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Amitriptyline: instructions for use

Amitriptyline: instructions for use

ATC code N06A A09.

Dosage form: coated tablets.

Form release: round biconvex tablets of yellow color, film coated.

Clinico-pharmacological group: drugs that have a timolyptichesky, antixiolytic, sedative and antidepressant effects on the nervous system.

Pharmacotherapeutic group: Psychoanaleptics. Antidepressants. Non-selective blockers of reverse neuronal uptake of biogenic amines containing one amine group.

Composition

Active ingredient: amitriptyline hydrochloride

Excipients:

  • monocrystalline cellulose;
  • lactose monohydrate;
  • hypromellose;
  • silica colloidal anhydrous;
  • E171 (titanium dioxide);
  • polysorbate 80;
  • talc;
  • sodium croscarmelose;
  • magnesium stearate;
  • polyethylene glycol 6000;
  • E122 (Carmoisin).

Packaging

Tablets in a blister (10 pieces), a cardboard box.

Pharmacodynamics

The mechanism of the antidepressant effect of the drug is based on the inhibition of the reverse neuronal uptake of dopamine, norepinephrine and serotonin. It is an antagonist of muscarinic cholinergic receptors, has anti-adrenergic and antihistamine properties, and is effective in bedtime incontinence. It has a central analgesic effect, anti-bolemic and anti-ulcer effects. For the full manifestation of the antidepressant action takes 2-4 weeks.

Pharmacokinetics

The bioavailability of Amitriptyline with parenteral administration is 30-60%, the bioavailability of nortriptyline, which is its active metabolite, is 46-70%. To achieve the maximum concentration in the blood takes 2-7.5 hours from the start.

C max in the blood plasma - 0.04-0.16 µg / ml. The drug has the ability to pass through histohematogenous barriers, including the blood-brain barrier. In tissues it accumulates in greater concentration than in blood. Communication with plasma proteins is 92-96%.

The drug disintegrates in the liver with the formation of active and inactive metabolites. Plasma elimination half-life: for amitriptyline - 10-28 hours, for nortriptyline - 16-80 hours. 80% of the drug is excreted by the kidneys, partially excreted along with the bile within a few days. Able to penetrate the placental barrier, in breast milk is found in the same quantities as in the plasma.


Indications for use

  • Schizophrenia;
  • Anxiety-depressive states;
  • Unspecified organic psychosis (involutional, neurotic, endogenous, reactive brain damage);
  • Nervous bulimia;
  • Behavioral disorders;
  • Drug psychosis;
  • Migraine prophylaxis;
  • Inorganic enuresis;
  • Chronic neurogenic pain syndrome;
  • Mixed emotional disorders.

Side effects

Dry mouth, a violation of taste, nausea, vomiting, diarrhea, constipation and other disorders of the digestive tract. Skin allergic reactions, dizziness, weakness, sleep disorders. Delay urination, increased sweating, movement disorders. Symptoms of heart failure, visual impairment, increased intraocular pressure, paresis of the ciliary muscle of the eye. Changes in the composition of the blood, impaired potency, changes in libido, intestinal obstruction. With prolonged use of the drug weight gain, an increase in the size of the mammary glands (in women and men), hair loss and an increase in lymph nodes.

Contraindications

  • Hypersensitivity to the drug;
  • Myocardial infarction (acute phase and rehabilitation period);
  • Use in 2 weeks prior to treatment, antidepressants (MAO inhibitors);
  • Arterial hypertension;
  • Prostate adenoma ;
  • Pyloric stenosis;
  • Heart failure (decompensation stage);
  • Heart block (violation of intracardiac conduction);
  • Atony of the bladder;
  • Intestinal obstruction;
  • Children's age up to 6 years;
  • Pregnancy and lactation;
  • Renal and hepatic failure.

Interaction with other drugs

Amitriptyline is incompatible with antidepressants (MAO inhibitors). Strengthens the inhibitory effect on the central nervous system while using it with anticonvulsants, hypnotics, anesthetics and analgesics. When interacting with anticholinergic drugs and neuroleptics, an increase in body temperature, development of intestinal obstruction is possible. Simultaneous use with catecholamines and other adrenergic stimulants can cause heart rhythm disturbances and the development of severe arterial hypertension. Able to reduce the effect of sympatholytics and vasoconstrictor drugs. The simultaneous use of Amitriptyline and Cimetidine, due to the increase in plasma concentration of the antidepressant, leads to the development of toxic effects, barbiturates and Carbamazepine reduce its concentration. Oral estrogen-containing contraceptives increase the bioavailability of the drug, quinidine slows down its metabolism. When used together with acetaldehyde dehydrogenase inhibitors, it is possible to develop delirium (mental disorder that occurs with impaired consciousness). Interaction with Probukol strengthens cardiac arrhythmia. While taking Amitriptyline, it is possible to increase the depression provoked by glucocorticoid drugs. Combined use with drugs used in the treatment of thyrotoxicosis increases the risk of agranulocytosis. With great caution should use the drug when using baclofen and digitalis.

Dosage and administration

Initial dose for adults - 25-50 mg;

The average daily initial dose for adults: 150-250 mg, divided into 2-3 doses. Within 5-6 days the dose is gradually increased;

For treatment on an outpatient basis, the maximum dose is 150 mg / day;

For treatment in a hospital, the maximum dose is up to 300 mg / day;

For elderly patients - up to 100 mg / day;

In the treatment of chronic neurogenic headaches - 12.5-25 mg / day;

For children older than 6 years (in the treatment of enuresis) - 12.5-25 mg / day (no more than 2.5 mg mg per 1 kg of body weight).

Overdose

In case of an overdose of Amitriptyline, an increase in body temperature, disturbance of cardiac conduction, ventricular arrhythmia, extrasystole, hallucinations, delirium, convulsions , coma are observed.

Terms of implementation

Amitriptyline tablets are prescription drugs, i.e. prescription of a doctor.

Storage conditions

Store in a dark, protected from light and moisture, out of the reach of children, at a temperature not exceeding 25 C.

Shelf life

The drug is usable for 4 years from the date of issue. Use of the product after the expiration date indicated on the package is prohibited.

Analogs of Amitriptyline

  • Amizole tablets
  • Amirol tablets
  • Amitriptyline - LENS tablets
  • Vero-amitriptyline tablets
  • Saroten Retard Tablets
  • Damilen maleate tablets
  • Amitriptyline-Ferein tablets

Prices Amitriptyline

Amitriptyline tablets 10 mg, 50 pcs. - from 20r.

Amitriptyline tablets 25 mg, 50 pcs. - from 31 p.

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