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Elavil (Amitriptyline) is in a class of drugs called tricyclic antidepressants. Amitriptyline affects chemicals in the brain that may become unbalanced and cause depression.

Uses Amitriptyline (am-ee-TRIP-tih-leen) 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. How to take Amitriptyline may be taken with food or on an empty stomach. Amitriptyline may take up to 30 days to control symptoms of depression. Use as directed by your doctor. Continue to use Amitriptyline even if you feel well. Do not miss any doses. Avoid eating or drinking grapefruit juice while taking Amitriptyline. Side effects Check with your doctor if any of these most common side effects persist or become bothersome: Blurred vision, change in sexual desire or ability, constipation, diarrhea, dizziness, drowsiness, dry mouth, headache, loss of appetite, nausea, tiredness, trouble sleeping, weakness. Seek medical attention right away if any of these severe side effects occur: Severe allergic reactions (rash, hives, itching, difficulty breathing, tightness in the chest, swelling of the mouth, face, lips, or tongue), chest pain, confusion, dark urine, delusions, difficulty speaking or swallowing; fainting, fast or irregular heartbeat; fever, chills, or sore throat; hallucinations, new or worsening agitation, anxiety, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being, restlessness, or inability to sit still; numbness or tingling in an arm or leg; one-sided weakness, seizures, severe or persistent dizziness or headache; severe or persistent trouble sleeping; slurred speech, suicidal thoughts or actions; tremor, trouble urinating, uncontrolled muscle movements (eg, of face, tongue, arms, legs); unusual bleeding or bruising; unusual or severe mental or mood changes; vision problems, yellowing of the skin or eyes. Symptoms of overdose may include flushing, fast or irregular heartbeat, dry mouth, drowsiness, confusion, agitation, enlarged pupils, seizures, loss of consciousness, hallucinations, stupor, mydriasis, hyperpyrexia, paralytic ileus, urinary retention, decreased GI motility, cardiovascular toxicity, rhabdomyolysis, renal failure, respiratory depression, cyanosis, shock, diaphoresis, aspiration, ARDS, hyperthermia, hypothermia, polyradiculoneuropathy, muscle rigidity, disorders of ocular motility, vomiting. If you suspect an overdose of Amitriptyline, seek medical attention immediately. Precaution Some medical conditions may interact with Amitriptyline. Tell your doctor if you have any medical conditions, especially if any of the following apply to you: If you are pregnant, planning to become pregnant, or are breast-feeding If you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement; If you have allergies to medicines, foods, or other substances; If you have a history of mental illness (eg, bipolar disorder, mania, manic-depression), or have considered or attempted suicide; If you have alcoholism or regularly consume 3 or more alcoholic beverages per day; If you have glaucoma, an irregular heartbeat, heart disease, chest pain, liver disease, prostate problems, thyroid disease, or are unable to urinate (urinary retention); If you have a history of seizures, epilepsy, or porphyria. Amitriptyline may cause dizziness, drowsiness, or blurred vision. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Amitriptyline. Using Amitriptyline alone, with other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks. Avoid drinking alcohol or taking other medicines that cause drowsiness (eg, sedatives, tranquilizers) while taking Amitriptyline. Amitriptyline will add to the effects of alcohol and other depressants. Amitriptyline may cause dizziness, lightheadedness, or fainting, alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects. Involuntary and uncontrollable movements may develop in patients taking Amitriptyline. Occurrence is highest among the elderly, especially women. The risk of developing these involuntary movements and the likelihood they will become permanent are increased with long-term use and with high doses. However, it is possible to develop these symptoms after short-term use at low doses. Contact your health care provider at once if any of the following occur: involuntary movements of the tongue, face, mouth, or jaw (eg, protrusion of tongue, puffing of cheeks, puckering of mouth, chewing movements), sometimes accompanied by involuntary movements of the arms and legs. Amitriptyline may cause sensitivity to sunlight. Avoid prolonged exposure to the sun and other ultraviolet light (eg, tanning beds). Use sunscreens and wear protective clothing until tolerance is determined. Do not become overheated in hot weather or during exercise or other activities since heatstroke may occur. Contact your doctor at once if new, worsened, or sudden symptoms such as depressed mood, anxious, restless, or irritable behavior; panic attacks, or any unusual change in mood or behavior occur. Contact your doctor right away if any signs of suicidal thoughts or actions occur. Diabetes patients - Amitriptyline may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine. Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Amitriptyline. Use caution in the elderly, they may be more sensitive to its effects, especially lightheadedness upon standing, rapid heartbeat, breathing problems, difficult urination, and constipation. Amitriptyline has been shown to cause harm to the human fetus. If you plan on becoming pregnant, discuss with your doctor the benefits and risks of using Amitriptyline during pregnancy. Amitriptyline is excreted in the breast milk. Do not breast-feed while taking Amitriptyline. Drug interactions Tell your health care provider if you are taking any other medicines, especially any of the following: MAOIs (eg, phenelzine, selegiline) because they can cause serious, sometimes life-threatening, reactions. Do NOT take MAO inhibitors with, or within 2 weeks of taking, Amitriptyline; Anticholinergics (eg, scopolamine), bupropion, cimetidine, fluconazole, phenothiazines (eg, chlorpromazine), SSRIs (eg, fluoxetine), terbinafine, or valproic acid because side effects such as blurred vision, difficult urination, drowsiness or sedation, dry mouth, or lightheadedness may occur; Antihistamines (eg, diphenhydramine), cisapride, droperidol, ketolides (eg, telithromycin), macrolides (eg, erythromycin), mibefradil, pimozide, or streptogramins (eg, quinupristin/dalfopristin) because serious side effects on the heart (eg, racing heartbeat, dizziness, fainting, life-threatening abnormal heartbeat leading to unconsciousness, and lack of heartbeat, may be increased by Amitriptyline; Carbamazepine, thyroid medicines (eg, levothyroxine, Synthroid), or stimulants (eg, albuterol, pseudoephedrine) because their side effects may be increased by Amitriptyline; Warfarin because side effects such as serious bleeding may be increased by Amitriptyline; Clonidine, guanethidine, or guanfacine because the effectiveness of these medicines may be decreased. This may not be a complete list of all interactions that may occur. Ask your health care provider if Amitriptyline may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine. Missed dose If you miss a dose of Amitriptyline, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. Storage Store Amitriptyline at room temperature, below 86 degrees F (30 degrees C) in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Amitriptyline out of the reach of children and away from pets.

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