Amitriptyline
- Atc Codes:N06AA09
- CAS Codes:549-18-8#50-48-6
- PHARMGKB ID:549-18-8#50-48-6
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Substrate of
- Inhibits
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Tryptizol; Belgium: Redomex; Bulgaria: Amitriptylin; Cyprus: Amirol, Ormal, Saroten Retard; Czech Republic: Amitriptylin; Denmark: Amitriptylin, Saroten; Estonia: Amitriptylin, Amitriptyline, Saroten; Finland: Triptyl; France: Elavil, Laroxyl; Germany: Amineurin, Amitriptylin, Psypharm, Saroten, Syneudon; Greece: Maxivalet, Saroten, Stelminal, Thymontil; Hungary: Teperin; Ireland: Amitriptyline; Italy: Adepril, Amitr, Laroxyl, Triptizol; Latvia: Amitriptyline, Amitriptylinum, Saroten Retard; Lithuania: Amitriptyline; Luxembourg: Equilibrin; Malta: Amirol, Tryptizol; Netherlands: Amitriptyline, Sarotex, Tryptizol; Poland: Amitriptylinum; Portugal: Adt, Tryptizol; Romania: Amitriptilin, Amitriptilina; Slovakia: Amitriptylin; Slovenia: Amyzol; Spain: Deprelio, Tryptizol; Sweden: Saroten, Tryptizol; UK: Amitriptyline.
North America
Canada: Amitriptyline, Elavil, Levate, Novo-Triptyn; USA: Amitriptyline.
Latin America
Argentina: Amitriptilina, Fiorda, Tryptalgin, Tryptanol, Uxen Retard; Brazil: Amitriptilina, Amytril, Neo Amitriptilin, Neurotrypt, Protanol, Trisomatol, Tryptanol; Mexico: Anapsique, Tryptanol.
Asia
Japan: Amiplin, Normaln, Tryptanol.
Drug combinations
Amitriptyline and Chlordiazepoxide
Amitriptyline and Medazepam
Amitriptyline and Perphenazine
Amitriptyline, Diazepam, and Perphenazine
Chemistry
Amitriptyline Hydrochloride: C~20~H~23~N HCl. Mw: 313.86. (1) 1-Propanamine, 3-(10,11-dihydro-5H-dibenzo[a,d]cyclohepten-5-ylidene)-N,N-dimethyl-, hydrochloride; (2) 10,11-Dihydro-N,N-dimethyl-5H-dibenzo[a,d]cycloheptene-Δ^5^,^γ^-propylamine hydrochloride. CAS-549-18-8; CAS-50-48-6 (amitriptyline).
Pharmacologic Category
Antidepressants; Tricyclics and Other Norepinephrine-reuptake Inhibitors. (ATC-Code: N06AA09).
Mechanism of action
Increases synaptic concentration of serotonin and/or norepinephrine in the central nervous system by inhibiting their reuptake in the presynaptic neuronal membrane.
Therapeutic use
Relief of symptoms of depression.
Pregnancy and lactiation implications
Teratogenic effects have been observed in animal studies. Amitriptyline crosses the human placenta and CNS effects, limb deformities and developmental delay have been noted in case reports. Administration is not recommended during lactation.
Unlabeled use
Analgesic for certain chronic and neuropathic pain. Prophylaxis against migraine headaches. Treatment of depressive disorders in children.
Contraindications
Hypersensitivity to amitriptyline or any component of the formulation (cross-sensitivity with other tricyclics). Use of MAO inhibitors.
Warnings and precautions
Risk of suicidal thinking and behavior. May worsen psychosis or precipitate a shift to mania or hypomania in bipolar disorder. Not for treatment of bipolar depression. Anticholinergic effects (constipation, xerostomia, blurred vision, urinary retention) may occur. Bone marrow suppression (rarely). May cause orthostatic hypotension. Sedation. Caution in cardiovascular disease (previous myocardial infarction, stroke, tachycardia, or conduction abnormalities), diabetes mellitus, hepatic and renal impairment, hyperthyroidism/thyroid supplementation or seizures. Hyperpyrexia (in combination with anticholinergics and/or neuroleptics) has been observed. Effects may be potentiated with other sedative drugs or ethanol. Therapy should not be abruptly discontinued. May increase risks associated with electroconvulsive therapy.