Amitriptyline
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TCA, Antidepressant
Amitriptyline
Elavil
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Effects
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Interactions
Pharmacogenomic + mechanism interactions
Pharmacogenomic guideline recommendationsCPIC and Dutch Pharmacogenetics Working Group clinical guidelines
CPIC rec 8093277 [Strong]: Avoid amitriptyline use. If a amitripyline is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. CPIC pair-level A (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040] FDA labeling (Precautions)
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CPIC rec 8093287 [Strong]: Avoid amitriptyline use; If amitriptyline is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustment. CPIC pair-level A (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040] FDA labeling (Precautions)
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CPIC rec 8093287 [Strong]: Avoid amitriptyline use; If amitriptyline is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustment. CPIC pair-level A (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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CPIC rec 8093249 [Strong]: Initiate therapy with recommended starting dose. CPIC pair-level A (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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CPIC rec 8093249 [Strong]: Initiate therapy with recommended starting dose. CPIC pair-level A (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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CPIC rec 8093272 [Strong]: Initiate therapy with recommended starting dose. CPIC pair-level A (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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CPIC rec 8093390 [Strong]: Initiate therapy with recommended starting dose. CPIC pair-level A (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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CPIC rec 8093295 [Moderate]: Avoid amitriptyline use. If amitripyline is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. CPIC pair-level A (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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CPIC rec 8093295 [Moderate]: Avoid amitriptyline use. If amitripyline is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. CPIC pair-level A (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040] FDA labeling (Precautions)
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CPIC rec 8093410 [Moderate]: Avoid amitriptyline use. If amitripyline is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. CPIC pair-level A (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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CPIC rec 8093268 [Moderate]: Consider a 25% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. CPIC pair-level A (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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CPIC rec 8093254 [Optional]: Avoid amitriptyline use. If a amitripyline is warranted, consider a 50% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level A (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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CPIC rec 8093291 [Optional]: Avoid amitriptyline use; If amitriptyline is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level A (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040] FDA labeling (Precautions)
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CPIC rec 8093323 [Optional]: Avoid amitriptyline use; If amitriptyline is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level A (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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CPIC rec 8093346 [Optional]: Avoid amitriptyline use; If amitriptyline is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level A (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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CPIC rec 8093392 [Optional]: Avoid amitriptyline use. If a amitripyline is warranted, consider a 50% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level A (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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CPIC rec 8093314 [Optional]: Consider alternative drug not metabolized by CYP2C19; If amitriptyline is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level A (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040] FDA labeling (Precautions)
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CPIC rec 8093314 [Optional]: Consider alternative drug not metabolized by CYP2C19; If amitriptyline is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level A (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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CPIC rec 8093318 [Optional]: Consider alternative drug not metabolized by CYP2C19; If amitriptyline is warranted, utilize therapeutic drug monitoring to guide dose adjustment. CPIC pair-level A (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040] FDA labeling (Precautions)
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CPIC rec 8093337 [Optional]: Consider alternative drug not metabolized by CYP2C19; If amitriptyline is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level A (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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Patient experience
Fluoxetine via Category:Antidepressants exp n/a/5 outcome n/a (n=1) exp 1.0/5 outcome +33.0 (n=1)
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Summary
Classes
TCA, Antidepressant
Common uses
Pharmacy
Pharmacology
Purported mechanism
Serotonin and norepinephrine reuptake inhibitor; anticholinergic