Amitriptyline (Elavil)

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Description Amitriptyline tablets belong to a class of drugs called tricyclic antidepressants (TCAs), used in the treatment of symptoms of mental depression, including anxiety. Elavil is thought to improve mood by raising the level of neurotransmitters (the brain messenger chemicals norepinephrine and serotonin) thereby improving anxiety with its sedative effects. Side effects of amitriptyline include dry mouth, mild drowsiness, photosensitivity, urinary retention, tinnitus (ringing in the ears), and confusion. It should be taken at night due to its sedative effects. It may take up to two to three weeks to take effect.

Original uses (on-label) Depression

Newly discovered uses (off-label) Chronic fatigue syndrome, chronic nausea and vomiting, chronic neuropathic pain, diabetic neuropathy, dyspepsia, fibromyalgia, interstitial cystitis, irritable bowel syndrome, migraine prevention, multiple sclerosis, panic disorder, post-herpetic neuralgia, post-traumatic stress disorder, pruritus, urticaria, vulvodynia.

Potential side effects Sudden drop in blood pressure upon standing from a sitting or lying down position, increased heart rate, changes in heart rhythm, restlessness, dizziness, insomnia, sedation, allergic rash, hives, photosensitivity reaction (skin reaction related to sun exposure), loss of hair, weight gain, dry mouth, constipation, urinary retention, various blood abnormalities, blurred vision, pupil widening, ocular pressure increase, ringing in the ears, numbness, tremor, sweating, withdrawal reactions.

Cautions

Do not use if you have been taking an MAO inhibitor such as phenelzine, tranylcypromine, or isocarboxazid within the past 14 days. When used with MAO-I’s, fever, high blood pressure, increased heart rate, confusion, seizures, and deaths have been reported.
Do not use this drug immediately after a heart attack.
This drug can cause sedation, which may impair performance of tasks requiring alertness. Sedative effects may be additive with other drugs that cause similar effects.
If you're planning to buy amitriptyline online, please remember that this drug may worsen psychosis or mania in patients with bipolar disease.
Stop therapy with doctor permission and according to instructions (gradual taper) prior to elective surgery.
Do not abruptly stop taking this medication; instead, taper gradually.
Before buying Amitriptyline, notify your doctor if you have low blood pressure, as this drug can cause low blood pressure episodes.
Use with caution if you have urinary retention, history of cardiac disease, seizure disorders, diabetes, benign prostatic hyperplasia, narrow angle glaucoma, dry mouth, visual problems, constipation, or a history of bowel obstruction.
The possibility of suicide attempt may persist until remission occurs.
Use with caution if you have hyperthyroid disorder or if you are receiving thyroid supplementation.
Use with caution if you have liver or kidney dysfunction, or if you are elderly.

Drug interactions MAO inhibitors (e.g., phenelzine, tranylcypromine, isocarboxazid), ritonavir, bupropion, amphetamines, anticholinergics, sedatives, chlorpropamide, tolazamide, warfarin, fluoxetine, fluvoxamine, citalopram, escitalopram, paroxetine, sertraline, cimetidine, carbamazepine, haloperidol, smoking, methylphenidate, valproic acid, clonidine, venlafaxine, protease inhibitors, quinidine, diltiazem, verapamil, lithium, phenothiazines, drugs which prolong QT interval.

Food interactions Alcohol

Herbal interactions Valerian, St. John’s wort, kava kava, gotu kola

Pregnancy and breast-feeding cautions FDA Pregnancy Risk Category C. This drug is excreted in the breast milk; breast-feeding is not recommended during therapy.

Buy Amitriptyline online

Where can I buy Amitriptyline without prescription?
Elavil antidepressant is a prescription drug that comes in 10 mg, 25 mg, 50 mg tablets. It is available on prescription only as tablets for oral use, but the online pharmacy, will sell Elavil without prescription. You may be able to order Amitriptyline from them online and save the local pharmacy markup.

Special information It may take a few weeks to experience the full benefits of Elavil treatment. Individuals taking it are encouraged to expect up to a 30 day wait before seeing improvement. Amitriptyline effectiveness depends on building up a steady dose of the medication in your body and maintaining it over time. This medication will commonly be prescribed for no more than 6 months, at which time your doctor may want to evaluate your treatment or recommend tests to see if you're having any physical reactions to the medication you may not be aware of. Do not skip doses, even if you feel you do not need them, as this may reduce the effectiveness of Elavil.

Treatment of multiple sclerosis You can order amitriptyline to treat MS. Multiple Sclerosis patients may suffer neuropathic pain — pain that arises from nerve dysfunction, not a result of direct injury. Painful paresthesias (burning sensations, pins and needles, and stabbing pains) are caused by damage to the regulating pathways of the brain and spinal cord. This type of pain has also been treated with amitriptyline. Other off-label uses of this drug include migraine prevention, tension headache prevention, chronic pain, fibromyalgia, neuropathy, and trigeminal neuralgia (a facial nerve disorder). TCAs should not be used in combination with another type of antidepressant called MAO inhibitors.

What is Amitriptyline? Increases concentration of serotonin and/or norepinephrine in the central nervous system, which may alter mood and other symptoms.

Brands & Classes Brand name
Elavil, Endep, Amitone, Amit, Amitryn

Generic name
Amitriptyline

Chemical class
Dibenzocycloheptene derivative; tertiary amine.

Therapeutic class
Antidepressant, tricyclic; antineurolgic; anxiolytic, anti-migraine.

Avail forms Tablets - Oral 10 mg, 25 mg, 50 mg.

Dosage ADULT
PO 50-100 mg hs, may increase to 200 mg/day, not to exceed 300 mg/day (chronic pain doses usually at lower end of range).

Adolescent / Geriatric
PO 30 mg/day in divided doses, may be increased to 150 mg/day.

CHILD
Chronic pain management: PO 0.1 mg/kg/day in 3 divided doses initially, advance as tolerated over 2-3 weeks to 0.5-2 mg/kg qhs. Depression: PO 1 mg/kg/day in 3 divided doses initially with increases to 1.5 mg/kg/day.