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Elavil Side Effects

Generic Name: amitriptyline

Note: This document contains side effect information about amitriptyline. Some of the dosage forms listed on this page may not apply to the brand name Elavil.

For the Consumer

Applies to amitriptyline: oral tablet

Along with its needed effects, amitriptyline (the active ingredient contained in Elavil) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking amitriptyline:

Incidence not known
  • Abdominal or stomach pain
  • agitation
  • black, tarry stools
  • bleeding gums
  • blood in urine or stools
  • blurred vision
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • change in consciousness
  • changes in patterns and rhythms of speech
  • chest pain or discomfort
  • chills
  • cold sweats
  • coma
  • confusion
  • confusion about identity, place, and time
  • continuing ringing, buzzing, or other unexplained noise in ears
  • convulsions
  • cool, pale skin
  • cough or hoarseness
  • dark urine
  • decrease in frequency of urination
  • decrease in urine volume
  • decreased urine output
  • difficulty in breathing
  • difficulty in passing urine (dribbling)
  • difficulty in speaking
  • disturbance of accommodation
  • disturbed concentration
  • dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
  • double vision
  • drooling
  • dry mouth
  • excitement
  • fainting
  • false beliefs that cannot be changed by facts
  • fast, slow, or irregular heartbeat
  • fear or nervousness
  • fever with or without chills
  • flushed, dry skin
  • fruit-like breath odor
  • general feeling of tiredness or weakness
  • headache
  • hearing loss
  • high fever
  • high or low blood pressure
  • hostility
  • inability to move arms, legs, or facial muscles
  • inability to speak
  • increased hunger
  • increased need to urinate
  • increased ocular pressure
  • increased sweating
  • increased thirst
  • increased urination
  • irritability
  • lack of coordination
  • lethargy
  • light-colored stools
  • lip smacking or puckering
  • loss of appetite
  • loss of balance control
  • loss of bladder control
  • loss of consciousness
  • lower back or side pain
  • mental depression or anxiety
  • muscle spasm or jerking of all extremities
  • muscle tightness
  • muscle trembling, jerking, or stiffness
  • muscle twitching
  • nausea and vomiting
  • nightmares or unusually vivid dreams
  • overactive reflexes
  • painful or difficult urination
  • passing urine more often
  • pinpoint red spots on skin
  • poor coordination
  • pounding in the ears
  • puffing of cheeks
  • rapid or worm-like movements of tongue
  • rapid weight gain
  • restlessness
  • seeing, hearing, or feeling things that are not there
  • seizures
  • severe muscle stiffness
  • shakiness and unsteady walk
  • shivering
  • shortness of breath
  • shuffling walk
  • sleeplessness
  • slow speech
  • slurred speech
  • sore throat
  • sores, ulcers, or white spots on lips or in mouth
  • stiffness of limbs
  • stupor
  • sudden loss of consciousness
  • sweating
  • swelling of face, ankles, or hands
  • swelling or puffiness of face
  • swollen glands
  • talking or acting with excitement you cannot control
  • trouble in speaking
  • trouble sleeping
  • troubled breathing
  • twisting movements of body pain or discomfort in arms, jaw, back, or neck
  • unable to sleep
  • uncontrolled chewing movements
  • uncontrolled movements, especially of arms, face, neck, back, and legs
  • unexplained weight loss
  • unpleasant breath odor
  • unsteadiness, trembling, or other problems with muscle control or coordination
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • unusually pale skin
  • upper right abdominal pain
  • vomiting of blood
  • weakness in arms, hands, legs, or feet
  • weight gain or loss
  • yellow eyes and skin

Get emergency help immediately if any of the following symptoms of overdose occur while taking amitriptyline:

Symptoms of Overdose
  • Clumsiness
  • drowsiness
  • low body temperature
  • muscle aches
  • muscle weakness
  • sleepiness
  • tiredness
  • weak or feeble pulse

Some side effects of amitriptyline may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known
  • Bigger, dilated, or enlarged pupils (black part of eye)
  • black tongue
  • bloating
  • breast enlargement in females
  • constipation
  • decreased interest in sexual intercourse
  • diarrhea
  • hair loss, thinning of hair
  • hives or welts
  • inability to have or keep an erection
  • increased in sexual ability, desire, drive, or performance
  • increased interest in sexual intercourse
  • increased sensitivity of eyes to light
  • loss in sexual ability, desire, drive, or performance
  • loss of sense of taste
  • redness or other discoloration of skin
  • severe sunburn
  • skin rash
  • swelling of testicles
  • swelling of the breasts or breast soreness in males
  • swelling of the parotid glands
  • swelling or inflammation of the mouth
  • unexpected or excess milk flow from breasts

For Healthcare Professionals

Applies to amitriptyline: compounding powder, intramuscular solution, oral tablet


Frequency not reported: Weakness, fatigue, hyperpyrexia, edema of face and tongue[Ref]

Nervous system

Rare (less than 0.1%): Serotonin syndrome
Frequency not reported: Coma, seizures, confusional states, disorientation, incoordination, ataxia, tremors, peripheral neuropathy, numbness, tingling and paresthesia of the extremities, extrapyramidal symptoms (including abnormal involuntary movements and tardive dyskinesia), dysarthria, disturbed concentration, restlessness, drowsiness, dizziness, headache, tinnitus, alteration in EEG patterns, irritability, sleep disturbance, ageusia
Postmarketing reports: Syndrome resembling neuroleptic malignant syndrome (NMS) including muscle rigidity, fever, mental status changes, diaphoresis, tachycardia[Ref]


Frequency not reported: Myocardial infarction, stroke, nonspecific ECG changes and changes in AV conduction, heart block, arrhythmias, hypotension (particularly orthostatic hypotension), syncope, hypertension, tachycardia, palpitation[Ref]


Rare (less than 0.1%): Mania/hypomania
Frequency not reported: Hallucinations, delusions, excitement, anxiety, insomnia, nightmares, suicidal ideation/behaviors[Ref]


Frequency not reported: Paralytic ileus, constipation, dry mouth, nausea, epigastric distress, vomiting, stomatitis, peculiar taste, diarrhea, parotid swelling, black tongue[Ref]


The most commonly reported side effects were tremors, dizziness, headache, dry mouth, constipation, and nausea.[Ref]


Frequency not reported: Urinary retention, dilatation of the urinary tract, testicular swelling, gynecomastia (male), breast enlargement, galactorrhea (female), increased or decreased libido, impotence, urinary frequency[Ref]


Frequency not reported: Bone marrow depression (including agranulocytosis, leukopenia, thrombocytopenia), purpura, eosinophilia[Ref]


Frequency not reported: Syndrome of inappropriate ADH (antidiuretic hormone) secretion[Ref]


Rare (less than 0.1%): Hepatitis (including altered liver function, cholestasis and jaundice), hepatic failure, hepatic necrosis[Ref]


Frequency not reported: Skin rash, urticaria, photosensitization, alopecia, increased perspiration[Ref]


Frequency not reported: Lupus-like syndrome (migratory arthritis, positive ANA and rheumatoid factor)[Ref]


Frequency not reported: Anorexia, elevation or lowering of blood sugar levels, weight gain or loss, hyponatremia, increased appetite[Ref]


Frequency not reported: Blurred vision, disturbance of accommodation, increased ocular pressure, mydriasis[Ref]


1. Cerner Multum, Inc. "Australian Product Information." O 0

2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

3. "Product Information. Elavil (amitriptyline)." Stuart Pharmaceuticals, Wilmington, DE.

Some side effects of Elavil may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.