AMITRIPTYLINE — 75 mg tablets

Tricyclic antidepressant • neuropathic pain • migraine prophylaxis • Rx-only

Prescription-only medicine. Educational content: strengths, brand examples, safety notes, FAQ, and official references. Always follow your local leaflet and clinician guidance.

🔎 Quick Links

📦 Snapshot
🧠 Overview
🏷️ Brands
⚠️ Safety
❓ FAQ
📚 References

📦 Product Snapshot

Active substanceAmitriptyline hydrochloride

Available strengths10 mg · 25 mg · 50 mg (also 75 mg, 100 mg, 150 mg in some markets)

Dosage formFilm‑coated tablets · oral solution (25 mg/5 mL)

Also available as combination products with benzodiazepines in some countries (not first-line).

Reference brandsElavil® (US) · Tryptanol® (EU, Australia) · Entrip® (Australia)

India brand examplesTridep® (Baroque Pharmaceuticals) · Amitone® · Myteka® · Amitor®

Primary indicationsMajor depressive disorder · Neuropathic pain (off-label) · Migraine prophylaxis (off-label) · Nocturnal enuresis in children

Label‑first: indications vary by country. For depression, SSRIs are now preferred due to safety profile.

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Rx-only • label-first • verify local guidance

🧠 Overview

Amitriptyline is a first-generation tricyclic antidepressant (TCA). Its therapeutic effects stem from potent inhibition of serotonin and norepinephrine reuptake, along with antagonism at histaminergic (H1), muscarinic, and alpha-adrenergic receptors. This multi-receptor profile explains both its efficacy and its broad side effect spectrum.

Dose-dependent applications: At antidepressant doses (75–150 mg daily), it is effective for major depressive disorder, particularly endogenous depression with biological features. However, due to its side effect profile and toxicity in overdose, SSRIs are now preferred first-line for depression. At low doses (10–30 mg daily), amitriptyline is widely used off-label for chronic neuropathic pain, fibromyalgia, tension-type headache, migraine prophylaxis, and irritable bowel syndrome — leveraging its analgesic and sedative properties independent of antidepressant effects.

Special populations: Amitriptyline is also approved for nocturnal enuresis in children (ages 6+ in some countries), though desmopressin is often preferred. In elderly patients, lower doses are recommended due to increased susceptibility to anticholinergic effects, sedation, and fall risk.

Regulatory context: Due to its narrow therapeutic index and cardiovascular toxicity, amitriptyline carries a boxed warning for suicidal thoughts and behaviors in young adults. Prescribing should be limited to small quantities initially, with close monitoring during dose titration.

🏷️ Strengths & Brand Examples

Available strengths (globally)

10 mg, 25 mg, 50 mg tablets (most common)
75 mg, 100 mg, 150 mg tablets (for higher-dose maintenance)
Oral solution 25 mg/5 mL (for patients who cannot swallow tablets or require precise dosing)

India brands (examples)

Tridep® 25 mg (Baroque Pharmaceuticals) — registered in Philippines, manufactured in India
Amitone® 10/25/50 mg (Sun Pharma)
Myteka® 10/25 mg (Abbott)
Amitor® 25 mg (Torrent)
Amiline® 10/25 mg (Cipla)

International reference brands

Elavil® (US — original brand, now discontinued in some markets)
Tryptanol® (Australia, EU — Merck Sharp & Dohme)
Entrip® 10/25/50 mg (Alphapharm, Australia) — available with consumer medicine information leaflets

Cost information (India)

Average price: ₹0.50–₹2.00 per tablet depending on strength and brand. One of the most affordable antidepressants available.

Note: brand availability changes. Verify manufacturer and on‑pack labeling for current listings. Always obtain with valid prescription.

⚠️ Safety, Side Effects & Monitoring

Commonly discussed effects

Dry mouth, constipation, blurred vision (anticholinergic effects)
Drowsiness, sedation (useful for insomnia at low doses)
Dizziness, orthostatic hypotension
Weight gain (can be significant with long-term use)
Sexual dysfunction (decreased libido, erectile dysfunction)
Headache, tremor
Photosensitivity (increased risk of sunburn)
At higher doses: cardiac arrhythmias, QT prolongation

Serious risks & label-first warnings

• Suicidal ideation (boxed warning): Increased risk in children, adolescents, and young adults (ages 18–24) during initial treatment. Monitor closely for worsening depression or suicidal thoughts.
• Cardiotoxicity: Avoid in recent myocardial infarction, heart block, or arrhythmias. Can prolong QT interval — caution with other QT-prolonging drugs.
• MAOI interaction: Contraindicated with MAOIs (including linezolid and IV methylene blue). Allow at least 14 days between stopping MAOI and starting amitriptyline.
• Seizure threshold: May lower seizure threshold — use caution in epilepsy.
• Angle-closure glaucoma: Can precipitate acute attack due to mydriasis.
• Urinary retention: Contraindicated in prostatic hypertrophy or bladder outflow obstruction.
• Withdrawal: Abrupt discontinuation causes nausea, headache, malaise. Taper gradually over weeks.
• Overdose risk: Highly dangerous in overdose (seizures, arrhythmias, coma). Limit quantity prescribed.

Contraindications & precautions

Absolute contraindications: Recent MI, arrhythmias, mania, severe liver disease, concurrent MAOIs.
Use with caution: Epilepsy, hyperthyroidism, diabetes (may alter blood glucose), constipation/ileus, benign prostatic hyperplasia, glaucoma, suicidal ideation.
Pregnancy: Crosses placenta — limited data but risk of neonatal withdrawal if used in third trimester. Use only if benefit outweighs risk.
Breastfeeding: Present in milk — monitor infant for sedation. Generally considered compatible by WHO, but discuss with doctor.

❓ FAQ

FAQ question #1: Is amitriptyline still used for depression?

Answer: Yes, but it is no longer first-line due to its side effect profile and toxicity in overdose. SSRIs (like fluoxetine, sertraline) are generally preferred. However, amitriptyline may be used when other antidepressants have failed, or when additional benefits (sleep, pain) are desired.

FAQ question #2: Why is amitriptyline prescribed for pain at low doses?

Answer: At low doses (10–30 mg), amitriptyline blocks sodium channels and enhances descending pain inhibition pathways independently of its antidepressant effect. It is effective for neuropathic pain (diabetic neuropathy, postherpetic neuralgia), fibromyalgia, and tension-type headache. Benefits for pain often appear sooner (1–2 weeks) than antidepressant effects.

FAQ question #3: Can I drink alcohol while taking amitriptyline?

Answer: It is best to avoid alcohol, especially when starting treatment. Both are CNS depressants and can cause additive drowsiness, dizziness, and impaired coordination. Alcohol may also worsen side effects like dry mouth and constipation.

FAQ question #4: Will I gain weight on amitriptyline?

Answer: Weight gain is a common side effect, affecting up to 20-30% of users. It is dose-dependent and may be due to increased appetite, carbohydrate cravings, and fluid retention. Monitor weight regularly and discuss with your doctor if weight gain becomes problematic.

FAQ question #5: How do I stop taking amitriptyline safely?

Answer: Never stop abruptly — withdrawal symptoms (nausea, headache, anxiety, insomnia) are common. Your doctor will recommend a gradual taper over several weeks to months, depending on your dose and duration of treatment. The goal is to minimize discontinuation symptoms.