Comparative Pharmacology
Head-to-head clinical analysis: AMITRIL versus AVENTYL HYDROCHLORIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AMITRIL versus AVENTYL HYDROCHLORIDE.
AMITRIL vs AVENTYL HYDROCHLORIDE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Amitriptyline inhibits the reuptake of serotonin and norepinephrine, thereby increasing their synaptic concentrations. It also blocks histamine H1, alpha-1 adrenergic, and muscarinic receptors.
Nortriptyline hydrochloride, the active ingredient in Aventyl Hydrochloride, is a tricyclic antidepressant that inhibits the reuptake of norepinephrine and serotonin at the presynaptic neuronal membrane, increasing their concentrations in the synaptic cleft. It also has antihistaminic, anticholinergic, and sedative properties.
Adults: Initial 25 mg PO once daily at bedtime, increase by 25 mg every 3-7 days as tolerated to typical maintenance 75-150 mg/day PO divided doses or single dose at bedtime. Maximum 300 mg/day.
25 mg orally three times daily; may increase gradually to 150 mg/day in divided doses. Maximum dose 150 mg/day.
None Documented
None Documented
Terminal elimination half-life: 15–25 hours (mean 20 h); may extend to >40 h in elderly or hepatic impairment.
Terminal elimination half-life is approximately 19–24 hours; may be prolonged in elderly and patients with hepatic impairment.
Renal: ~70% as metabolites, <5% unchanged; fecal: ~30% via bile.
Primarily renal (approximately 70% as metabolites, <5% unchanged); biliary/fecal excretion accounts for ~30%.
Category C
Category C
Tricyclic Antidepressant
Tricyclic Antidepressant