Comparative Pharmacology
Head-to-head clinical analysis: AMITRIL versus ELAVIL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AMITRIL versus ELAVIL.
AMITRIL vs ELAVIL
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.
Amitriptyline inhibits the reuptake of serotonin and norepinephrine in the central nervous system, increasing their synaptic concentrations. It also exhibits anticholinergic, antihistaminergic, and alpha-adrenergic blocking effects.
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.
Oral: Initial 75 mg/day in divided doses or 50-100 mg at bedtime; increase to 150 mg/day; maximum 300 mg/day. IM: 20-30 mg q6h, switch to oral as soon as possible.
None Documented
None Documented
Terminal elimination half-life: 15–25 hours (mean 20 h); may extend to >40 h in elderly or hepatic impairment.
10–50 hours (mean ~20 hours); terminal elimination half-life is prolonged in elderly and patients with hepatic impairment; steady-state achieved in 7–21 days.
Renal: ~70% as metabolites, <5% unchanged; fecal: ~30% via bile.
Renal (approximately 40% as metabolites, <5% unchanged); biliary/fecal (approximately 60% as metabolites, including glucuronide conjugates).
Category C
Category C
Tricyclic Antidepressant
Tricyclic Antidepressant