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