Comparative Pharmacology
Head-to-head clinical analysis: ELAVIL versus SILENOR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ELAVIL versus SILENOR.
ELAVIL vs SILENOR
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.
Selective histamine H1 receptor antagonist; promotes sleep by antagonizing central histaminergic neurotransmission.
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.
6 mg orally once daily at bedtime, not to exceed 6 mg/day.
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 elimination half-life is approximately 10 hours (range 8-15 hours) in healthy adults; prolonged in elderly and hepatic impairment.
Renal (approximately 40% as metabolites, <5% unchanged); biliary/fecal (approximately 60% as metabolites, including glucuronide conjugates).
Primarily renal (approximately 60% as unchanged drug and metabolites), with 30% fecal elimination.
Category C
Category C
Tricyclic Antidepressant
Tricyclic Antidepressant