Indications
Imipramine Hydrochloride is a tricyclic antidepressant used to treat depression. It is also used, for a limited time, to help children aged 6 years and over who wet the bed at night (nocturnal enuresis) when other measures have not worked.
How It Works
Imipramine increases the amount of two brain chemicals, noradrenaline and serotonin, by stopping nerve cells from taking them back up too quickly. Over several weeks this helps lift mood. It also has effects on the bladder and on sleep that help reduce bedwetting.
Dosage and Administration
The dose is set and adjusted by your doctor, as prescribed. Treatment usually starts low and is increased slowly over days to weeks, and older adults often need lower doses. For bedwetting, a single dose is usually given about an hour before bedtime, as prescribed for the child’s age. Swallow tablets with water, with or without food. It may take 2 to 4 weeks or longer to feel the full benefit for depression. Do not stop suddenly; your doctor will reduce the dose gradually.
Interactions
- MAO inhibitors (including Linezolid and Selegiline): dangerous reaction; do not use within 14 days of each other.
- SSRIs such as Fluoxetine, Paroxetine and Sertraline: can raise Imipramine levels and risk of serotonin syndrome.
- Alcohol, sleeping pills, opioids and antihistamines: more drowsiness.
- Medicines that affect heart rhythm (QT prolongation), such as some antiarrhythmics, antipsychotics and Macrolide antibiotics.
- Adrenaline and Noradrenaline: blood pressure effects may be stronger.
- Clonidine and other blood pressure medicines: effects may change.
- Cimetidine and some antifungals: may raise Imipramine levels.
Contraindications
- Allergy to Imipramine or other tricyclic antidepressants.
- Recent heart attack, heart block or certain heart rhythm problems.
- Use with, or within 14 days of, an MAO inhibitor.
- Mania, severe liver disease.
Side Effects
Common effects include dry mouth, constipation, blurred vision, difficulty passing urine, drowsiness, dizziness on standing, sweating, fast heartbeat, weight gain, tremor and sexual problems. Many ease after the first weeks.
Get urgent medical help if you have thoughts of harming yourself, fainting, a fast or irregular heartbeat, chest pain, seizures, severe confusion, eye pain with blurred vision (possible glaucoma), inability to pass urine, a high fever with stiff muscles, or signs of a severe allergic reaction.
Pregnancy and Lactation
Use in pregnancy only if your doctor decides the benefit is greater than the risk; newborns may have withdrawal symptoms if used near delivery. Small amounts pass into breast milk; talk to your doctor before breastfeeding.
Precautions and Warnings
Antidepressants can increase suicidal thoughts in children, teenagers and young adults, especially early in treatment or after dose changes; family members should watch for mood changes. Use with care in heart disease, epilepsy, glaucoma, enlarged prostate, thyroid disease, diabetes and bipolar disorder. It can cause drowsiness; do not drive until you know how it affects you, and avoid alcohol. Keep it out of children’s reach: even a small overdose can be fatal for a child.
Overdose
Overdose is very dangerous and can quickly cause drowsiness, confusion, dilated pupils, seizures, low blood pressure, dangerous heart rhythm problems and coma. Call emergency services or go to hospital at once, even if the person seems well.
Therapeutic Class
Tricyclic antidepressant.
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.