$Unique_ID{BRK03189} $Pretitle{} $Title{imipramine} $Subject{hydrochloride Janimine Abbott Tipramine Major Tofranil Geigy Tofranil-PM Tricyclic antidepressant imipramine mental depression chemicals nerve transmission enuresis bed-wetting children} $Volume{} $Log{ Tofranil-PM*0318901.scf} Copyright (C) 1993 Publications International, Ltd. imipramine ------------------------------------------------------------------------------ BRAND NAMES (Manufacturers) imipramine hydrochloride (various manufacturers) Janimine (Abbott) Tipramine (Major) Tofranil (Geigy) Tofranil-PM (Geigy) TYPE OF DRUG Tricyclic antidepressant INGREDIENT imipramine DOSAGE FORMS Tablets (10 mg, 25 mg, and 50 mg) Capsules (75 mg, 100 mg, 125 mg, and 150 mg) STORAGE Store at room temperature in a tightly closed container. USES Imipramine is used to relieve the symptoms of mental depression. This medication belongs to a group of drugs referred to as tricyclic antidepressants. These medicines are thought to relieve depression by increasing the concentration of certain chemicals necessary for nerve transmission in the brain. This medication is also used to treat enuresis (bed-wetting) in children six to 12 years of age. TREATMENT Imipramine should be taken exactly as your doctor prescribes. It can be taken with water or with food to lessen the chance of stomach irritation, unless your doctor tells you to do otherwise. If you miss a dose of this medication, take the missed dose as soon as possible, then return to your regular dosing schedule. If, however, the dose you missed was a once-a-day bedtime dose, do not take that dose in the morning; check with your doctor instead. If the dose is taken in the morning, it may cause unwanted side effects. Never double the dose. The effects of therapy with this medication may not become apparent for two or three weeks. SIDE EFFECTS Minor. Agitation, anxiety, blurred vision, confusion, constipation, cramps, diarrhea, dizziness, drowsiness, dry mouth, fatigue, heartburn, insomnia, loss of appetite, nausea, peculiar tastes in the mouth, restlessness, sweating, vomiting, weakness, or weight gain or loss. As your body adjusts to the medication, these side effects should disappear. This drug may cause increased sensitivity to sunlight. Therefore, avoid prolonged exposure to sunlight and sunlamps. Wear protective clothing, and use an effective sunscreen. Dry mouth caused by therapy with this medication can be relieved by chewing sugarless gum or by sucking on ice chips or a piece of hard candy. To relieve constipation, increase the amount of fiber in your diet (fresh fruits and vegetables, salads, bran, and whole-grain breads), exercise, and drink more water (unless your doctor directs you to do otherwise). To avoid dizziness or light-headedness when you stand, contract and relax the muscles of your legs for a few moments before rising. Do this by pushing one foot against the floor while raising the other foot slightly, alternating feet so that you are "pumping" your legs in a pedaling motion. Major. Tell your doctor about any side effects that are persistent or particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about chest pains, convulsions, difficulty in urinating, enlarged or painful breasts (in both sexes), fainting, fever, fluid retention, hair loss, hallucinations, headaches, impotence, mood changes, mouth sores, nervousness, nightmares, numbness in the fingers or toes, palpitations, ringing in the ears, seizures, skin rash, sleep disorders, sore throat, tremors, uncoordinated movements or balance problems, unusual bleeding or bruising, or yellowing of the eyes or skin. INTERACTIONS Imipramine interacts with a number of other types of medications: 1. Extreme drowsiness can occur when this medicine is taken with central nervous system depressants (such as alcohol, antihistamines, barbiturates, benzodiazepine tranquilizers, muscle relaxants, narcotics, pain medications, phenothiazine tranquilizers, and sleeping medications) or with other tricyclic antidepressants. 2. Imipramine may decrease the effectiveness of antiseizure medications and may block the blood-pressure-lowering effects of clonidine and guanethidine. 3. Oral contraceptives (birth control pills) and estrogen-containing drugs can increase the side effects and reduce the effectiveness of the tricyclic antidepressants (including imipramine). 4. Cimetidine can decrease the breakdown of imipramine in the body, thus increasing the possibility of side effects. 5. Tricyclic antidepressants may increase the side effects of thyroid medication and of over-the-counter (nonprescription) cough, cold, allergy, asthma, sinus, and diet medications. 6. The concurrent use of tricyclic antidepressants and monoamine oxidase (MAO) inhibitors should be avoided, because the combination may result in fever, convulsions, or high blood pressure. At least 14 days should separate the use of this drug and the use of an MAO inhibitor. BE SURE TO TELL YOUR DOCTOR about any medications you are currently taking, especially those listed above. WARNINGS * Tell your doctor if you have had unusual or allergic reactions to any medications, especially to imipramine or any of the other tricyclic antidepressants (such as amitriptyline, doxepin, trimipramine, amoxapine, protriptyline, desipramine, maprotiline, and nortriptyline). * Tell your doctor if you have a history of alcoholism or if you have ever had asthma, high blood pressure, liver or kidney disease, heart disease, a heart attack, circulatory disease, stomach problems, intestinal problems, difficulty in urinating, enlarged prostate gland, epilepsy, glaucoma, thyroid disease, mental illness, or electroshock therapy. * If the use of imipramine makes you dizzy or drowsy, do not take part in any activity that requires alertness, such as driving a car or operating potentially dangerous machinery. * Before having surgery or any other medical or dental treatment, tell your doctor or dentist you are taking this drug. * Do not stop taking this drug suddenly. Stopping it abruptly can cause nausea, headache, stomach upset, fatigue, or a worsening of your condition. Your doctor may want to reduce the dosage gradually. * The effects of this medication may last as long as seven days after you stop taking it, so continue to observe all precautions during that period. * Some of these products contain the color additive FD&C Yellow No. 5 (tartrazine), which can cause allergic-type reactions (skin rash, fainting, difficulty in breathing) in certain susceptible individuals. * The elderly may be at increased risk for experiencing side effects. Report any such effects, especially dizziness, drowsiness, dry mouth, difficulty urinating, or mental confusion to your doctor. * Be sure to tell your doctor if you are pregnant. Adverse effects have been observed in the fetuses of animals that were given large doses of this drug during pregnancy. Also, tell your doctor if you are breast-feeding an infant. Small amounts of this drug can pass into breast milk and may cause unwanted effects in nursing infants. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.