Does amitriptyline (a tricyclic antidepressant) cause an increase in creatinine (CR) levels, indicating impaired renal function?

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Last updated: April 30, 2025View editorial policy

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From the Research

Amitriptyline does not typically cause a significant increase in creatinine (Cr) levels. Creatinine is a waste product that's primarily cleared by the kidneys and is used as a marker of kidney function. While amitriptyline, a tricyclic antidepressant commonly used for depression, neuropathic pain, and migraine prevention, has many potential side effects, kidney dysfunction or elevated creatinine is not generally among them. The medication is primarily metabolized by the liver and excreted through urine, but it doesn't directly impact kidney filtration mechanisms that would lead to creatinine elevation. Some key points to consider:

  • A study from 1 found that amitriptyline had pleiotropic effects that ameliorated renal fibrosis, suggesting a potential protective effect on the kidneys.
  • Another study from 2 found that patients with chronic renal failure had decreased concentrations of amitriptyline and its active metabolites, which may decrease the clinical effectiveness of the drug.
  • However, it's worth noting that amitriptyline can cause urinary retention in some patients, particularly older adults or those with prostatic hypertrophy, which could potentially lead to kidney issues if severe and prolonged, but this would be an indirect effect rather than a direct impact on creatinine levels, as noted in 3. If a patient taking amitriptyline experiences an increase in creatinine levels, other causes should be investigated, such as dehydration, other medications, underlying kidney disease, or muscle breakdown, as suggested by 4.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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