Elavil

Generic Name: amitriptyline (a mee TRIP ti leen)
Brand Names: Elavil

What is Elavil?

Elavil (amitriptyline) is a tricyclic antidepressant.

Elavil affects chemicals in the brain that may be unbalanced in people with depression.

Elavil is used to treat symptoms of depression.

Important information

You should not use Elavil if you have recently had a heart attack.

Do not use Elavil if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Before taking Elavil, tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, Symbyax), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft).

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You may have thoughts about suicide when you first start taking an antidepressant such as Elavil, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Before taking this medicine

You should not use Elavil if you are allergic to amitriptyline, or:

if you have recently had a heart attack.

Do not use Elavil if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

To make sure Elavil is safe for you, tell your doctor if you have:

bipolar disorder (manic-depression) or schizophrenia;

a history of mental illness or psychosis;

liver disease;

heart disease;

a history of heart attack, stroke, or seizures;

diabetes (amitriptyline may raise or lower blood sugar);

glaucoma; or

problems with urination.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

It is not known whether amitriptyline will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using Elavil.

Amitriptyline can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using Elavil.

Elavil is not approved for use by anyone younger than 12 years old.

How should I take Elavil?

Take Elavil exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.

If you need surgery, tell the surgeon ahead of time that you are using Elavil. You may need to stop using the medicine for a short time.

Do not stop using Elavil suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using Elavil.

Store at room temperature away from moisture, heat, and light.

Elavil dosing information

Usual Adult Dose of Elavil for Depression:

Outpatients:

Usual dose: 75 mg orally per day in divided doses; this may be increased to a total of 150 mg per day if needed

Alternate dose: 40 to 100 mg orally as a single dose at bedtime; this may be increased by 25 or 50 mg as needed at bedtime to a total of 150 mg per day

Maximum dose: 150 mg orally per day

Inpatients:

Initial dose: 100 mg orally per day

Maintenance dose: 40 to 100 mg orally as a single dose at bedtime

Maximum dose: 300 mg orally per day

Comments:

-Dosage should be reduced to the lowest amount that will maintain relief of symptoms, when satisfactory improvement has been obtained.

-Dose increases should preferably be made in the late afternoon or at bedtime due to the sedative effect.

-The full therapeutic effect may take as long as 30 days to develop.

-Maintenance therapy should be continued for 3 months or longer to lessen the possibility of relapse.

Use: Relief of symptoms of depression

Usual Geriatric Dose of Elavil for Depression:

10 mg orally 3 times a day with 20 mg at bedtime

Comments:

-The full therapeutic effect may take as long as 30 days to develop.

-Elderly patients should be monitored carefully and serum levels obtained as clinically appropriate.

-Dose adjustments should be made according to clinical response.

Use: Relief of symptoms of depression

Usual Pediatric Dose for Depression:

12 years or older:

10 mg orally 3 times a day with 20 mg at bedtime

Use: Relief of symptoms of depression

See also: Dosage Information (in more detail)

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of amitriptyline can be fatal.

Overdose symptoms may include uneven heartbeats, extreme drowsiness, confusion, agitation, vomiting, hallucinations, feeling hot or cold, muscle stiffness, seizure (convulsions), or fainting.

What should I avoid while taking Elavil?

Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with Elavil.

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Avoid exposure to sunlight or tanning beds. Elavil can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Elavil side effects

Get emergency medical help if you have signs of an allergic reaction to Elavil: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

unusual thoughts or behavior;

a light-headed feeling, like you might pass out;

chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating;

pounding heartbeats or fluttering in your chest;

confusion, hallucinations;

a seizure (convulsions);

painful or difficult urination;

severe constipation;

easy bruising, unusual bleeding; or

sudden weakness or ill feeling, fever, chills, sore throat, mouth sores, red or swollen gums, trouble swallowing.

Common Elavil side effects may include:

constipation, diarrhea;

nausea, vomiting, upset stomach;

mouth pain, unusual taste, black tongue;

appetite or weight changes;

urinating less than usual;

itching or rash;

breast swelling (in men or women); or

decreased sex drive, impotence, or difficulty having an orgasm.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Elavil?

Taking this medicine with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking Elavil with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone.

Tell your doctor about all your current medicines and any you start or stop using, especially:

other antidepressants;

cimetidine;