8 July 2017
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General Info: Uses and Effects
Amitriptyline is also known as Elavil, its brand name. Amitriptyline is a drug used throughout the world for the treatment of mental illnesses. It is also used for treatment of other disorders, including anxiety disorder, bipolar disorder, and attention deficit hyperactivity disorder. Moreover, the drug is used to deal with insomnia, migraines, and neuropathic pain. The mechanism of action of Elavil is not clear. Amitriptyline is a tricyclic antidepressant that is taken through oral ingestion.
The US Food and Drug Administration (FDA) approved Elavil as a medicine in 1961. Nowadays, Amitriptyline is considered the safest drug and listed in the World Health Organization's List of Essential Medicines. In the USA the cost of this medicament is $0.2 while in other developing countries the price is adjusted between $0.01 and $0.04.
Contraindication: Important to Know
Elavil Amitriptyline is known by its effectiveness in major depressive disorder (MDD). It has been observed that the drug is more efficient medicine as an antidepressant. It also includes selective serotonin reuptake inhibitors (SSRIs). Amitriptyline, due to its low tolerability, is not used as an antidepressant. Despite the fact that its overdose can cause severe toxicity, but still this drug is used as a medication for pain.
Amitriptyline is also used for the treatment of nocturnal enuresis, fibromyalgia, migraine and neuropathic pain prevention. The drug is also considered effective for the treatment of irritable bowel syndrome (IBS). Elavil is used to treat serious cases of abdominal pain in those patients having a disorder related to IBS. Intake of this medicine on regular basis is essential for better results. Amitriptyline shows a poor profile of tolerability, although a solid evidence base supports its effectiveness in this indication. It is observed that during the treatment of depression, Elavil Generic can also be taken as an efficient anticholinergic drug in the proper treatment of early-stage Parkinson's disease.
Most common contraindications of Amitriptyline are:
- Coronary artery blockage;
- Arrhythmias, particularly heart block to any degree;
- Breast feeding women;
- Mania disorder;
- Severe liver problem;
- Hypersensitivity to TCAs;
- History of myocardial infarction disorder;
- Congestive heart failure;
- Frequent headaches;
- Patients who are taking monoamine oxidase inhibitors (MAOIs) or have taken them within the last 14 days.;
- Being under 7 years of age.
Elavil should be used very carefully after the prescription of a medical physician.
Overdose of Amitriptyline is very dangerous to human health. The treatment of overdose has the same procedure as applicable for some other TCAs. Adverse cardiac effects and serotonin are treated in the same way. The British National Formulary has also researched that overdose of Elavil is critical to human life. Consequently, Amitriptyline and other TCAs are generally not recommended for the treatment of depression patients. The overdose of other antidepressants including SNRIs and SSRIs are generally considered safe as compared to the overdose of TCAs.
Overdose of Amitriptyline is very dangerous to heart issues. But overdose for cardiac arrhythmias can be treated with Propranolol. If remained unattended, it may cause heart failure; consequently, digitalis is used for the treatment. Proper and regular checkups are necessary for the cardiac monitoring during five days of overdose. Elavil has capability to enhance the depressant action of CNS. But it cannot treat the anticonvulsant action of Barbiturantes, consequently, Diazepam and inhalation of Anaesthetic is observed to control the convulsion. Amitriptyline has power to bind protein at the high level, so Dialysis is not sufficient to minimize the concentration due to overdose.
Overdose of Amitriptyline can be easily treated as no specific antidote is recommended to reduce the effect of overdose. Activated charcoal has an ability to reduce the concentration of Amitriptyline within 1 to 2 hours. Activated charcoal can be delivered directly to the stomach if a patient of overdose has an impaired gag reflex. Patients with Elavil overdose are advised for the ECG monitoring due to abnormalities in cardiac conduction. Similarly, body temperature should be monitored on regular basis.
The dosage of Amitriptyline without any certain range may cause the following symptoms:
- Severe hypotension (very low blood pressure);
- Muscle rigidity;
- Tachycardia (increased heart rate);
- Congestive heart failure;
- Drowsiness and sleepiness;
- Hyperactive reflexes;
- Convulsions (e.g. seizures, myoclonus);
- Arrhythmic abnormalities;
Side effects of Elavil Amitriptyline include loss of libido and impotence, nightmares and insomnia, drowsiness and sleeping disturbance, as well as constipation, dryness on mouth, dizziness, trouble in eye sight, low blood pressure. Usage of Amitriptyline has some severe side effects over fraction of patients, including urinary retention, risk of increased heart failure, glaucoma, increased feeling of suicide especially under the age of 25 years of patients along with seizures. It has severe adverse effects to cardiovascular health including QT-interval prolongation, orthostatic hypotension and sinus tachycardia. Amitriptyline also creates cognitive effects, including agitation, anxiety, mood swings, confusion, and delirium. Some common side effects of the drug are headache, sleepiness, and excessive weight gain.
The research is still not sufficient related to use of Elavil during pregnancy and lactation.
Interaction with Other Drugs
Elavil Generic is known to interact with:
- Antipsychotics that can improve the sedative, pyrexic, epileptogenic, and anticholinergic effects.
- Medications that are the subject to gastric inactivation (e.g. Levodopa) due to the potential for Amitriptyline to delay gastric emptying and reduce intestinal motility.
- CYP2D6 inhibitors and substrates, like Fluoxetine, to increase in plasma concentrations of the medicine.
- Monoamine oxidase inhibitors to induce a serotonin syndrome.
- Disulfiram - the development of delirium.
- Thyroid hormones have a potential for increased adverse reactions, such as arrhythmias and CNS stimulation.
- ECT may increase the risks associated with this treatment.
- Medications (e.g. Anticoagulants) can be the subject to maximum absorption in the small intestine.
- Serotonergic agents, such as the triptans and SSRIs due to the potential for serotonin syndrome.
- Guanethidine as it minimizes the antihypertensive effects of Elavil.
- Antithyroid medications create the risk of agranulocytosis.
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