$Unique_ID{BRK01989}
$Pretitle{}
$Title{IMIPRAMINE}
$Subject{imipramine hydrochloride (various manufacturers)
Janimine (Abbott)
Tipramine (Major)
Tofranil (Geigy)
Tofranil-PM (Geigy)}
$Volume{}
$Log{
Tofranil*0198901.scf}

Copyright (C) 1991 Publications International, Ltd.


IMIPRAMINE
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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 some 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.
     Before starting to take imipramine, BE SURE TO TELL YOUR DOCTOR about any
medications you are currently taking, especially any of 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 this drug 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.  Studies in humans
have not been conducted, but 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, such as
irritability or sleeping problems, in nursing infants.

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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.
