{"id":1632,"date":"2023-06-25T17:28:42","date_gmt":"2023-06-25T17:28:42","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/amitriptyline-hydrochloride\/"},"modified":"2023-06-25T19:58:31","modified_gmt":"2023-06-25T19:58:31","slug":"amitriptyline-hydrochloride","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/amitriptyline-hydrochloride\/","title":{"rendered":"Amitriptyline hydrochloride"},"content":{"rendered":"

<\/p>\n

Amitriptyline hydrochloride<\/h1>\n

CLINICAL USE<\/h3>\n

Tricyclic antidepressant:<\/p>\n

  • Depression, used especially wheresedation is required<\/li>\n
  • Neuropathic pain
    \n

    DOSE IN NORMAL RENAL FUNCTION<\/h3>\n

    10\u2013200 mg daily depending on indication<\/p>\n

    PHARMACOKINETICS<\/h3>\n<\/li>\n
  • Molecular weight                           :
    \n313.9<\/li>\n
  • %Protein binding                           :
    \n96<\/li>\n
  • %Excreted unchanged in urine     :
    \n<2<\/li>\n
  • Volume of distribution (L\/kg)       :
    \n6\u201336<\/li>\n
  • half-life \u2013 normal\/ESRD (hrs)      :
    \n9\u201325\/Unchanged<\/p>\n

    DOSE IN RENAL IMPAIRMENT<\/h3>\n

    GFR (mL\/MIN)<\/h4>\n<\/li>\n
  • 20 to 50     : Dose as in normal renal function<\/li>\n
  • 10 to 20     : Dose as in normal renal function<\/li>\n
  • <10           :
    \nDose as in normal renal function<\/p>\n

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES<\/h3>\n<\/li>\n
  • CAPD                :
    \nNot dialysed. Dose as in normal renal function<\/li>\n
  • HD                     :
    \nNot dialysed. Dose as in normal renal function<\/li>\n
  • HDF\/high flux   :
    \nUnknown dialysability. Dose as in
    \nnormal renal function<\/li>\n
  • CAV\/VVHD      :
    \nNot dialysed. Dose as in normal renal function<\/p>\n

    IMPORTANT DRUG INTERACTIONS<\/h3>\n

    Potentially hazardous interactions with other drugs
    \nAlcohol: increased sedative effect<\/li>\n

  • Analgesics: increased risk of CNS toxicitywith tramadol; possibly increased risk
    \nof side effects with nefopam; possibly
    \nincreased sedative effects with opioids<\/li>\n
  • Antiarrhythmics: increased risk ofventricular arrhythmias with amiodarone
    \n\u2013 avoid concomitant use; increased risk
    \nof ventricular arrhythmias with drugs that
    \nprolong the QT interval; increased risk of
    \narrhythmias with propafenone<\/li>\n
  • Antibacterials: increased risk ofventricular arrhythmias with moxifloxacin
    \n\u2013 avoid concomitant use; concentration
    \npossibly reduced by rifampicin<\/li>\n
  • Anticoagulants: may alter anticoagulanteffect of coumarins<\/li>\n
  • Antidepressants: possibly increasedserotonergic effects with duloxetine;
    \nenhanced CNS excitation and
    \nhypertension with MAOIs and
    \nmoclobemide; concentration possibly
    \nincreased with SSRIs; concentration
    \nreduced by St John\u2019s wort<\/li>\n
  • Anti-epileptics: convulsive thresholdlowered; concentration reduced by
    \ncarbamazepine, primidone, barbiturates
    \nand possibly phenytoin<\/li>\n
  • Antimalarials: avoid concomitant use withartemether\/lumefantrine
    \nAntipsychotics: increased risk of<\/p>\n

    ventricular arrhythmias especially with
    \npimozide; increased antimuscarinic
    \neffects with clozapine and phenothiazines;
    \nconcentration increased by antipsychotics<\/li>\n

  • Antivirals: increased tricyclic side effectswith amprenavir; concentration possibly
    \nincreased with ritonavir
    \nAtomoxetine: increased risk of ventricular<\/p>\n

    arrhythmias and possibly convulsions
    \nBeta-blockers: increased risk of ventricular<\/p>\n

    arrhythmias with sotalol<\/li>\n

  • Clonidine: tricyclics antagonisehypotensive effect; increased risk of
    \nhypertension on clonidine withdrawal<\/li>\n
  • Dopaminergics: avoid use withentacapone; CNS toxicity reported with
    \nselegiline and rasagiline<\/li>\n
  • Pentamidine: increased risk of ventriculararrhythmias<\/li>\n
  • Sibutramine: increased risk of CNStoxicity \u2013 avoid concomitant use.<\/li>\n
  • Sympathomimetics: increased risk ofhypertension and arrhythmias with
    \nadrenaline and noradrenaline; metabolism
    \npossibly inhibited by methylphenidate<\/p>\n

    ADMINISTRATION<\/h3>\n

    Reconstition<\/h4>\n

    \u2013<\/p>\n

    Route<\/h4>\n

    Oral<\/p>\n

    Rate of Administration<\/h4>\n

    \u2013<\/p>\n

    Comments<\/h4>\n

    \u2013<\/p>\n

    OTHER INFORMATION<\/h4>\n<\/li>\n
  • Introduce treatment gradually in renalimpairment due to dizziness and postural
    \nhypotension<\/li>\n
  • Withdraw treatment gradually<\/li>\n
  • Anticholinergic side effects: causes urinaryretention, drowsiness, dry mouth, blurred
    \nvision and constipation<\/li>\n","protected":false},"excerpt":{"rendered":"

    Amitriptyline hydrochloride CLINICAL USE Tricyclic antidepressant: Depression, used especially wheresedation<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-1632","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1632","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=1632"}],"version-history":[{"count":1,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1632\/revisions"}],"predecessor-version":[{"id":2927,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1632\/revisions\/2927"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=1632"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=1632"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=1632"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}