seizures, and hepatitis are
rare side effects.
Amitriptyline is used with caution in patients with seizures since it can
increase the risk of seizures. Amitriptyline is used with caution in patients
with prostate enlargement because of the risk of increasing retention of urine
due to the inability to urinate. Amitriptyline can cause elevated pressure in
the eyes of certain patients with glaucoma.
Antidepressants increased the risk of suicidal thinking and behavior in
short-term studies in children and adolescents with depression and other
psychiatric disorders. Anyone considering the use of amitriptyline or any other
antidepressant in a child or adolescent must balance this risk with the clinical
need. Patients who are started on therapy should be closely observed for
clinical worsening, suicidal thinking or behavior, and unusual changes in
behavior.
If amitriptyline is discontinued abruptly, dizziness, headache, nausea, and
restlessness may occur. Withdrawal symptoms may occur when even a few doses are
missed. Therefore, it is recommended that the dose of antidepressant be reduced
gradually when therapy is discontinued.
Reference: FDA Prescribing Information
Last Editorial Review: 1/10/2008
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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