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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).


 Fighting the Fight: Fibromyalgia Explained



Fighting the Fight: Fibromyalgia Explained

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:



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



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



-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



-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;


heart rhythm medicine such as flecainide, propafenone, quinidine, and others; or

medicine to treat mental illness.

This list is not complete. Other drugs may interact with amitriptyline, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Note: This page contains information about the side effects of amitriptyline. Some of the dosage forms included on this document may not apply to the brand name Elavil.



For the Consumer

Applies to amitriptyline: oral tablet


In addition to its needed effects, some unwanted effects may be caused by amitriptyline (the active ingredient contained in Elavil). In the event that any of these side effects do occur, they may require medical attention.


Major Side Effects

You should check with your doctor immediately if any of these side effects occur when taking amitriptyline:


Incidence not known:

Abdominal or stomach pain


black, tarry stools

bleeding gums

blood in urine or stools

blurred vision

burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

change in consciousness

changes in patterns and rhythms of speech

chest pain or discomfort


cold sweats



confusion about identity, place, and time

continuing ringing, buzzing, or other unexplained noise in ears


cool, pale skin

cough or hoarseness

dark urine

decrease in frequency of urination

decrease in urine volume

decreased urine output

difficulty in breathing

difficulty in passing urine (dribbling)

difficulty in speaking

disturbance of accommodation

disturbed concentration

dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly

double vision


dry mouth



false beliefs that cannot be changed by facts

fast, slow, or irregular heartbeat

fear or nervousness

fever with or without chills

flushed, dry skin

fruit-like breath odor

general feeling of tiredness or weakness


hearing loss

high fever

high or low blood pressure


inability to move arms, legs, or facial muscles

inability to speak

increased hunger

increased need to urinate

increased ocular pressure

increased sweating

increased thirst

increased urination


lack of coordination


light-colored stools

lip smacking or puckering

loss of appetite

loss of balance control

loss of bladder control

loss of consciousness

lower back or side pain

mental depression or anxiety

muscle spasm or jerking of all extremities

muscle tightness

muscle trembling, jerking, or stiffness

muscle twitching

nausea and vomiting

nightmares or unusually vivid dreams

overactive reflexes

painful or difficult urination

passing urine more often

pinpoint red spots on skin

poor coordination

pounding in the ears

puffing of cheeks

rapid or worm-like movements of tongue

rapid weight gain


seeing, hearing, or feeling things that are not there


severe muscle stiffness

shakiness and unsteady walk


shortness of breath

shuffling walk


slow speech

slurred speech

sore throat

sores, ulcers, or white spots on lips or in mouth

stiffness of limbs


sudden loss of consciousness


swelling of face, ankles, or hands

swelling or puffiness of face

swollen glands

talking or acting with excitement you cannot control

trouble in speaking

trouble sleeping

troubled breathing

twisting movements of body pain or discomfort in arms, jaw, back, or neck

unable to sleep

uncontrolled chewing movements

uncontrolled movements, especially of arms, face, neck, back, and legs

unexplained weight loss

unpleasant breath odor

unsteadiness, trembling, or other problems with muscle control or coordination

unusual bleeding or bruising

unusual tiredness or weakness

unusually pale skin

upper right abdominal pain

vomiting of blood

weakness in arms, hands, legs, or feet

weight gain or loss

yellow eyes and skin

If any of the following symptoms of overdose occur while taking amitriptyline, get emergency help immediately:


Symptoms of overdose:



low body temperature

muscle aches

muscle weakness



weak or feeble pulse

Minor Side Effects

Some of the side effects that can occur with amitriptyline may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:


Incidence not known:

Bigger, dilated, or enlarged pupils (black part of eye)

black tongue


breast enlargement in females


decreased interest in sexual intercourse


hair loss, thinning of hair

hives or welts

inability to have or keep an erection

increased in sexual ability, desire, drive, or performance

increased interest in sexual intercourse

increased sensitivity of eyes to light

loss in sexual ability, desire, drive, or performance

loss of sense of taste

redness or other discoloration of skin

severe sunburn

skin rash

swelling of testicles

swelling of the breasts or breast soreness in males

swelling of the parotid glands

swelling or inflammation of the mouth

unexpected or excess milk flow from breasts


For Healthcare Professionals

Applies to amitriptyline: compounding powder, intramuscular solution, oral tablet



Frequency not reported: Weakness, fatigue, hyperpyrexia, edema of face and tongue[Ref]


Nervous system

Rare (less than 0.1%): Serotonin syndrome

Frequency not reported: Coma, seizures, confusional states, disorientation, incoordination, ataxia, tremors, peripheral neuropathy, numbness, tingling and paresthesia of the extremities, extrapyramidal symptoms (including abnormal involuntary movements and tardive dyskinesia), dysarthria, disturbed concentration, restlessness, drowsiness, dizziness, headache, tinnitus, alteration in EEG patterns, irritability, sleep disturbance, ageusia

Postmarketing reports: Syndrome resembling neuroleptic malignant syndrome (NMS) including muscle rigidity, fever, mental status changes, diaphoresis, tachycardia[Ref]



Frequency not reported: Myocardial infarction, stroke, nonspecific ECG changes and changes in AV conduction, heart block, arrhythmias, hypotension (particularly orthostatic hypotension), syncope, hypertension, tachycardia, palpitation[Ref]



Rare (less than 0.1%): Mania/hypomania

Frequency not reported: Hallucinations, delusions, excitement, anxiety, insomnia, nightmares, suicidal ideation/behaviors[Ref]



Frequency not reported: Paralytic ileus, constipation, dry mouth, nausea, epigastric distress, vomiting, stomatitis, peculiar taste, diarrhea, parotid swelling, black tongue[Ref]



The most commonly reported side effects were tremors, dizziness, headache, dry mouth, constipation, and nausea.[Ref]



Frequency not reported: Urinary retention, dilatation of the urinary tract, testicular swelling, gynecomastia (male), breast enlargement, galactorrhea (female), increased or decreased libido, impotence, urinary frequency[Ref]



Frequency not reported: Bone marrow depression (including agranulocytosis, leukopenia, thrombocytopenia), purpura, eosinophilia[Ref]



Frequency not reported: Syndrome of inappropriate ADH (antidiuretic hormone) secretion[Ref]



Rare (less than 0.1%): Hepatitis (including altered liver function, cholestasis and jaundice), hepatic failure, hepatic necrosis[Ref]



Frequency not reported: Skin rash, urticaria, photosensitization, alopecia, increased perspiration[Ref]



Frequency not reported: Lupus-like syndrome (migratory arthritis, positive ANA and rheumatoid factor)[Ref]



Frequency not reported: Anorexia, elevation or lowering of blood sugar levels, weight gain or loss, hyponatremia, increased appetite[Ref]



Frequency not reported: Blurred vision, disturbance of accommodation, increased ocular pressure, mydriasis[Ref]




1. Cerner Multum, Inc. "Australian Product Information." O 0

2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

3. "Product Information. Elavil (amitriptyline)." Stuart Pharmaceuticals, Wilmington, DE.

Not all side effects for Elavil may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.




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Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. 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 substances you are taking, check with your doctor, nurse, or pharmacist.

Elavil dosage information:


Elavil (amitriptyline hydrochloride) tablet


General dosage information for the active ingredient contained in Elavil:


Amitriptyline (oral tablet, intramuscular solution, compounding powder)


Please confirm that the medication forms on the dosage document(s) above are relevant for the specific drug you are interested in.

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