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Updated 11 February 2013

Imipramine

Imipramine is used for the treatment of depressive illness and panic disorders.

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Imipramine is the active ingredient of Ethipramine and Tofranil.

General information

Imipramine is used for the treatment of depressive illness and panic disorders. It is also used as adjunctive therapy for bed-wetting in children older than six years of age. Imipramine is furthermore used with great success in the treatment of chronic pain syndromes (neck and back pain, amongst others) and migraine. It has also been used to treat nerve pain such as that accompanied by shingles.

Imipramine elevates mood, increase physical activity, improves appetite and restores interest in everyday activities.

Because on its effect on appetite, many taking imipramine may experience unwelcome weight gain.

The drug - less sedating than many other antidepressants - may aggravate insomnia if taken at night.

How does imipramine work?

Imipramine has an effect on serotonin, noradrenaline and acethylcholine. These brain chemicals play an important role in mood, emotion, mental state and anxiety; by elevating these brain chemicals, the conditions for which imipramine is indicated, is greatly improved.

Fast facts

Drug schedule: Schedule 5

Available as : tablets

What does it do? Imipramine is an antidepressant, and anti-panic agent

Overdose risk: High

Dependence risk: Low

Available as a generic? Yes

Available on prescription only? Yes

User information

Onset of effect: Antidepressant effect is only evident after 3-6 weeks.

Duration of action: As an antidepressant the effects may for as long as 6 weeks after discontinuing drug.

Dietary advice: Take imipramine with food to reduce gastrointestinal side effects.

Stopping this medicine: Stopping this medication too soon may cause a recurrence of the original symptoms. Always consult your doctor before discontinuing use.

Prolonged use: No problem foreseen; tolerance to many side effects may occur over time. It should not be prescribed to children as a treatment for bed-wetting for longer than 3 months.

Special precautions

Alert your doctor before using this drug if:

  • you have epilepsy,
  • you have abnormal heart rhythms,
  • you have impaired liver function,
  • you had a recent heart attack,
  • you have a thyroid condition,
  • you have an enlarged prostate,
  • you have glaucoma, or
  • if you are taking other medication.

Pregnancy: Avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.

Breastfeeding: Avoid. It is unknown how this medication may affect your baby. Consult your doctor before use.

Porphyria: Avoid. This medication may cause serious adverse effects. Consult your doctor before use.

Infants and children: Safety and efficacy of this medication has not been established for children under the age of 6 for bed-wetting, and children under the age of 16 for depression.

Elderly: Caution is advised in the elderly as side effects may be more severe.

Driving and hazardous work: Caution is advised as use of this medication may lead to reduced alertness and blurred vision. Avoid such activities until you know how it affects you.

Alcohol: Avoid concomitant use of alcohol, as it may potentiate sedative effects

Possible side effects

Side effect

Frequency

Consult your doctor

Common

Rare

Only if severe

In all cases

Confusion

x

x

Dry mouth

x

x

Headache

x

x

Nausea/ vomiting

x

x

Weight gain/ increased appetite

x

x

Heartburn

x

x

Constipation

x

x

Difficulty urinating

x

x

Hallucinations

x

x

Fatigue

x

x

Blurred vision

x

x

Impaired concentration

x

x

Dilated pupils/ eye pain

x

x

Difficulty breathing

x

x

Seizures

x

x

Palpitations

x

x

Fever/ sore throat

x

x

Interactions

Drug interactions

Warfarin

Blood clotting time may be affected

Antihistamines

Increased risk of heart rhythm disturbance

Barbiturates

Reduced imipramine efficacy

Benzodiazepines

Possible increase in sedative effects

Bupropion

Possible imipramine toxicity

Cimetidine

Possible imipramine toxicity

Fluoxetine

Increased risk of serotonin toxicity

Fluvoxamine

Increased risk of imipramine toxicity

Monoamine oxidase-inhibitors

Serious interactions may occur. Wait at least until after stopping MAOI before starting imipramine

Nitrates

Possible reduced effect on sublingual (under tongue) nitrates

Oral contraceptives

Increased risk of imipramine toxicity

Rifampicin

Reduced effect of imipramine

Sertraline

Increased risk of serotonin toxicity

Tobacco

Possible reduced effect of imipramine

Disease interactions

Consult your doctor before using this drug if you have epilepsy, glaucoma, abnormal heart rhythms, impaired liver function, have had a recent heart attack, have a thyroid condition, or if you have an enlarged prostate.

Overdose action

A small overdose is no cause for concern. In case of intentional large overdose, seek emergency medical attention.

Recommended dosage

Adults: 10-100mg daily.

Bedwetting

Children 6-7: 10-25mg after supper

Children 8-11:25-50mg after supper

Children over 11: 25-75mg at bedtime

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

 
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