Generic drug of the therapeutic class: Analgesics
active ingredients: Amitriptyline
Box of 60
- Major depressive episodes (that is, characterized).
- Nocturnal enuresis of the child in case any organic pathology has been excluded.
Dosage ELAVIL 25 mg Film-coated tablet Box of 60
Use the appropriate dosage according to the prescribed daily dose.
The usual dosage for the treatment of depression ranges from 75 to 150 mg per day.
The initial dose is usually 75 mg, but can be individually adjusted within the recommended dose range. This dosage may be re-evaluated after 3 weeks of effective treatment at effective doses.
In infant psychiatry, the effective daily dose is less than or equal to 1 mg / kg of body weight.
- Administration mode :
The pharmacokinetic characteristics of this medicine allow for a single daily dose, during or at a distance from meals.
The most important intake can be given in the evening to facilitate sleep.
- Duration of the treatment :
Antidepressant treatment is symptomatic.
The treatment of an episode is several months (usually about 6 months) to prevent the risk of relapse of the depressive episode.
ENURESIE (from 6 years old):
- Do not exceed recommended doses.
- The dosage varies according to the age, the daily dose being administered at bedtime:
. child from 6 to 10 years : 10 to 20 mg per day,
. child from 11 to 16 years old : 25 to 50 mg a day.
The recommended dosages are low compared to those used in depression. Sedation is utilized by administering the drug at bedtime, and the anticholinergic peripheral effect is an advantage in this indication.
RISK POPULATIONS :
Treatment will be initiated at a low dosage, that is, in practice at half the recommended minimum dosage (see pharmacokinetic properties).
The entire daily dose can be administered either in divided doses or in one dose, preferably at bedtime.
The increase in doses, if necessary, will be gradual, with clinical surveillance: the adverse effects of imipramines can have serious consequences for the elderly (falls, confusion).
- Hepatic and renal impairment:
A decrease in dosage may be required in these patients (see section 5.2).
- This medicine MUST NEVER be prescribed in the following cases:
. Hypersensitivity to amitriptyline.
. Known risk of glaucoma by closing the angle.
. Risk of urinary retention related to urethroprostatic disorders.
. Recent myocardial infarction.
. Association with non-selective MAOIs (iproniazide, nialamide) and sultopride (see interactions section).
- Due to the presence of lactose, this drug is contraindicated in case of congenital galactosemia, glucose-galactose malabsorption syndrome or lactase deficiency.
NOT RECOMMENDED :
- Breast-feeding: Amitriptyline and its active metabolite pass into breast milk. As a precaution, breastfeeding should be avoided.
- Associations advised against : alcohol; clonidine, guanfacine and related; MAOI selective A (moclobemide, toloxatone); linezolid; alpha and beta sympathomimetics: epinephrine, norepinephrine, adrenaline, norepinephrine, dopamine for parenteral systemic action.
Elavil side effects
They derive for the most part from the pharmacological properties of imipramine antidepressants.
· Related to the peripheral effects of the molecule: they are usually mild and usually give way to further treatment or a reduction in dosage.
o anticholinergic effect (in order of decreasing frequency): dryness of the mouth, constipation, accommodation problems, tachycardia, sweating, urination problems and possibly urinary retention;
o adrenolytic effect: orthostatic hypotension, impotence.
· Related to central effects:
o frequently observed: somnolence or sedation (antihistamine effect), more marked at the beginning of treatment;
o much rarer: tremor, seizures on predisposed terrain, transient confusional states, serotonin syndrome (in combination).
· Linked to the nature of depressive illness:
o removal of psychomotor inhibition, with suicidal risk;
o reversal of mood with onset of manic episodes;
o reactivation of delirium in psychotic subjects;
o paroxysmal manifestations of anxiety.
Cases of suicidal ideation and behavior have been reported during or shortly after treatment with ELAVIL (see Warnings and Precautions ).
· Imipramine antidepressants may also result in:
o weight gain,
o Conduction or rhythm disorders (with high doses),
o endocrine disorders: breast hypertrophy, galactorrhea,
o hot flashes
o allergic skin reactions,
o exceptional cytolytic or cholestatic hepatitis,
o haematological disorders: eosinophilia, leukopenia, agranulocytosis, thrombocytopenia,
· Class effect:
Epidemiological studies, mainly in patients aged 50 years and older, show an increased risk of bone fractures in patients receiving selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants. The mechanism leading to this risk is unknown.
Some of these side effects can be prevented or prevented by adjuvant or corrective therapies, or even reduction of the dosage.