Amitriptyline belongs to antidepressants, and on group belonging to tricyclic compounds.
The mechanism of therapeutic action is based on the inhibition of the reverse neuronal uptake of norepinephrine and serotonin. As a result, their concentration in the synapses of the central nervous system increases significantly. To the additional positive effects of the reception can be attributed to the central analgesic, anti-tumor and anti-ulcer action.
On this page you will find all the information about Amitriptyline: complete instructions for use for this drug, average prices in pharmacies, complete and incomplete analogues of the drug, as well as reviews of people who have already used Amitriptyline. Want to leave your opinion? Please write in the comments.
Pharmacy sales terms
It is released on prescription.
How much is Amitriptyline? The average price in pharmacies is at 30 rubles.
Release form and composition
On 10 tablets with a dosage of 25 mg in the blister. 5 blisters of 10 tablets each are placed in a pack of cardboard.
- 1 tablet contains amitriptyline hydrochloride in recalculation on amitriptyline-25 mg;
- excipients: lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, hypromellose, magnesium stearate, aerosil, macrogol 6000, titanium dioxide, talc, tween-80, acid red 2 C.
The mechanism of the antidepressant effect of the drug is based on the inhibition of the reverse neuronal uptake of dopamine, norepinephrine and serotonin.
It is an antagonist of muscarinic cholinergic receptors, has anti-adrenergic and antihistamine properties, and is effective in bedtime incontinence. It has a central analgesic effect, anti-bolemic and anti-ulcer effects. For the full manifestation of the antidepressant action takes 2-4 weeks.
Indications for use
According to the instructions, Amitriptyline is prescribed for the treatment of depressive states of an involutionary, reactive, endogenous, medicinal nature, as well as depressions against the background of alcohol abuse, organic brain lesions, accompanied by sleep disorders, agitation, anxiety.
Indications for the use of Amitriptyline are:
- Schizophrenic psychosis;
- Emotional mixed disorders;
- Behavior disorders;
- Nocturnal enuresis (except that caused by low bladder tone);
- Nervous bulimia;
- Chronic pains (migraine, atypical facial pain, pain in cancer patients, post-traumatic and diabetic neuropathy, rheumatic pain, postherpetic neuralgia).
Amitriptyline is also used in gastrointestinal ulcers, for relieving headaches and preventing migraines.
Amitriptyline is contraindicated for use in the event of the development of such conditions:
- individual intolerance to the active substance;
- with a pronounced increase in blood pressure;
- in severe disorders of the liver and urinary system;
- heart failure (decompensated);
- acute infarction and recovery period after a similar condition;
- in violation of the conduction of the heart muscles;
- exacerbations of gastric ulcer and duodenal ulcer;
- the drug is not used in the treatment of pregnant and lactating women, as well as patients under the age of 6 years.
Simultaneous use with MAO inhibitors, patients with atony of the bladder, intestinal obstruction and prostatic hypertrophy is strictly contraindicated.
The drug is used with extreme caution during the treatment of people with a history of alcoholism, bronchial asthma, a tendency to manic-depressive psychosis, epilepsy, hyperthyroidism, angina, heart failure, angle-closure glaucoma, intraocular hypertension, schizophrenia.
Use during pregnancy and lactation
In pregnant women, the drug should be used only if the intended benefit to the mother outweighs the potential risk to the fetus.
Penetrates into breast milk and may cause drowsiness in infants. In order to avoid the development of the syndrome of "cancellation" in newborns (manifested by shortness of breath, drowsiness, intestinal colic, increased nervous irritability, increased or decreased blood pressure, tremor or spastic phenomena), amitriptyline is gradually canceled at least 7 weeks before the expected birth.
Instructions for use Amitriptyline
The instructions for use indicated that Amitriptyline tablets are prescribed by mouth (during or after a meal).
- The initial daily dose for oral administration is 50-75 mg (25 mg in 2-3 doses), then gradually increase the dose by 25-50 mg, until the desired antidepressant effect is obtained. The optimal daily therapeutic dose is 150-200mg (the maximum part of the dose is taken at night).
- In severe depressions resistant to therapy, the dose is increased to 300 mg or more, to the maximum tolerated dose. In these cases, treatment is advisable to start with intramuscular or intravenous administration of the drug, while applying a higher initial dose, accelerating the buildup of dosages under the control of the somatic condition. After a stable antidepressant effect is obtained, after 2-4 weeks, the doses are gradually and slowly reduced.
- In the case of signs of depression with a decrease in dose, you must return to the previous dose. If the patient's condition does not improve within 3-4 weeks of treatment, then further therapy is inappropriate.
In elderly patients with mild disorders, in outpatient practice, the doses are 25-50-100 mg (max) in divided doses or 1 time per day for the night. For the prevention of migraine, chronic pain of a neurogenic nature (including prolonged headaches) from 12.5-25mg to 100mg / day. Interaction with other drugs Amitriptyline potentiates the central nervous system depression with the following drugs: antipsychotics, sedatives and hypnotics, anticonvulsants, central and narcotic analgesics, anesthetics, and alcohol.
Assign intramuscularly or intravenously.
In severe depressions resistant to therapy: intramuscularly or intravenously (injected slowly!) Is administered at a dose of 10-20-30 mg up to 4 times a day, the dose should be increased gradually, the maximum daily dose of 150 mg; after 1-2 weeks, they start taking the drug inside. Children over the age of 12 and older people are given lower doses and increased more slowly.
When combined use of amitriptyline with neuroleptics, and / or anticholinergic drugs, a febrile temperature reaction, paralytic intestinal obstruction can occur. Amitriptyline potentiates the hypertensive effects of catecholamines, but inhibits the effects of drugs affecting the release of norepinephrine.
Amitriptyline can reduce the antihypertensive effect of sympatholytics (octadine, guanethidine, and drugs with a similar mechanism of action).
With simultaneous use of amitriptyline and cimetidine, plasma concentrations of amitriptyline may increase.
Simultaneous use of amitriptyline with MAO inhibitors can be fatal. A break in treatment between taking MAO inhibitors and tricyclic antidepressants should be at least 14 days!
According to reviews of Amitriptilin, the most common side effects of the drug are: increased intraocular pressure, accommodation disturbances, constipation, urinary retention, dry mouth, intestinal obstruction, drowsiness, fever.
In addition, patients may experience the following side effects:
- central nervous system disorders: dizziness, drowsiness, tremor;
- disorders of the gastrointestinal tract: a violation of taste, stomatitis, nausea, vomiting, the development of anorexia, in rare cases, violations of the liver;
- disorders of the cardiovascular system: tachycardia, increased blood pressure, orthostatic hypotension, and others;
- allergic reactions. According to reviews of Amitriptilin, some patients had a rash and other allergic reactions;
- endocrine disruption: decreased libido and potency, altered secretion of ADH, gynecomastia.
After reading reviews of Amitriptilin, you can find information that long-term use of the drug can lead to an increase in body weight.
The drug is prescribed with caution to people with manic-depressive psychosis, there is a risk of the disease going to the manic stage.
It should also be remembered that the use of Amitriptyline in tablets with a daily dose of the drug above 150 mg leads to a decrease in the seizure threshold. Therefore, patients with a history of convulsive seizures, as well as those patients in whom they may occur due to age or injuries, must take into account the risk of seizures.
Perhaps an increase in the severity of the described side effects.
Acute amitripine poisoning poses a danger to the life of the patient, even with a satisfactory general condition and preservation of respiratory function. Convulsions and severe disorders of the vital functions of the body may occur unexpectedly. A sign of a severe cardiotoxic effect — extension of the OK5 complex on the ECG — may appear only after 3-5 days (latent period) after taking a toxic dose. -
Treatment: In case of overdose, you should immediately call an ambulance.
Before treatment, blood pressure level monitoring is required. Parenteral Amitriptyline is administered exclusively under the supervision of a physician in a hospital. In the first days of treatment it is necessary to observe bed rest. Requires a complete rejection of the reception of ethanol.
Abrupt refusal of therapy may cause a "cancellation" syndrome. The drug in a dose of more than 150 mg per day leads to a decrease in the threshold of seizure activity, which is important to consider when developing epileptic seizures in patients with predisposition. Perhaps the development of hypomaniacal or manic states in individuals with cyclical, affective disorders during the depressive phase. If necessary, treatment is resumed from small doses after the relief of these conditions. Care must be taken when treating people taking thyroid hormone medications when treating patients with thyrotoxicosis because of the possible risk of cardiotoxic effects.
The drug can trigger the development of paralytic intestinal obstruction in the elderly, as well as prone to chronic constipation. It is mandatory to warn anesthesiologists about taking amitriptyline before performing local or general anesthesia. Long-term therapy provokes the development of caries. Possible increase in riboflavin. Amitriptyline enters breast milk, in infants causes increased drowsiness. The drug has an impact on the management of vehicles.
- Simultaneous use with clonidine and guanethidine, leads to a decrease in the therapeutic effect of the latter, associated with a decrease in blood pressure;
- Simultaneous use with drugs that have a blocking effect on monoamine oxidase, leads to a sharp increase in blood pressure;
- Simultaneous use with Sucralfate leads to a significant decrease in the absorption of Amitriptyline and an increase in its plasma concentration;
- Simultaneous use with fluoxetine, quinidine and cimetidine, leads to an increase in the concentration of Amitriptyline and the development of symptoms of poisoning;
- With simultaneous use with drugs that have a blocking effect on acetylcholine receptors, a depressant effect on the central nervous system, lowering blood pressure, drugs that have a therapeutic effect associated with the activity of the heart and drugs containing ethyl alcohol or alcohol products, there is a significant increase in the therapeutic effect of the latter .
- Simultaneous use with carbamazepine leads to increased elimination of Amitriptyline from the body and a sharp decrease in its therapeutic effects.
Structural analogues of the active substance:
- Amitriptyline Treatment;
- Amitriptyline Nycomed;
- Amitriptyline Grindeks;
- Amitriptyline LENS;
- Amitriptyline hydrochloride;
- Saroten retard;
Before using analogues consult your doctor.
Storage conditions and shelf life
Store the preparation in a dry, dark place at a temperature not exceeding 25 ° C. Keep out of the reach of children.
Shelf life - 3 years. Do not use after expiration date.