Drug Uses

Elavil is indicated for the relief of symptoms of depression. Endogenous depression is more likely to be alleviated than are other depressive states.

How Taken

Elavil comes as a tablet to take by mouth. It is usually taken one to four times a day and may be taken with or without food. Take Elavil exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Continue to take Elavil even if you feel well. Do not stop taking Elavil without talking to your doctor, especially if you have taken large doses for a long time. Your doctor probably will want to decrease your dose gradually. This drug must be taken regularly for a few weeks before its full effect is felt.

Warnings/Precautions

Before taking Elavil, tell your doctor if you have liver disease; kidney disease; asthma; thyroid disease; diabetes; stomach or intestinal problems; high blood pressure or heart disease; had a heart attack in the last 6 weeks; an enlarged prostate or difficulty urinating; or glaucoma. You may not be able to take Elavil, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above. Elavil may be harmful to an unborn baby. Do not take Elavil without first talking to your doctor if you are pregnant or could become pregnant during treatment. Elavil passes into breast milk and may affect a nursing baby. Do not take Elavil without first talking to your doctor if you are breast-feeding a baby. If you are over 60 years of age, you may be more likely to experience side effects such as drowsiness, dizziness, unsteadiness, feeling uncoordinated and low blood pressure. Your doctor may prescribe a lower dose of this medication.

Missed Dose

Take the missed dose as soon as you remember. If it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take a double dose of this medication unless otherwise directed by your doctor.

Possible Side Effects

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Elavil. Older adults are especially liable to certain side effects of Elavil, including rapid heartbeat, constipation, dry mouth, blurred vision, sedation, and confusion, and are in greater danger of sustaining a fall. Side effects may include: Abnormal movements, anxiety, black tongue, blurred vision, breast development in males, breast enlargement, coma, confusion, constipation, delusions, diarrhea, difficult or frequent urination, difficulty in speech, dilation of pupils, disorientation, disturbed concentration, dizziness on getting up, dizziness or light-headedness, drowsiness, dry mouth, excessive or spontaneous flow of milk, excitement, fatigue, fluid retention, hair loss, hallucinations, headache, heart attack, hepatitis, high blood pressure, high fever, high or low blood sugar, hives, impotence, inability to sleep, increased or decreased sex drive, increased perspiration, increased pressure within the eye, inflammation of the mouth, intestinal obstruction, irregular heartbeat, lack or loss of coordination, loss of appetite, low blood pressure, nausea, nightmares, numbness, rapid and/or fast, fluttery heartbeat, rash, red or purple spots on skin, restlessness, ringing in the ears, seizures, sensitivity to light, stomach upset, strange taste, stroke, swelling due to fluid retention in the face and tongue, swelling of testicles, swollen glands, tingling and pins and needles in the arms and legs, tremors, vomiting, weakness, weight gain or loss, yellowed eyes and skin. Side effects due to rapid decrease or abrupt withdrawal from Elavil include: Headache, nausea, vague feeling of bodily discomfort Side effects due to gradual dosage reduction may include: Dream and sleep disturbances, irritability, and restlessness.

Storage

Store Elavil tablets in a well-closed container. Avoid storage at temperatures above 30°C (86°F). In addition, Elavil tablets 10 mg must be protected from light and stored in a well-closed, light-resistant container.

Overdose

Critical manifestations of overdose include: cardiac dysrhythmias, severe hypotension, convulsions, and CNS depression, including coma. Changes in the electrocardiogram, particularly in QRS axis or width, are clinically significant indictors of tricyclic antidepressant toxicity. Other signs of overdose may include: impaired myocardial contractility, confusion, disturbed concentration, transient visual hallucinations, and dilated pupils, disorders of ocular motility, agitation, hyperactive reflexes, stupor, drowsiness, muscle rigidity, vomiting, hypothermia, and hyperpyrexia. Deaths may occur from over dosage with this class of drugs.

More Information

Use caution when driving, operating machinery, or performing other hazardous activities. Elavil may cause drowsiness or dizziness. If you experience drowsiness or dizziness, avoid these activities. Dizziness is likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking Elavil. Do not stop taking Elavil suddenly. This could cause symptoms such as nausea, headache, and malaise.

Disclaimer

This drug information is for your information purposes only, it is not intended that this information covers all uses, directions, drug interactions, precautions, or adverse effects of your medication. This is only general information, and should not be relied on for any purpose. It should not be construed as containing specific instructions for any particular patient. We disclaim all responsibility for the accuracy and reliability of this information, and/or any consequences arising from the use of this information, including damage or adverse consequences to persons or property, however such damages or consequences arise. No warranty, either expressed or implied, is made in regards to this information.

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Dr. Peter Schlegel of the Cornell Medical Center in New York, along with a colleague, recently treated two men for infertility and found when both patients stopped taking their prescription antidepressant medications -- selective serotonin reuptake inhibitors (SSRIs) -- their sperm counts dramatically increased. Schlegel then observed that when both men re-started their antidepressants, their fertility problems returned.
One patient was taking citalopram -- sold as Cipramil -- and the other was on sertraline, sold as Lustral. The second patient switched to venlafaxtine -- Effexor -- and again his sperm count dropped to near zero. Schlegel believes that because SSRI drugs affect both sperm count and the ability of sperm to move, the antidepressants may be preventing sperm from reaching the semen.
"The patients had normal sperm counts and motility before medication," Schlegel said. "On the medication they have deterioration of both. The same patients going on and off medication had the same pattern. It shows a strong association."
The U.S. Food and Drug Administration required most SSRI drugs to carry the agency's strongest "black box" warning in 2004 for their association with increased risk of suicide. Other common side effects of the drugs include impotence and delayed ejaculation.
Allan Pacey, senior lecturer in andrology at the University of Sheffield, said, "There does seem to be a major correlation. Maybe this is an unknown side effect of these drugs that is only just coming to light."
Schlegel's study linking low sperm count to SSRI drug use noted that an additional dozen patients reported similar effects from the antidepressants. Because of the small number of patients involved, the study's implications need verification, Schlegel said. A clinical trial involving 30 male patients taking sertraline has begun to bolster Schlegel's findings.
The researchers warned that men taking SSRIs to treat mental disorders, who are concerned about low sperm counts, should not alter their drug use without consulting a qualified medical professional.

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