Comparative Pharmacology
Head-to-head clinical analysis: ELAVIL versus IMIPRAMINE HYDROCHLORIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ELAVIL versus IMIPRAMINE HYDROCHLORIDE.
ELAVIL vs IMIPRAMINE HYDROCHLORIDE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
Tricyclic antidepressant that inhibits the reuptake of norepinephrine and serotonin at presynaptic neuronal membranes, increasing their synaptic concentrations. Also has anticholinergic, antihistaminergic, and alpha-1 adrenergic blocking effects.
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.
Initial 75 mg/day orally in divided doses, increase to 150-200 mg/day; maximum 300 mg/day. For maintenance, 50-150 mg/day orally.
None Documented
None Documented
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.
Terminal half-life 11-25 hours (mean ~20 h); clinical context: steady-state achieved in ~1 week, dosing adjustment needed in hepatic impairment
Renal (approximately 40% as metabolites, <5% unchanged); biliary/fecal (approximately 60% as metabolites, including glucuronide conjugates).
Renal (70% as metabolites, <5% unchanged), biliary/fecal (30%)
Category C
Category C
Tricyclic Antidepressant
Tricyclic Antidepressant