英文药名: Elavil(Amitriptyline Tablets)

中文药名: 阿米替林片,依拉维,氨三环庚素

药品名称

通用名称：阿米替林　　
英文名称：Amitriptyline 　　
中文别名：阿密替林、氨三环庚素、依拉维　　
英文别名：Amavil、Amilent、Amiline、Amilit、Amitid、Amitril、Amitripthyline、Amitriptol、Annolytin、Deprex、Elaril、Elavil、Endep、Laroxyl、Larozyl、Levate、Meravil、Miketorin、Novotriptyn、Redomex、Sarotex、Teperin、Trepiline、Triptizol、Tryptanol、Tryptizol
药理作用　　

本品口服吸收完全，8-12小时血药浓度达高峰。在血中90％与血浆蛋白结合。部分经肝脏代谢为去甲替林，本产物仍有抗抑郁作用。由肾脏及肠道排出，排泄慢，24小时约排出40％，72小时排出60％。停药３周仍可在尿中检出。半衰期一般32－40小时。
适应症　　

本品在三环类抗抑郁药中镇静效应最强，对抑郁患者可使情绪明显改善，适用于治疗焦虑性或激动性抑郁症。
用法用量　　

口服成人常用量；开始一次 25mg，每日 2-4次，然后根据病情和耐受情况逐渐增至每日 150-300mg。　　　　
(1).治抑郁症:口服一次25mg,一日2次.以后递增至每150-300mg.维持量每日50-150mg.
(2).治遗尿症:睡前服10-25mg.
任何疑问，请遵医嘱！
制剂/规格

盐酸阿米替林片10mg； 25mg； 50mg； 75mg 每片
禁用/慎用　　

(1)交叉过敏。对三环类某一药过敏者，对另一药也有可能过敏。　　
(2)动物实验证明，用量超过了成人常用量数倍，可使胚胎或胎儿产生毒性反应。孕妇使用应慎重权衡利弊。　　
(3)三环类药均可自乳汁排出，哺乳期妇女应慎用。　　
(4)6-12岁儿童，可用丙米嗪治疗遗尿症。少年病人对三环类药较敏感，治疗抑郁症时须减量。　　
(5)老年病人因为代谢与排泄均下降，对本类药的敏感性增强，用量一定要减小。使用中应格外注意防止体位性低血压以致摔倒。　　
(6)下列情况应慎用或禁用；
①急性心肌梗塞恢复期病人禁用；
②支气管哮喘；
③心血管疾病；
④癫痫症；
⑤青光眼；
⑥肝功能损伤；
⑦甲亢；
⑧前列腺肥大；
⑨精神分裂症；
⑩尿潴留。　　
严重心脏病,高血压,青光眼,前列腺肥大及尿潴留者禁用. 癫痫病史者慎用.
给药说明　　

(1)使用三环类药时，用量必须注意个体化。　　
(2)宜在饭后服药，以减少胃部刺激。　　
(3)开始服药时常先出现镇静，抗抑郁的疗效需在 1-4周之间才明显。　　
(4)维持治疗时，可每晚一次顿服。但老年、少年与心脏病患者仍宜分服。　　
(5)对易发生头昏、萎靡等不良反应者，可在晚间一次顿服，以免影响白天工作。　　
(6)突然停药时可产生头痛、恶心与不适，宜采取在 1-2个月期间逐渐减少用量的办法。　　
(7)治疗期应定期随访检查；
①血细胞计数；
②血压；
③心脏功能监测；
④肝功能测定。
不良反应　　

①偶有视力减退、眼痛(青光眼发作)、低血压昏倒、出现幻觉或谵妄状态、心律失常、心动过缓、肌肉震颤、尿潴留、癫痫发作、皮疹、咽痛、高热(颗粒细胞减少症)、黄疸等，须引起注意，采取相应的医疗措施；
②遇有便秘、头昏、萎靡、口干、头痛、恶心、心率增快、多汗、皮肤对光敏感、失眠等，应及时停药或减量。　　
口干,嗜睡,便秘,视物模糊(复视),心动过速.个别病例体位性低血压,可引起肝损害,迟发性运动障碍,排尿困难.
注意事项 　　

1.不良反应比丙咪嗪少而轻，常见有口干、嗜睡、便秘、视力模糊、排尿困难、心悸，还可能引起心律失常，偶见体位性低血压、肝功能损害及迟发性运动障碍。
2.严重心脏病、高血压、青光眼、前列腺肥大及尿潴留者禁用。有癫痫病史者慎用。
药物相互作用　　

(1)乙醇与三环类药并用，可以促使中枢神经的抑制作用。　　
(2)与抗惊厥药并用，三环类可降低癫痫阈值，从而降低抗惊厥药的作用，须调整抗癫痫药的用量。　　
(3)与抗组胺药或抗胆碱药并用，药效相互加强，需及时调整用量。　　
(4)胍乙啶与三环类药并用，前者的抗高血压作用可被减低。但多虑平用量未超过每日150mg时，胍乙啶的疗效可不受影响。　　
(5)与雌激素或含雌激素的避孕药并用，可增加三环类药的不良反应，同时减少抗抑郁效能。　　
(6)与单胺氧化酶抑制药合用，可产生高血压危象，且已有死亡的报道。一般应在前者停用两周后，再使用三环类药。　　
(7)与肾上腺素受体激动药并用，可引起严重高血压与高热。　　
(8)与甲状腺制剂合用，可互相增效，导致心律失常，两者均须减量。
包装规格：
·10mg *100 片
·25mg *100 片
·50mg *100 片
·75mg *100 片

Elavil (Amitriptyline, Endep) Side effects
Elavil (Amitriptyline, Endep) is a part of a drug group called tricyclic antidepressants. Tricyclic antidepressants increase the availability of three different neurotransmitters thought of being responsible for mood.

There are different indications for this drug. It can be prescribed for treating depression, bulimia, chronic pain caused by fibromyalgia, neuropathic nerve pain and other conditions, severe IBS, reducing the incidence of chronic headaches or migraines, ulcers, uncontrollable hiccups, primary insomnia, and to control the involuntary crying and laughing often experienced by individuals with multiple sclerosis.

Elavil (Amitriptyline, Endep) does not start “working” right away. It may take up to a few weeks to feel any benefits. Doctors encourage their patients to be patient and wait up to 30 days before experiencing any positive changes. With this drug it is important to build up a steady dose overtime and then try to maintain it. The drug doses should not be skipped or altered on your own, because skipping could decrease the effectiveness of the drug; abruptly decreasing or stopping may cause side effects such as headaches, nausea, and a feeling of bodily discomfort while gradual dose reduction may induce disturbances in sleep and dreams, irritability, and restlessness.

Elavil (Amitriptyline, Endep) is most commonly prescribed for no more than 6 months during which time your doctor should follow your reaction to the drug.
Side Effects
Like with any antidepressant, side effects are likely to occur during Elavil treatment. In the first few days of the treatment, you are likely to experience sleepiness.

Other frequent side effects of this drug are: blurry vision, constipation, difficulty urinating, dry mouth, fatigue, sensitivity to sunlight and temperature sensitivity. Fatigue can be reduced by taking Elavil with food or in the evening. To avoid getting burned or developing other skin problems, make sure you wear sunglasses, protective clothing, and apply sunscreen (minimum SPF 15) and under no circumstances use sunlamps and tanning beds. Saunas, jacuzzis and exposure to extremely cold weather should be avoided too due to temperature sensitivity.

Other reported side effects taken for different conditions such as depression, insomnia, neuropathy, anxiety, severe IBS, fybromyalgia are: weight gain, sleeping for 12-15 hrs per day, excessive sweating especially around neck and upper chest area, decrease in libido, being groggy in the morning, inability to lose weight, increased appetite, bladder spasms, sore throat, etc

Occasional Elavil side effects include changes in blood sugar, dental cavities, dizziness, fainting, headache, hives, indigestion, nausea, rash, shaking, swelling of the face or tongue, unsteadiness, weakness. To relieve indigestion and nausea, try taking Elavil with food.

Rare Elavil side effects include breast enlargement, brown or red spots on skin, change in sense of taste or hearing, irritated tongue or mouth, nightmares, sexual dysfunction including impotence and problems with orgasms, vomiting, etc.

It is not wise to stop taking the drug because of the side effects. Many of the side effects can be treated and someone even lived with.
However, reporting the side effects to your doctor is important especially if they are new and sudden and especially if you start having thoughts about suicide or hurting yourself.

Elavil as well as other antidepressants have been linked to increased risk of suicidal thinking and behaviour in children and adolescents with depression and other psychiatric disorders.
Elavil Interactions
Since this drug is a central nervous system depressant, it should be used very cautiously in combination with any medication that warns it 'may cause drowsiness,' or increases your level of alertness.

Elavil in combination with alcohol can cause dangerous side effects.
Elavil may also interact with grapefruit and grapefruit juice.
Elavil can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.