amitriptyline
Brand names: Elavil
Amitriptyline is a medicine used to treat depression. It may take up to 30 days to feel the full effect.
Drug Pricing (NADAC)
Generic Price
$0.03/unit
Generic Available
Yes (9 manufacturers)
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
Amitriptyline is used to relieve the symptoms of depression.
Common side effects
Drowsiness, Dizziness, Weakness
Key warnings
Antidepressants may increase the risk of suicidal thoughts or actions in children, teens, and young adults.
How It Works
Amitriptyline belongs to a class of drugs called tricyclic antidepressants (TCAs). It works by increasing the levels of certain chemicals in your brain. These chemicals help improve your mood.
How to Take It
Start with a low dose and increase it slowly. For adults, the starting dose is usually 75 mg per day, divided into smaller doses. Your doctor may increase this to 150 mg per day if needed. Some people take 50 to 100 mg at bedtime.
Pregnancy & Breastfeeding
Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. It is not known if amitriptyline will harm your unborn baby. Amitriptyline can pass into breast milk.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.
Storage
Store at room temperature away from moisture and heat.
Side Effects (from patient reports)
Based on 12,353 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 16,403 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.
Total Reports
16,403
Death-Related Reports
1,235
Hospitalization Reports
5,471
Top Indication
Product Used For Unknown Indication
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | PAIN | 1,565 |
| 2 | NAUSEA | 1,434 |
| 3 | HEADACHE | 1,381 |
| 4 | FATIGUE | 1,371 |
| 5 | DYSPNOEA | 1,340 |
| 6 | DIZZINESS | 1,153 |
| 7 | DIARRHOEA | 1,087 |
| 8 | MALAISE | 1,031 |
| 9 | FALL | 1,013 |
| 10 | VOMITING | 984 |
| 11 | OFF LABEL USE | 979 |
| 12 | ARTHRALGIA | 922 |
| 13 | COGNITIVE DISORDER | 921 |
| 14 | DRUG INEFFECTIVE | 869 |
| 15 | ANXIETY | 817 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
Antidepressants may increase the risk of suicidal thoughts or actions in children, teens, and young adults. Your doctor should closely monitor you for worsening depression or unusual changes in behavior. Amitriptyline is not approved for use in children.
Known Drug Interactions
Dose adjustment is not recommended for risperidone tablets when co-administered with ranitidine, cimetidine, amitriptyline, or erythromycin [see Table 18 ] . Do not exceed twice the patient’s usual dose Enzyme (CYP3A) inhibitors Ranitidine 150 mg twice daily 1 mg single dose 1.2 1.4 Dose adjustment not needed Cimetidine 400 mg twice daily 1 mg single dose 1.1 1.3 Dose adjustment not needed Erythromycin 500 mg four times daily 1 mg single dose 1.1 0.94 Dose adjustment not needed Other Drugs Amitriptyline 50 mg twice daily 3 mg twice daily 1.2 1.1 Dose adjustment not Needed *Change relative t...
Mechanism: Amitriptyline causes a very small increase in risperidone levels in the body, but the change is not large enough to be significant.
What to do: No dose adjustment is needed when these two medications are taken together.
While all the selective serotonin reuptake inhibitors (SSRIs), e.g., fluoxetine, sertraline, and paroxetine, inhibit P450 2D6, they may vary in the extent of inhibition.
Mechanism: Sertraline slows down the liver's ability to process amitriptyline. This can cause amitriptyline to build up to higher levels in your body.
What to do: Your doctor may need to adjust your dose or watch you closely for increased side effects.
While all the selective serotonin reuptake inhibitors (SSRIs), e.g., fluoxetine, sertraline, and paroxetine, inhibit P450 2D6, they may vary in the extent of inhibition. Of particular importance, sufficient time must elapse before initiating TCA treatment in a patient being withdrawn from fluoxetine, given the long half-life of the parent and active metabolite (at least 5 weeks may be necessary).
Mechanism: Fluoxetine blocks the liver from breaking down amitriptyline and stays in the body for a very long time. This can cause amitriptyline levels to become too high even after you stop taking fluoxetine.
What to do: You should wait at least five weeks after stopping fluoxetine before you start taking amitriptyline.
While all the selective serotonin reuptake inhibitors (SSRIs), e.g., fluoxetine, sertraline, and paroxetine, inhibit P450 2D6, they may vary in the extent of inhibition.
Mechanism: Paroxetine interferes with the liver enzyme that clears amitriptyline from your body. This makes the amitriptyline stay in your blood longer than it should.
What to do: Your doctor should monitor you for side effects and may need to lower your amitriptyline dose.
Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section.
Mechanism: Disulfiram can interfere with how your liver breaks down amitriptyline. This can lead to higher levels of the medication in your system.
What to do: Use this combination with caution and follow your doctor's instructions for monitoring your symptoms.
Common Questions
Can I stop taking amitriptyline suddenly?
How long does it take for amitriptyline to work?
Can I drink alcohol while taking amitriptyline?
What should I do if I experience side effects?
Can amitriptyline be used for children?
Will amitriptyline make me gain weight?
Can I take other medications with amitriptyline?
What time of day should I take amitriptyline?
Is amitriptyline addictive?
What should I do if I think I have overdosed?
What are the common side effects of amitriptyline?
Does amitriptyline interact with other medications?
What drug class is amitriptyline?
Is amitriptyline safe during pregnancy?
Related Medications in Tricyclic Antidepressant (TCA)
Other drugs grouped near amitriptyline — same-class peers and common alternatives.
acamprosate
Campral
Acamprosate is a medicine that can help you stay away from alcohol if you are alcohol-dependent and have already stopped drinking.
Compare with amitriptyline →
alprazolam
Xanax
Alprazolam (Xanax) is a medication that can help you with anxiety and panic disorders.
Compare with amitriptyline →
amphetamine/dextroamphetamine
Adderall, Adderall XR
Adderall XR is a stimulant medicine.
Compare with amitriptyline →
aripiprazole
Abilify
Aripiprazole (Abilify) is a medicine used to treat certain mental disorders and mood problems.
Compare with amitriptyline →
asenapine
Saphris
Asenapine (Saphris) is an antipsychotic medicine.
Compare with amitriptyline →
Medication Guides
Understanding Drug Interactions
How CYP450 enzymes, inhibitors, and inducers affect your medications
Generic vs Brand Name Drugs
FDA requirements, cost savings, and when the difference matters
Narrow Therapeutic Index Drugs
Why some drugs demand precise dosing and monitoring
Common Drug Interactions
Dangerous medication combinations and how to protect yourself
Related Health & Safety Data
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Medicare procedure pricing for 9,297 procedures
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What the FDA Data Shows for amitriptyline
The FDA label for amitriptyline (sold under brand names such as Elavil) classifies it as a prescription-only medication in the Tricyclic Antidepressant (TCA) class. Amitriptyline is used to relieve the symptoms of depression. Official labeling lists 8 commonly reported side effects, including Drowsiness, Dizziness, Weakness.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 12,353 voluntary reports. The database also lists 21 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated major severity. NADAC pricing from CMS shows a generic unit cost of $0.03.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: June 12, 2024
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages