Leitura clínica
Comentário
Antidepressivo tricíclico e analgésico com marcadas propriedades anticolinérgicas e sedativas. Indicado no tratamento da depressão, dor neuropática e profilaxia da enxaqueca. É metabolizado em nortriptilina (Weissman 2004) . Administração oral em duas doses diárias. É excretado no leite materno em quantidade clinicamente insignificante. (Bader 1980, Brixen 1982, Pittard 1986, Breyer 1995) Os níveis plasmáticos no lactente foram indetectáveis. (Ericsson 1979, Bader 1980, Brixen 1982, Breyer 1995) ou muito baixos. (Yoshida 1997) Não foram observados efeitos secundários mesmo com doses maternas de 150 - 175 mg/dia (Brixen 1982, Misri 1991, Nulman 2002) , embora haja um caso publicado de sedação em um lactente de 15 dias poucos dias depois de sua mãe tomar apenas 10 mg diários de amitriptilina por problemas de insônia e ansiedade (Uguz 2017) . Não foram medidos níveis nem no leite nem no plasma do lactente ou materno. A amitriptilina pode produzir galactorreia com ou sem hiperprolactinemia. (Suthar 2018, Coker 2010, Egberts 1997) Vigiar sonolência e alimentação adequada do lactente. Não se recomenda compartilhar a cama com o bebê se estiver tomando este medicamento. (ABM 2020 y 2008, UNICEF 2018, 2017, 2014 y 2013, Landa 2012, UNICEF 2006) Autores especialistas consideram possível o uso desta medicação durante a amamentação. (Hale, Uguz 2021) Até que sejam conhecidos mais dados publicados sobre este fármaco em relação à amamentação, podem ser preferíveis alternativas conhecidas mais seguras (Sriraman 2015, Davanzo 2011, ABM 2008) , especialmente durante o período neonatal e em caso de prematuridade. Mulheres com depressão durante a gravidez precisam de mais apoio à amamentação por terem maior risco de problemas e interrupção precoce da amamentação. (Grzeskowiak 2018, Leggett 2017, Venkatesh 2017, Gorman 2012) Pode consultar abaixo a informação deste produto relacionado: Depressão Materna (Produto seguro e/ou a amamentação é a melhor opção.)
Encontrabilidade
Outros nomes e marcas
Sinônimos e grafias 8
- Embonato de amitriptilina
- Hidrocloruro de amitriptilina
- Αμιτρυπτιλίνη
- أميتريبتيلين
- Амитриптилин
- 阿米替林
- アミトリプチリン
- N06AA09
Marcas comerciais na fonte 41
- ADT (Portugal)
- Adepril
- Adepsique
- Amineurin
- Amitrip
- Amitrol
- Amytril
- Amyzol
- Anapsique
- Deprelio
- Domical
- Elavil
- Eliwel
- Endep
- Laroxyl
- Lentizol
- Minitran (Grecia)
- Mutabon
- Noriline
- Novoprotect
- Polytanol
- Protanol
- Redomex
- Saroten
- Sarotena
- Sarotex
- Stelminal
- Syneudon
- Teperin
- Trepiline
- Tripsol
- Tripsyline
- Tripta
- Triptafen
- Triptizol
- Triptyl
- Triptyline
- Tryptanol
- Tryptizol
- Tryptomer
- Uxen
Dados da fonte
Farmacocinética
| Variável | Valor | Unidade |
|---|---|---|
| Biodisp. oral | 100 | % |
| Peso Molecular | 314 | daltons |
| Unión proteínas | 95 | % |
| Vd | 6 - 10 | l/Kg |
| Tmax | 4 | horas |
| T½ | 31 - 46 | horas |
| Índice L/P | 1 - 1,7 | - |
| Dosis Teórica | 0,02 | mg/Kg/d |
| Dosis Relativa | 4 | % |
| Dosis Rel. Ped. | 1,3 - 2 | % |
Rastreabilidade
Bibliografia
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