Imipramine
Generic name: Imipramine
Brand Name: Tofranil
Indications
Imipramine is indicated for the relief of symptoms of depression. It may also be used as temporary adjunctive therapy in reducing enuresis in children aged 6 years and older, after possible organic causes have been excluded by appropriate tests
Dosage and Administration
Imipramine is supplied as 10mg 25mg and 50mg tablets.
Normal Dosage:
Depression
Usual Adult Dose
Hospitalized Patients - Initially, 100 mg/day in divided doses gradually increased to 200 mg/day as required. If no response after two weeks, increase to 250 to 300 mg/day.
Outpatients - Initially, 75 mg/day increased to 150 mg/day. Dosages over 200 mg/day are not recommended. Maintenance, 50 to 150 mg/day.
Adolescent and Geriatric Patients - Initially, 30 to 40 mg/day; it is generally not necessary to exceed 100 mg/day.
Childhood Enuresis
Initially, an oral dose of 25 mg/day should be tried in children aged 6 and older. Medication should be given one hour before bedtime. If a satisfactory response does not occur within one week, increase the dose to 50 mg nightly in children under 12 years; children over 12 may receive up to 75 mg nightly.
Overdose: Overdose symptoms include seizures, confusion, drowsiness, agitation, hallucinations, and low blood pressure.
Drug Description
Tofranil is supplied in tablet form for oral administration.
Tofranil, imipramine hydrochloride USP, the original tricyclic antidepressant, is a member of the dibenzazepine group of compounds. It is designated 5-3-(Dimethylamino)propyl-10,11-dihydro-5H-dibenz[b,f]-azepine monohydrochloride. Its structural formula is:
Side Effects
The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
- Dry mouth
- Constipation
- Difficulty in passing urine (urinary retention)
- Blurred vision
- Faster than normal heart beat (tachycardia)
- Sweating
- Shaking, usually of the hands (tremor)
- Drowsiness
- Weakness
- Drop in blood pressure when going from lying or sitting to sitting or standing, causing dizziness and lightheadedness (postural hypotension)
- Confusion
- Sensation of ringing, or other noise in the ears (tinnitus)
- Headache
- Weight changes
- Allergic skin reactions
- Sexual problems
- Blood disorders
- Jaundice
- Abnormal heart beats (arrhythmias)
- Behavioural disturbances in children treated for bedwetting
- Convulsions (fits)
Precautions
- Use caution when driving, operating machinery, or performing other hazardous activities.
- Use alcohol cautiously. Alcohol may increase drowsiness and dizziness during treatment and may reduce the effectiveness of this drug.
- Do not take this medication if you have taken a monoamine oxidase inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) within the last 14 days.
- Before taking this medication, tell your doctor if you have:
- liver disease
- kidney disease
- asthma
- thyroid disease
- diabetes
- stomach or intestinal problems
- high blood pressure or heart disease
- had a heart attack in the last 6 weeks
- You may not be able to take this medication, or you may require a special dosage or monitoring during therapy if you have any of the conditions listed above.
Drug Interactions
- Imipramine interacts with other medications and drugs that slow the brain's processes, such as alcohol, barbiturates, benzodiazepines, e.g. lorazepam (Ativan), diazepam (Valium), temazepam (Restoril), oxazepam (Serax), clonazepam (Klonopin), zolpidem (Ambien), and narcotics. Reserpine, given to patients taking TCAs, can cause agitation and anxiety.
- Imipramine and other TCAs should not be used with monoamine oxidase inhibiting drugs, for example, isocarboazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and procarbazine (Matulane), since high fever, convulsions and even death can occur.
- Drugs other than those listed here may also interact. Talk to your doctor before taking any prescription or over-the-counter medicines, including vitamins, minerals, and medicines prescribed by other doctors.
