Amitriptyline Dosages for Adults: Your GoodRx Guide

Amitriptyline belongs to a class of medications called tricyclic antidepressants (TCAs). It raises the levels of serotonin and norepinephrine in your brain to help you feel more balanced. But, just like with any medication, it's important to take the right amount. In this guide, we’ll cover the approved amitriptyline dosages for adults to help you or a loved one take it safely and get the most out of it.

What’s the typical amitriptyline dosage for adults?

Amitriptyline is FDA-approved for depression in adults. Adolescents ages 13 to 17 can also take it, but there aren’t clear dosage guidelines for this age group. Although it’s commonly used off label for other conditions, such as insomnia, anxiety, and chronic pain, there aren’t approved amitriptyline dosages for them either. 

In any case, it’s best to follow your healthcare provider’s dosing instructions.

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Depression

For adults, there are two recommended ways to start taking amitriptyline for depression. The first is to start with 75 mg per day divided into several smaller doses throughout the day. The other is to start with 50 mg to 100 mg once daily at bedtime.

Your healthcare provider may then raise your dose depending on how amitriptyline is working for you. These increases are usually made in small amounts — 25 mg to 50 mg at a time. The maximum recommended daily amitriptyline dosage is 150 mg per day.

If you’re in the hospital when you start taking amitriptyline, you may receive a higher dosage. In this instance, you may start with 100 mg of amitriptyline per day. Your healthcare provider may then slowly increase the dose up to 200 mg per day based on your response. The maximum recommended amitriptyline dosage if you’re in the hospital is 300 mg per day.

Once you find the effective amitriptyline dosage for your needs, you’ll enter what’s called the “maintenance phase.” You’ll usually continue taking the same amitriptyline dosage during this time. Keep in mind that it may take up to 30 days to feel the full effect of amitriptyline. 

The maintenance phase is normally continued for at least 3 months to help treat depression symptoms and help prevent them from returning. After 3 months, you and your healthcare provider can work together to decide if you should keep taking the medication. 

What’s the best way to take amitriptyline?

Amitriptyline is available as an oral tablet in several different doses:

• 10 mg

• 25 mg

• 50 mg

• 75 mg

• 100 mg

• 150 mg

You should take your amitriptyline dose(s) at about the same time each day. And you can take it with or without food.

Your healthcare provider will help you figure out the best way for you to take your medication. They may recommend that you divide your daily amitriptyline dose into several smaller doses throughout the day. Or they could suggest taking it as one dose before bedtime. It’s common for amitriptyline to make you feel tired, so taking it before bed can help you avoid feeling sleepy during the day. 

Your provider may start you at a low amitriptyline dosage and slowly increase it over time. This helps them find the right amitriptyline dosage to manage your symptoms while avoiding unwanted side effects that may come with higher doses.

Don’t stop taking amitriptyline or adjust your dosage on your own, especially if you’ve been taking it for a long time. Doing so may cause withdrawal symptoms and could be dangerous to your health. It’s best to speak with your healthcare provider — they can safely guide you through any necessary dosage changes.

Are there any dosage adjustments for medical conditions?

Sometimes, your amitriptyline dosage may need to be adjusted because of your age or other medical conditions.

Dosage for people with liver problems

Amitriptyline is broken down and removed from the body by your liver. So if you have liver problems, there’s a chance that too much amitriptyline could build up in your body. This could increase your risk of side effects.

Because of this, amitriptyline should be used with caution in people with liver impairment. If you have liver problems, your healthcare provider can help decide if amitriptyline is safe for you to take and what dose is best.

Dosage for people aged 65 years and over

If you’re 65 years of age or older, you may need a lower amitriptyline dosage. The recommended daily dosage is 10 mg three times a day and 20 mg at bedtime (4 total doses, 50 mg per day). But lower doses may also be effective. Your healthcare provider will help determine the best dosage for you.

What happens if you miss a dose of amitriptyline?

If you miss your dose of amitriptyline and it’s close to the time you normally take it, go ahead and take your usual dose. But if it’s almost time for your next dose, skip the missed dose and continue with your next dose as usual. Don’t double up on your dose to make up for missing one.

If you miss more than one dose, you might experience withdrawal symptoms like headaches, trouble sleeping, and nausea. If this happens, contact your healthcare provider for directions on how to get back on track with your treatment.

You’ll get the best results from your amitriptyline treatment by taking it consistently every day. If you find it hard to remember, consider using a medication reminder app on your phone or a medication organizer to help.

What should you do if you take too much amitriptyline?

If you accidentally take one extra amitriptyline tablet, it’s not likely to cause a problem. You may not notice any negative effects. Or you may have more side effects, such as dizziness, drowsiness, or dry mouth, until the extra medication wears off.

If you take a large amount of amitriptyline, it can be dangerous to your health. Having too much amitriptyline in your system can cause abnormal heart rhythms, very low blood pressure (hypotension), and seizures. It may even lead to death in extreme cases. 

If you or someone you know has taken too much amitriptyline, contact your healthcare provider or call the Poison Control Center at 1-800-222-1222. But if you have any of the above symptoms, it’s best to seek emergency medical attention right away.

How to save on amitriptyline

Amitriptyline is available as a lower-cost generic medication. GoodRx can help you save over 70% off the average retail price of the generic version. Generic amitriptyline’s price at certain pharmacies is as low as $4.00 with a free GoodRx discount.

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Written by:

Jill Barat, PharmD

Jill Barat, PharmD has nearly 10 years of experience as a pharmacist, including serving as the pharmacist in charge at an independent sterile and non-sterile compounding pharmacy. She also worked as the head of medical content for a telemedicine company.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

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