Amitriptyline: Difference between revisions
ClaireLewis (talk | contribs) (Created page with "==Administration== *Type: Tricyclic antidepressant *Dosage Forms: *Routes of Administration: oral, IM *Common Trade Names: Elavil ==Adult Dosing== *50-100-300mg daily, in...") |
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==Administration== | ==Administration== | ||
*Type: [[Tricyclic antidepressant]] | *Type: [[Tricyclic antidepressant]] | ||
*Dosage Forms: | *Dosage Forms: tablet, injectable solution | ||
*Routes of Administration: | *Routes of Administration: PO, IM | ||
*Common Trade Names: Elavil | *Common Trade Names: Elavil, Levate | ||
==Adult Dosing== | ==Adult Dosing== | ||
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*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C | ||
*[[Lactation risk categories|Lactation risk]]: Infant risk cannot be ruled out | *[[Lactation risk categories|Lactation risk]]: Infant risk cannot be ruled out | ||
*Renal dosing: | *Renal dosing: TCAs like amitryptyline don't require dose adjustment in mild or moderate renal impairment but are often avoided in kidney disease because of the increased risk for adverse cardiac side effects such as arrhythmias. | ||
*Hepatic dosing: use with caution | *Hepatic dosing: avoid in patients with liver failure and use with caution in those with impaired liver function, as lower doses may be required to reach therapeutic serum levels since TCAs like amitryptyline are metabolized by the liver | ||
==Contraindications== | ==Contraindications== | ||
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==Pharmacology== | ==Pharmacology== | ||
*Half-life: | *Half-life: 9 - 27 hours | ||
*Metabolism: Hepatic via CYP2D6 | *Metabolism: Hepatic via CYP2D6 | ||
*Excretion: | *Excretion: Urine, small amounts in feces | ||
==Mechanism of Action== | ==Mechanism of Action== | ||
Neurotransmitter (especially norepinephrine and serotonin) reuptake inhibitor; anticholinergic | |||
==Comments== | ==Comments== | ||
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==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Pharmacology]] | [[Category:Pharmacology]] [[Category:Psychiatry]] | ||
Latest revision as of 03:13, 12 June 2024
Administration
- Type: Tricyclic antidepressant
- Dosage Forms: tablet, injectable solution
- Routes of Administration: PO, IM
- Common Trade Names: Elavil, Levate
Adult Dosing
- 50-100-300mg daily, in 1-3 doses
Pediatric Dosing
Safety/efficacy not established in children <12yo
- >12yo: 10mg TID and 20mg qHS
Special Populations
- Pregnancy Rating: C
- Lactation risk: Infant risk cannot be ruled out
- Renal dosing: TCAs like amitryptyline don't require dose adjustment in mild or moderate renal impairment but are often avoided in kidney disease because of the increased risk for adverse cardiac side effects such as arrhythmias.
- Hepatic dosing: avoid in patients with liver failure and use with caution in those with impaired liver function, as lower doses may be required to reach therapeutic serum levels since TCAs like amitryptyline are metabolized by the liver
Contraindications
- Allergy to class/drug
- Use of MAOIs concomitantly or within 14 days
- Recent MI
- Concomitant use of cisapride
Adverse Reactions
Serious
- Prolonged QT, dysrhythmia, MI, sudden cardiac death
- Agranulocytosis
- Hepatotoxicity
- Neuroleptic malignant syndrome
- Seizure
- Worsening depression, suicidality
Common
- Somnolence, dizziness
- Headache
- Constipation, xerostomia
- Blurred vision
- Weight gain
Pharmacology
- Half-life: 9 - 27 hours
- Metabolism: Hepatic via CYP2D6
- Excretion: Urine, small amounts in feces
Mechanism of Action
Neurotransmitter (especially norepinephrine and serotonin) reuptake inhibitor; anticholinergic