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Imipramine

Sounds like 'ih-MIH-pra-meen'

Key points about imipramine

Imipramine is used to treat depression and night-time bed wetting in older children.
Imipramine is also called Tofranil®.
Find out how to take it safely and possible side effects.

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Imipramine belongs to a group of medicines called tricyclic antidepressants. In the past, these medicines were commonly used for depression, but today doctors usually prescribe newer classes of antidepressants. Tricyclic antidepressants are used for severe depression or when other antidepressants are unsuitable. Read more about antidepressants.

In Aotearoa New Zealand, imipramine is available as tablets in different strengths – 10 mg and 25 mg.

If you need help or want to talk to somebody about your mental health, you can get support from any of the following:

Free call or text 1737 any time for support from a trained counsellor
Lifeline 0800 543 354 (0800 LIFELINE) or free text 4357 (HELP)
Suicide Crisis Helpline 0508 828 865 (0508 TAUTOKO)
Healthline 0800 611 116
Samaritans 0800 726 666.

The dose of imipramine will be different for different people.
Your doctor will usually start you on a low dose and increase this slowly. This allows your body to get used to the medicine and reduces side effects. Imipramine may be prescribed as a single dose to be taken at bedtime, or it may be prescribed in smaller doses taken 2 or 3 times a day.
Always take your imipramine exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much imipramine to take, how often to take it, and any special instructions.
If your tablets look different to your last supply, ask your doctor or pharmacist for advice.

Timing: Take imipramine at the same times each day.
Water: Swallow your imipramine tablets with a glass of water.
Food: You can take imipramine with or without food.
Keep taking imipramine every day: It may take a few weeks before you notice the full benefits of imipramine.
Don't stop suddenly: If you think imipramine isn't working for you, don't stop taking it suddenly. Talk to your doctor or nurse before stopping.
Missed dose: If you forget to take your dose, take it as soon as you remember. But if it's nearly time for your next dose, just take the next dose at the right time. Don't take double the dose.

Here are some things to know when you're taking imipramine. Other things may be important as well, so ask your healthcare provider what you should know about.

Alcohol: Avoid alcohol while you're taking imipramine, especially when you first start treatment. Drinking alcohol while taking imipramine can cause drowsiness and affect your concentration, putting you at risk of falls and other accidents. It can also cause agitation, aggression and forgetfulness. If you do drink alcohol, drink only small amounts and see how you feel. Don't stop taking your medicine.
Other medicines: Imipramine interacts with many other medicines, herbal supplements (eg, St. John's Wort) and rongoā Māori, so check with your doctor or pharmacist before starting imipramine or before starting any new medicines, products or supplements.
Diabetes: If you have diabetes, you may need to check your blood glucose more often because imipramine can affect the levels of glucose in your blood.

Like all medicines, imipramine can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Suicidal behaviour

The use of antidepressants has been linked with self-harm or suicidal thoughts and behaviour. Children, teenagers, young adults and people with a history of suicidal behaviour are most at risk. This is most likely during the first few weeks of starting treatment or if the dose is changed. It's important to look out for signs of suicidal behaviour eg, suicidal thoughts, self-harm, worsening of low mood, agitation or aggression.

If you notice any of these signs, contact your doctor immediately. If you need urgent help or are concerned, phone:

Lifeline 0800 543 354 (available 24/7), or
Healthline 0800 611 116, who can give you the phone number for your local mental health crisis line.

Other side effects

Side effects	What should I do?
Feeling sleepy, drowsy, or tired	These are quite common when you first start taking imipramine and usually go away with time. It may be best to take imipramine at bedtime. Be careful when driving or using tools until you know how this medicine affects you. These effects put you at risk of falls, and injuries especially if you are elderly. Tell your doctor if you're concerned. Don't drink alcohol.
Feeling dizzy, faint or lightheaded	Get up slowly when rising from a sitting or lying position. These effects put you at risk of falls, and injuries especially if you are an older person. Tell your doctor if you're concerned.
Dry mouth Constipation Sore mouth Anxiety or restlessness	These are quite common. Read more for advice on managing dry mouth and constipation. Tell your doctor.
Flushing, headache, restlessness	Ask your doctor for advice.
Suicidal thoughts, thoughts of harming yourself, or worsening depression	Tell your doctor immediately or ring Healthline 0800 611 116.
Signs of an allergic reaction, eg, skin rash	Tell your doctor immediately or ring Healthline 0800 611 116.
Signs of serotonin syndrome, eg, feeling agitated and restless, heavy sweating, shivering, fast heart rate or irregular heartbeat, headache, diarrhoea and rigid or twitching muscles	You are at increased risk of serotonin syndrome if you recently started taking imipramine, recently increased the dose or you're taking other medicines that can cause serotonin syndrome. Tell your doctor immediately or ring Healthline 0800 611 116.
Read more about medicines and side effects and reporting a reaction you think might be a side effect.