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.