Comparative Pharmacology
Head-to-head clinical analysis: AVENTYL HYDROCHLORIDE versus ELAVIL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AVENTYL HYDROCHLORIDE versus ELAVIL.
AVENTYL HYDROCHLORIDE vs ELAVIL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
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.
25 mg orally three times daily; may increase gradually to 150 mg/day in divided doses. Maximum dose 150 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 is approximately 19–24 hours; may be prolonged in elderly and patients with 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.
Primarily renal (approximately 70% as metabolites, <5% unchanged); biliary/fecal excretion accounts for ~30%.
Renal (approximately 40% as metabolites, <5% unchanged); biliary/fecal (approximately 60% as metabolites, including glucuronide conjugates).
Category C
Category C
Tricyclic Antidepressant
Tricyclic Antidepressant