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
  • Pregnancy Rating: C
  • Lactation risk: Infant risk cannot be ruled out
  • Renal dosing:
  • Hepatic dosing: use with caution

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

See Also

References
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