Elavil is used with caution in patients with seizures since it can increase the risk of seizures. Elavil is used with caution in patients with prostate enlargement  because of the risk of increasing retention of urine due to the inability to urinate. Elavil can cause elevated pressure in the eyes of certain patients with glaucoma.

Antidepressants increased the risk of suicidal thinking and behavior in short-term studies in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of Elavil or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidal thinking or behavior, and unusual changes in behavior.

If Elavil is discontinued abruptly, dizziness, headache, nausea, and restlessness may occur. Withdrawal symptoms may occur when even a few doses are missed. Therefore, it is recommended that the dose of antidepressant be reduced gradually when therapy is discontinued.

If you are pregnant or planning to become pregnant, inform your doctor immediately. This medication appears in breast milk. If Elavil is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment is finished.

Elavil may intensify the effects of alcohol. Do not drink alcohol while taking this medication.

If Elavil is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important that you consult with your doctor before taking Elavil in combination with the following:

Airway-opening drugs such as albuterol and pseudoephedrineAntidepressants that raise serotonin levels, such as fluoxetine, paroxetine, and sertralineOther antidepressants, such as amoxapineAntihistamines such as diphenhydramine and clemastine fumarateBarbiturates such as phenobarbitalCertain blood pressure medicines such as clonidineCimetidineDisulfiramDrugs that control spasms, such as dicyclomineEstrogen drugs and oral contraceptivesEthchlorvynolMajor tranquilizers such as chlorpromazine and thioridazineMAO inhibitors, such as phenelzine and tranylcypromineMedications for irregular heartbeat, such as flecainide and propafenonePainkillers such as acetaminophen and meperidineParkinsonism drugs such as benztropine and levodopaQuinidineSeizure medications such as carbamazepine and phenytoinSleep medicines such as flurazepam and triazolamThyroid hormonesTranquilizers such as alprazolam and chlordiazepoxideWarfarin

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:
  Blurred vision, bone marrow depression, bowel problems, breast enlargement (in males and females), constipation, dry mouth, hair loss, heart attack, high body temperature, problems urinating, rash, seizure, stroke, swelling of the testicles, water retention

• Side effects due to a rapid decrease in dose 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, restlessness

These side effects do not signify an addiction to the drug.