Tofranil (Imipramine). Dosage, Side Effects, Interactions
Tofranil (Imipramine) is a prescription drug used to treat the symptoms of depression. Tofranil can be used alone or with other medications.
Tofranil belongs to a class of drugs called antidepressants (TCAs).
It is not known if Tofranil is safe and effective in children under 6 years of age.
What are the possible side effects of Tofranil (Imipramine)?
Tofranil can cause serious side effects, including:
- mood or behavior changes,
- panic attacks,
- Sleep disorders,
- impulsive behavior
- hyperactivity (mental or physical),
- more depression,
- suicidal thoughts,
- blurred vision,
- tunnel vision,
- eye pain or swelling,
- see halos around lights,
- drowsiness ,
- new or worsening chest pain,
- pounding heartbeat,
- flutter in your chest
- sudden numbness or weakness,
- problems with vision, speech or balance,
- Sore throat,
- unusual thoughts or behavior
- painful or difficult urination,
- seizures and
- yellowing of the skin or eyes (jaundice)
Get medical help right away if you have any of the symptoms listed above.
The most common side effects of Tofranil are:
- tingly feeling,
- lack of coordination,
- dry mouth,
- blurred vision,
- ringing in your ears
- breast wells (both males and females),
- decreased sex drive,
- impotence and
- Difficulty having an orgasm
Tell the doctor if you have any side effects that bother you or that don’t go away.
These are not all of the possible side effects of Tofranil. For more information, contact your doctor or pharmacist.
DESCRIPTION OF Tofranil (Imipramine)
Tofranil comes in tablet form for oral administration.
Tofranil, Imipramine Hydrochloride USP, the original tricyclic antidepressant, belongs to the group of dibenzazepine compounds. It is referred to as 5-3-(dimethylamino)propyl-10,11-dihydro- 5H. Dibenz [ b,f ]-azepine monohydrochloride. Its structural formula is:
Imipramine Hydrochloride USP is a white to off-white, odorless or practically odorless crystalline powder. It is freely soluble in water and alcohol, soluble in acetone, and insoluble in ether and benzene.
Calcium phosphate, cellulose compounds, document sodium, iron oxides, magnesium stearate, polyethylene glycol, povidone, sodium starch glycolate, sucrose, talc and titanium dioxide.
To relieve symptoms of depression. Endogenous depression is more likely to be relieved than other depressive states. Up to three weeks of treatment may be required before optimal therapeutic effects are evident.
May be useful as a temporary adjunctive therapy to reduce enuresis in children 6 years and older, after appropriate testing has ruled out possible organic causes. In patients with daytime symptoms of frequency and urgency, the examination should include emptying cystourethrography and cystoscopy as needed. The effectiveness of the treatment may decrease with continued drug administration.
DOSAGE AND APPLICATION OF Tofranil (Imipramine)
Lower doses are recommended for elderly patients and adolescents. Lower dosages are also recommended for outpatients compared to hospitalized patients who are under close supervision. Dosing should be initiated at a low level and increased gradually, with careful consideration of clinical response and any signs of intolerance. After remission, maintenance medication may be needed for an extended period of time at the lowest dose that maintains remission.
Usual adult dose
Initially 100 mg/day gradually increased to 200 mg/day in divided doses as needed. If there is no response after two weeks, increase to 250-300 mg/day.
Initially 75 mg/day increased to 150 mg/day. Doses above 200 mg/day are not recommended. Maintenance, 50 to 150 mg/day.
Adolescents and geriatric patients
Initially 30 to 40 mg/day; It is generally not necessary to exceed 100 mg/day.
Initially, an oral dose of 25 mg/day should be attempted in children 6 years and older. Medications should be given an hour before bedtime. If there is no satisfactory response within a week, increase the dose to 50 mg nightly in children under 12 years of age. Children over 12 years old can receive up to 75 mg per night. A daily dose greater than 75 mg does not increase effectiveness and tends to increase side effects. There is evidence that the drug is more effective in early night bedwetting when given earlier and in divided doses, i. H. 25 mg in the afternoon, repeated at bedtime. Consideration should be given to initiating a drug-free phase following an appropriate therapeutic trial with a favorable response. The dosage should be decreased gradually rather than stopped abruptly. This can reduce the tendency to relapse. Children who relapse after stopping the drug do not always respond to subsequent treatment.
The safety and efficacy of Tofranil as a temporary add-on therapy for nocturnal enuresis in children less than 6 years of age has not been established.
SIDE EFFECTS OF Tofranil (Imipramine)
Note – Although the following listing contains some adverse reactions that have not been reported with this specific drug, the pharmacological similarities between the tricyclic antidepressants require that each of the reactions be considered when administering Tofranil.
Cardiovascular: orthostatic hypotension, hypertension, tachycardia, palpitations, myocardial infarction, arrhythmias, heart block, ECG changes, precipitation of heart failure, stroke.
Psychiatric: states of confusion (especially in the elderly) with hallucinations, disorientation, delusions; anxiety, restlessness, excitement; insomnia and nightmares; hypomania; aggravation of psychosis.
Neurological: numbness, tingling, paresthesia of extremities; incoordination, ataxia, tremors; peripheral neuropathy; extrapyramidal symptoms; seizures, changes in EEG patterns; tinnitus
Anticholinergic: dry mouth and rarely associated sublingual adenitis; blurred vision, accommodation disorders, mydriasis; constipation, paralytic ileus; Urinary retention, delayed micturition, dilation of the urinary tract.
Allergic: rash, petechiae, urticaria, itching, photosensitization; edema (general or of the face and tongue); drug fever; Cross sensitivity with desipramine.
Haematological: bone marrow depression including agranulocytosis; eosinophilia; purpura; thrombocytopenia.
Gastrointestinal: nausea and vomiting, anorexia, upset stomach, diarrhea; peculiar taste, stomatitis, abdominal cramps, black tongue.
Endocrine: gynecomastia in men; breast enlargement and galactorrhea in women; increased or decreased libido, impotence; testicular swelling; increase or decrease in blood sugar levels; inappropriate antidiuretic hormone (ADH) secretion syndrome.
Other: jaundice (simulation of an obstacle); altered liver function; weight gain or weight loss; sweat; Wash; urinary frequency; drowsiness, dizziness, weakness and fatigue; Headache; swelling of the parotid gland; alopecia; tendency to fall.
Withdrawal Symptoms: While not indicative of addiction, stopping treatment suddenly after prolonged therapy can result in nausea, headache, and malaise.
Note – In enuretic children treated with Tofranil, the most common side effects were nervousness, sleep disturbances, fatigue and mild gastrointestinal upset. These usually go away with continued drug administration or when the dosage is reduced. Other reactions that have been reported are constipation, convulsions, anxiety, emotional instability, syncope and collapse. All side effects reported in adults should be taken into account.
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