Imipramine
Brand name Tofranil
Used in the following combined preparations None
General Information
Imipramine belongs to the tricyclic class of antidepressant drugs. The drug is used mainly in the long-term treatment of depression to elevate mood, improve appetite, increase physical activity, and restore interest in everyday life. Because imipramine is less sedating than some other antidepressants, it is particularly useful when a depressed person is withdrawn or apathetic, although it can aggravate insomnia if it is taken in the evening.
Imipramine is also prescribed to treat night-time enuresis (bedwetting) in children, although proof of its benefit is not conclusive. Imipramine can cause a variety of side effects. In overdose the drug may cause coma and dangerous heart rhythms.
Information for Users
Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.
How taken it
Tablets, liquid.
Frequency and timing of doses
1-4 x daily.
Dosage range
Adults Usually 75-200mg daily. Children Reduced dose according to age and weight.
Onset of effect
Some benefits and effects may appear within hours, but full antidepressant effect may not be felt for 2-6 weeks.
Duration of action
Following prolonged treatment, antidepressant effect may persist for up to 6 weeks. Any adverse effects may wear off within days.
Diet advice
None.
Storage
Keep in a closed container in a cool, dry place out of the reach of children.
Missed dose
Take as soon as you remember. If your next dose is due within 3 hours, take a single dose now and skip the next.
Stopping the drug
Do not stop taking the drug without consulting your doctor, who will supervise a gradual reduction in dosage. Stopping abruptly may cause withdrawal symptoms.
Overdose Action
Seek immediate medical advice in all cases. Take emergency action if consciousness is lost.
See Drug poisoning emergency guide.
Possible Adverse Effects
The possible adverse effects of this drug are mainly the result of its anticholinergic action and its effect on the normal rhythm of the heart.
Interactions
Sedatives
Imipramine may increase the effects of sedative drugs.
Monoamine oxidase inhibitors (MAOIs)
There is a possibility of a serious interaction. Such drugs are prescribed together only under strict supervision.
Antihistamines
There is an increased risk of astemizole and terfenadine causing abnormal heart rhythms.
Phenytoin
Imipramine may increase levels of phenytoin.
Quick Reference
Drug group
Tricyclic antidepressant and drug for urinary disorders
Overdose danger rating High
Dependence rating Low
Prescription needed Yes
Available as generic Yes
Special Precautions
Be sure to tell your doctor if:
You have had heart problems.
You have long-term liver or kidney problems.
You have had epileptic fits. You have had glaucoma.
You have prostate trouble.
You have had mania or a psychotic illness. You are taking other medications.
Pregnancy
Safety in pregnancy not established. Discuss with your doctor.
Breast-feeding
The drug passes into the breast milk, but at normal doses adverse effects on the baby are unlikely. Discuss with your doctor.
Infants and children
Not recommended under 6 years. Reduced dose necessary in older children.
Over 60
Increased likelihood of adverse effects. Reduced dose may therefore be necessary.
Driving and hazardous work
Avoid such activities until you have learned how imipramine affects you because the drug may cause reduced alertness and blurred vision.
Alcohol
Avoid. Alcohol may increase the sedative effect of imipramine.
Surgery and general anaesthetics
Imipramine treatment may need to be stopped before you have a general anaesthetic. Discuss this with your doctor or dentist before any operation.
Prolonged Use
No problems expected. Imipramine is not usually prescribed for children as a treatment for bedwetting for longer than three months.
