Amitriptyline is a heterocyclic drug used to treat spontaneous endogenous depression and is extremely sedating. This drug may also be helpful in the treatment of agitation, anorexia, adjunctive treatment of neurogenic pain,  bulimia associated with depression, chronic hiccups,insomnia, major depression, or in a patient with chronic pain and other pain syndromes including: Ciguatera, posttherpetic neuralgia, neuropathic, and vulvodynia.



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CLASS: Tertiary Tricyclic.
Generic name: Amitriptyline Hydrochloride.
Type: Antidepressant.

Strengths:

Injection:
10 mg / ml.

Oral:
10mg / 5 ml.

Tables:
10mg, 25 mg, 50 mg, 75 mg, 100 mg, 150 mg.

Dosages:
Actual dosage must be determined by a  physician.

Injection:
20 to 30 mg 4 times daily.

Oral:
Start: 25 mg 2 to 4 times daily.
Increases: 10 to 25 mg daily in 1 week intervals.
Maintenance: 50 to 100 mg in 24 hours.
Maximum: 150 mg in 24 hours.

Normal dosage:

If under 12 years of age, ONLY USE IF UNDER THE GUIDANCE OF A CHILD PSYCHIATRIST!
18 to 60 years of age, 75 mg a day.
Over 60 years of age, Low dose and increased cautiously.

Problems with:

Liver Function: Lower dosage, as needed.
Kidney Function: Lower dosage, as needed.

Test:

Before taking: Electrocardiogram.
While taking: None.

Take With: May be taken without food.

Full Benefits In: In a few days to a few weeks. If any unpleasant side effects, they should appear right away.

Missed Dose(s): If you take this drug at bedtime and dosage is missed, do not take it in morning. If within one hour take, if over an hour skip and then continue on your normal schedule. Never Take a Double Dose!

If Stop Taking: Do not stop without consulting your physician and never abruptly.

Overdose symptoms include: Change in body temperature, convulsions, coma, congestive heart failure, or vomiting.
Overdose can be fatal!
Warning signs: Agitation, high body temperature, excessive movement, flushing, or stiff muscles.


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Warnings

The habit-forming potential is none. This drug if beneficial should be taken about six months, in a few up to a year.

Do not take this drug if you are pregnant try some non-drug alternatives.

Do not take this drug if planning to become pregnant. Do not take if you are breast-feeding.

Do not give this drug to anyone under the age of twelve. If over sixty only use drug in small doses and with close monitoring of it's side effects.  ( E.g. Blood pressure lowering, confusion )

Do not use if: You had negative reactions to this drug or any drug of this type in the past.

Inform your Doctor if: You had negative reactions to any drug or any drug of this type in the past. If you have epilepsy. If you are taking any other prescription or nonprescription drug. If you plan to be under anesthesia or having any surgery in the next few months, also if you will be undergoing any medical tests.


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Amitriptyline ( Symptoms or Effects )

Common: Blurred vision, constipation, drowsiness, dry mouth, increased sensitivity to sun, low blood pressure, increase in sweating, sleepiness, or weight gain.

Rare: Confusion, increased appetite, insomnia, racing heartbeat / palpitations, seizures, sexual problems, or skin rashes / allergies.

See physician always: Low blood pressure, confusion, seizures, sexual problems, or skin rashes / allergies.

See physician if severe: Blurred vision, constipation, drowsiness, dry mouth, racing heartbeat / palpitations, insomnia, increased sensitivity to sun, increase in sweating, sleepiness, weight gain, or increased appetite.

See physician NOW: Confusion or skin rashes / allergies.

Stop taking and see physician NOW:  Seizures.

Elavil
Amitriptyline (a mee TRIP ti leen)

Elavil, Endep, Vanatrip

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What is the most important information I should know about Elavil?
¢ It may be 4 weeks or more before you start to feel better, but do not stop taking Elavil without first talking to your doctor.
¢ Use caution when driving, operating machinery, or performing other hazardous activities. Elavil may cause drowsiness or dizziness. If you experience drowsiness or dizziness, avoid these activities.
¢ Dizziness is likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall.
¢ Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking Elavil.


What is Elavil?
¢ Elavil is in a class of drugs called tricyclic antidepressants. Elavil affects chemicals in the brain that may become unbalanced and cause depression.
¢ Elavil is used to relieve symptoms of depression such as feelings of sadness, worthlessness, or guilt; loss of interest in daily activities; changes in appetite; tiredness; sleeping too much; insomnia; and thoughts of death or suicide. Elavil is also sometimes used to treat certain types of pain.
¢ Elavil may also be used for purposes other than those listed in this medication guide.


What should I discuss with my healthcare provider before taking Elavil?
¢ Do not take Elavil if you have taken a monoamine oxidase inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) within the last 14 days.
¢ Before taking Elavil, tell your doctor if you have
    · liver disease;
    · kidney disease;
    · asthma;
    · thyroid disease;
    · diabetes;
    · stomach or intestinal problems;
    · high blood pressure or heart disease;
    · had a heart attack in the last 6 weeks;
    · an enlarged prostate or difficulty urinating; or
    · glaucoma.
¢ You may not be able to take Elavil, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
¢ Elavil may be harmful to an unborn baby. Do not take Elavil without first talking to your doctor if you are pregnant or could become pregnant during treatment.
¢ Elavil passes into breast milk and may affect a nursing baby. Do not take Elavil without first talking to your doctor if you are breast-feeding a baby.
¢ If you are over 60 years of age, you may be more likely to experience side effects such as drowsiness, dizziness, unsteadiness, feeling uncoordinated, and low blood pressure. Your doctor may prescribe a lower dose of this medication.


How should I take Elavil?
¢ Take Elavil exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
¢ Take each dose with a full glass (8 oz) of water.
¢ Elavil may be taken several times a day or in one daily dose (usually at bedtime). Follow your doctor's instructions.
¢ Do not stop taking Elavil suddenly. This could cause symptoms such as nausea, headache, and malaise.
¢ It may be 4 weeks or more before you start to feel better, but do not stop taking Elavil without first talking to your doctor.
¢ Store Elavil at room temperature away from moisture and heat.


What happens if I miss a dose?
¢ Take the missed dose as soon as you remember. If it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take a double dose of this medication unless otherwise directed by your doctor.


What happens if I overdose?
¢ Seek emergency medical attention.
¢ Symptoms of an Elavil overdose include seizures, confusion, drowsiness, agitation, hallucinations, and low blood pressure (dizziness, fatigue, fainting).


What should I avoid while taking Elavil?
¢ Use caution when driving, operating machinery, or performing other hazardous activities. Elavil may cause drowsiness or dizziness. If you experience drowsiness or dizziness, avoid these activities.
¢ Dizziness is likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall.
¢ Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking Elavil.
¢ Do not stop taking Elavil suddenly. This could cause symptoms such as nausea, headache, and malaise.


What are the possible side effects of Elavil?
¢ If you experience any of the following serious side effects, stop taking Elavil and contact your doctor immediately or seek emergency medical treatment:
    · an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, face, or tongue; or hives);
    · seizures;
    · a fast or irregular heartbeat;
    · a heart attack;
    · high blood pressure (blurred vision, headache);
    · difficulty urinating; or
    · fever with increased sweating, muscle stiffness, or severe muscle weakness.
¢ Other, less serious side effects may be more likely to occur. Continue to take Elavil and talk to your doctor if you experience
    · drowsiness or dizziness;
    · dry mouth and eyes;
    · constipation;
    · mild tremor;
    · sweating;
    · mild agitation, weakness, or headache;
    · ringing in the ears;
    · nausea; or
    · loss of weight or appetite.
¢ Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.


What other drugs will affect Elavil?
¢ Do not take Elavil if you have taken a monoamine oxidase inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) within the last 14 days.
¢ Elavil may increase the effects of other drugs that cause drowsiness, including other antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any other prescription or over-the-counter medicines without first talking to your doctor.
¢ Drugs other than those listed here may also interact with Elavil. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.


Where can I get more information?
¢ Your pharmacist has additional information about Elavil written for health professionals that you may read.

¢ Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
¢ Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Click here for more information on Elavil from the manufacturer.