Amitriptyline

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

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

Comments

See Also

References

Authors:

Claire, Matin Shah