Comparative Pharmacology
Head-to-head clinical analysis: AVENTYL versus ELAVIL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AVENTYL versus ELAVIL.
AVENTYL vs ELAVIL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Nortriptyline, the active ingredient, inhibits the reuptake of norepinephrine and serotonin in the central nervous system, potentiating their effects. It also has anticholinergic and antihistaminergic 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.
Adults: 25 mg orally 3 to 4 times daily, maximum 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: 19-24 hours; requires 4-6 days to reach steady state.
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 (30% as unchanged drug and metabolites); biliary/fecal (70% as metabolites)
Renal (approximately 40% as metabolites, <5% unchanged); biliary/fecal (approximately 60% as metabolites, including glucuronide conjugates).
Category C
Category C
Tricyclic Antidepressant
Tricyclic Antidepressant