Amitriptyline Hydrochloride (Elavil)

What is it?

Classed as an antidepressant it may also be used to promote restful sleep in those with certain rheumatic diseases. 

FDA approved:

April 1961

Brand Names and International Availability:

Adepril (Italy); Amicen; Amilent; Amilit (Italy); Amineurin (Germany); Amiplin (Taiwan); Amiprin (Japan); Amitrip (New-Zealand); Amyline (Ireland); Amyzol; Anapsique (Mexico); Apo-Amitriptyline (Canada); Domical (England, Hong-Kong); Elatrol (Israel); Elatrolet (Israel); Elavil (US); Enafon (Korea); Endep (Australia, New-Zealand); Etravil (Korea); Lantron (Japan); Laroxyl (Benin, Burkina-Faso, Ethiopia, Gambia, Ghana, Guinea, Ivory-Coast, Kenya, Liberia, Malawi, Mali, Mauritania, Mauritius, Morocco, Niger, Nigeria, Senegal, Seychelles, Sierra-Leone, South-Africa, Sudan, Tanzania, Tunia, Uganda, Zambia, Zimbabwe, France, Germany, Italy); Larozyl; Lentizol (Benin, Burkina-Faso, Ethiopia, Gambia, Ghana, Guinea, Ivory-Coast, Kenya, Liberia, Malawi, Mali, Mauritania, Mauritius, Morocco, Niger, Nigeria, Senegal, Seychelles, Sierra-Leone, South-Africa, Sudan, Tanzania, Tunia, Uganda, Zambia, Zimbabwe, England); Miketorin (Japan); Noriline (US); Novoprotect (Germany); Pinsanu *; Pinsaun (Taiwan); Redomex (Belgium); Saroten Retard (Malaysia); Saroten (Benin, Burkina-Faso, Ethiopia, Gambia, Ghana, Guinea, Ivory-Coast, Kenya, Liberia, Malawi, Mali, Mauritania, Mauritius, Morocco, Niger, Nigeria, Senegal, Seychelles, Sierra-Leone, South-Africa, Sudan, Tanzania, Tunia, Uganda, Zambia, Zimbabwe, Denmark, Germany, Sweden, Switzerland, Portugal, South-Africa, Cyprus, Iran, Greece, Finland, Taiwan); Sarotena (India); Sarotex (Netherlands, Norway); Syneudon (Germany); Teperin (Iraq, Jordan, Hungary); Trepiline (South-Africa); Tridep (India); Tripta (Malaysia, Thailand); Triptizol (Italy); Trynol (Taiwan); Tryptal (Israel); Tryptanol (Australia, New-Zealand, New-Zealand, Argentina, Mexico, Colombia, Japan, Hong-Kong, Malaysia, Thailand, South-Africa); Tryptine (Australia, New-Zealand); Tryptizol (England, Netherlands, Norway, Spain, Sweden, Switzerland, Portugal, Belgium, Denmark, Austria); Trytomer (India); Uxen (Argentina); Vanatrip (US)

How does it work?

The exact mechanism is not known. It appears to interfer with the reuptake of norepinephrine and/or serotonin in the brain. 

Dosage:

Up to 300mg per day may be used to treat depression. However much lower doses are usually used to treat rheumatic diseases.

How should I take it?

Take as ordered by your doctor, usually in the evening.

Contraindications:

Amitriptyline is contraindicated in people who have shown prior hypersensitivity to it.

It should be used with caution in people with a history of seizures.

It should be used with caution in people with a history of urinary retention.

It should be used with caution in people with a history of glaucoma.

It should be used with caution in people with a history of cardiovascular disorders.

Close supervision is required when amitriptyline is given to hyperthyroid patients or those receiving thyroid medication.

Amitriptyline should be used during pregnancy only if the potential benefit to the mother justifies the potential risk to the fetus.

Amitriptyline HCl should be used with caution in patients with impaired liver function.

Drugs Interactions:

It should not be given along with monoamine oxidase inhibitors. 

Do not use with Epinephrine.

Tagament can increase blood levels of amitriptyline and its side effects. 

Because of the potent nature of this medicine, be sure to tell your doctor about any other medicines you are taking, including nonprescription medicines and vitamins.

Possible side effects:

These side effects are not considered serious but are certainly annoying for those experiencing them. The most frequently reported side effects include anxiety, constipation, or diarrhea, drowsiness or dizziness, dry mouth, increased sensitivity of the skin to sun or ultraviolet light, loss of appetite, nausea, and weight gain or loss. 

More serious side effects that you should report right away include blurred vision or eye pain, breast enlargement in both males and females, confusion, hallucinations, difficulty breathing, fainting spells, irregular or fast, pounding heartbeat, palpitations, muscle stiffness, or spasms, pain or difficulty passing urine, loss of bladder control, seizures (convulsions), sexual difficulties, swelling of the testicles, unusual weakness or tiredness, and yellowing of the eyes or skin.

Precautions & Special Notes:

When possible, the drug should be discontinued several days before elective surgery.

The sedative effect of the medication can possibly impair the mental and physical abilities required for driving or operating machinery, especially in the first few days.

For more information:
RxList Elavil
MedicineNet Elavil

References:
Mosby’s GenRx®, 10th ed. Copyright © 2000 Mosby, Inc.
RxList.com