Amitriptyline: Uses, Side Effects, and Safety Guide
Amitriptyline is a tricyclic antidepressant that is approved to treat depression. It is also commonly prescribed off-label for certain chronic pain conditions, including nerve pain and migraines.
Amitriptyline may help with depression and some types of chronic pain, but it can cause significant side effects and interactions. Take it only as prescribed, and do not stop it suddenly without medical advice.
This medication carries a boxed (black box) warning — the strongest type of FDA warning. Review the full prescribing information before use.
Key facts at a glance
- ATC
- N06AA09
- Generic
- Amitriptyline
- Class
- tricyclic-antidepressant
- Brands
- Elavil
- Availability
- rx
- Pregnancy
- D
- Lactation
- unsafe
- Half-life (h)
- 30
- Routes
- oral
- Forms
- tablet
- Regions
- CN, US, EU, JP
- Monitoring
- suicidal-ideation, cardiac-qt, anticholinergic
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 500mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 250mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 400mg daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
8 groupspregnancy
first trimesteravoid if possible
avoid use during pregnancy unless benefits significantly outweigh risks
regular prenatal checkups and fetal monitoring
Use with caution and monitor for adverse effects.
pregnancy
third trimestertaper dose before delivery if possible
consider tapering in the last month; neonatal monitoring required after birth
fetal growth monitoring, neonatal assessment for withdrawal
Use with caution and monitor for adverse effects.
lactation
breastfeedinguse lowest effective dose
excreted in breast milk; monitor infant for sedation, feeding difficulties, or irritability
observe infant for excessive drowsiness, poor feeding, or developmental changes
Use with caution and monitor for adverse effects.
geriatric
elderlystart at 25-50% of adult dose, titrate slowly
increased sensitivity to anticholinergic and sedative effects; higher fall risk
regular monitoring of blood pressure, cardiac function, cognitive status
Use with caution and monitor for adverse effects.
pediatric_age
adolescents 12 17start with low dose, titrate slowly
black box warning for increased suicidal thoughts in children/adolescents; not typically first-line
close monitoring for worsening depression and suicidal ideation
Use with caution and monitor for adverse effects.
renal_impairment
severe renal impairmentreduce dose by 25-50%
use with caution; metabolites may accumulate
monitor renal function and drug levels if available
Use with caution and monitor for adverse effects.
hepatic_impairment
moderate hepatic impairmentreduce dose by 25-50%
metabolized in liver; use with caution
monitor liver function tests and clinical response
Use with caution and monitor for adverse effects.
hepatic_impairment
severe hepatic impairmentavoid use
contraindicated or use only with extreme caution at greatly reduced doses
frequent liver function monitoring if use is unavoidable
Use of this medication in this population requires careful consideration of risks and benefits.
Statistics and clinical data
Commonly prescribed since
General prescribing information
Drug class
Drug class information
Common uses
Common therapeutic uses
Common adult dose range
Dosage information
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed July 22, 2026. · Read our editorial policy