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Amitriptyline: General information
Amitriptyline belongs to the group of tricyclic antidepressants that have an expressed antidepressant and sedative effect. The medicine eliminates the symptoms of depression, anxiety and agitation.
Amitriptyline inhibits the reuptake mechanism of transmembrane norepinephrine and serotonin in adrenergic and serotonergic neurons. This effect may potentiate or prolong the activity of the neuron because reuptake plays an important physiological role in the transmission of biogenic amines. The effect on the reuptake of serotonin and / or norepinephrine provides an antidepressant effect of amitriptyline. Furthermore, it possesses antihistaminic and anticholinergic properties.
After oral administration the drug is rapidly absorbed from the gastrointestinal tract. The maximum concentration in plasma is reached after 6 hours.
Approximately 90% of amitriptyline reversibly binds with plasma proteins. The drug is metabolized in the liver and excreted by the kidneys and intestines. One third to one half of the amount administered is excreted by the kidneys within 24 hours.
Amitriptyline is used in treatment of:
– depression, conjugated to anxiety;
– nocturnal enuresis in children.
Amitriptyline 25mg must not be taken with MAO inhibitors, in the initial phase of recovery after myocardial infarction, congestive heart failure, and intestinal obstruction.
The drug is contraindicated in patients with known hypersensitivity to the ingredients of the medicine.
Amitriptyline is not recommended to take during pregnancy and lactation.
If you want to use Amitriptyline, you should be aware of its dosage. For ambulatory patients a standard daily dose is 75 -100 mg orally, divided into 3.
For other patients, the initial daily dose is 50-100 mg or 20-40 mg orally (1-2 ml) at 2-4 doses at daily administration. The drug is administered intramuscularly or intravenously. In the absence of the side effects the dose may be gradually increased to 300 mg / day.
Amitriptyline 50mg requires strict medical supervision when treating the patients with cardiovascular disorders, a history of narrow-angle glaucoma or increased intraocular pressure. Like other tricyclic antidepressants this medication is prescribed with caution for patients with severe hypertension, liver failure, and prostatic hypertrophy with urinary retention.
Amitriptyline 10mg should be prescribed with caution for patients with a history of seizures.
Prior to surgery under general anesthesia the therapy should be discontinued at least for 48 hours prior to general anesthesia.
When the therapy is combined with hormonal treatment for patients with hyperthyroidism, then a careful medical supervision is recommended.
When replacing the drug with MAO inhibitors, then a14-day break between the end and the beginning of therapy with the drug is required.
The physician must make sure to warn the patients about the effects of amitriptyline on the ability to concentrate the attention (driving and operating machinery).
Before you use amitriptyline, consider its interactions with other medications.
Simultaneous treatment with amitriptyline and other antidepressants may increase the antidepressant effect.
Co-administration of the drug and sympathomimetics may increase the risk of arrhythmias. Atropine and anticholinergic drugs (neuroleptics and anti-Parkinsonian agents) increase the risk of anticholinergic effects with the concurrent use of amitriptyline (dry mouth, constipation, blurred vision, cholinergic delirium in the elderly, etc.).
Amitriptyline: Side effects
If you want to use amitriptyline, read about its possible side effects. Side effects of amitriptyline occur infrequently and are less observed when compared to other antidepressants.
These include: dry mouth, drowsiness, headache, diplopia, blurred vision, increased intraocular pressure, hypotension, palpitation, tachycardia, constipation and urinary retention.