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|Imipramine HCl |
Drugs search, click the first letter of a drug name: | A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | 1 | 2 | 3 | 4 | 5 | 6 | 8 | 9 Home Imipramine HClPronouncation: (im-IPP-ruh-meen HIGH-droe-KLOR-ide)Class: Tricyclic compound Trade Names: Impril (Canada) Imipramine Pamoate Trade Names: Mechanism of ActionPharmacologyInhibits reuptake of norepinephrine and, to a lesser degree, serotonin in CNS. PharmacokineticsAbsorptionT max is 2 to 4 hr. Steady state is reached in 2 to 5 days. DistributionMore than 90% is protein bound. Lipid soluble. MetabolismSignificant first pass effect. Metabolism occurs in liver. Active metabolite is desipramine. EliminationThe t 1/2 is 11 to 25 hr. Peak2 to 4 weeks. Indications and UsageRelief of symptoms of depression; treatment of enuresis in children 6 yr and older. Unlabeled UsesTreatment of chronic pain, panic disorder, eating disorders (bulimia nervosa), and facilitation of cocaine withdrawal. ContraindicationsHypersensitivity to any tricyclic antidepressant. Generally not to be given in combination with or within 14 days of treatment with MAO inhibitor or during acute recovery phase of MI; cross-sensitivity may occur among the dibenzazepines. Dosage and AdministrationDepressionUse parenterally only in patients who are not able or not willing to take oral medication. Give via IM route. Do not administer IV. Up to 100 mg/day in divided doses may be given IM. Switch to oral as soon as possible. AdultsPO 100 to 300 mg/day, in divided doses or once daily at bedtime. Elderly & AdolescentsPO 30 to 40 mg/day; may increase up to 100 mg/day. ChildrenPO 1.5 mg/kg/day in divided doses; up to maximum of 5 mg/kg/day. Childhood Enuresis (6 yr)PO 25 mg/day given 1 hr before bedtime; if response unsatisfactory after 1 wk, may increase to 50 mg in children younger than 12 yr. Children older than 12 yr may receive 75 mg/night. Do not exceed 2.5 mg/kg/day. Drug InteractionsCarbamazepineCarbamazepine levels may increase; imipramine levels may decrease. Cimetidine, fluoxetineMay cause increased imipramine blood levels and effects. ClonidineMay result in hypertensive crisis. CNS depressantsDepressant effects may be additive. DicumarolAnticoagulant actions may increase. GuanethidineHypotensive action may be inhibited. MAO inhibitorsMay cause hyperpyretic crises, severe convulsions, and death when given with imipramine. SympathomimeticsPressor response may be decreased by indirect-acting sympathomimetics and increased by direct-acting ones. Laboratory Test InteractionsNone well documented. Adverse ReactionsCardiovascularOrthostatic hypotension; hypertension; tachycardia; palpitations; arrhythmias; ECG changes; stroke; heartblock; CHF. CNSConfusion; hallucinations; delusions; nervousness; restlessness; agitation; panic; insomnia; nightmares; mania; exacerbation of psychosis; drowsiness; dizziness; weakness; numbness; extrapyramidal symptoms; emotional lability; seizures; tremors. DermatologicRash; pruritus; photosensitivity reaction; dry skin; acne; itching. EENTNasal congestion; tinnitus; conjunctivitis; mydriasis; blurred vision; increased IOP. GINausea; vomiting; anorexia; GI distress; diarrhea; flatulence; peculiar taste in mouth; dry mouth; constipation. GenitourinaryImpotence; sexual dysfunction; nocturia; urinary frequency; UTI; vaginitis; cystitis; dysmenorrhea; amenorrhea; urinary retention and hesitancy. HematologicBone marrow depression including agranulocytosis; eosinophilia; purpura; thrombocytopenia; leukopenia. HepaticHepatitis; jaundice. MetabolicElevation or depression of blood sugar. RespiratoryPharyngitis; rhinitis; sinusitis; laryngitis; coughing. MiscellaneousBreast enlargement. PrecautionsPregnancyCategory D . LactationExcreted in breast milk. ChildrenSafety and efficacy of imipramine as temporary adjunctive therapy for nocturnal enuresis in pediatric patients younger than 6 yr have not been established; chronic use in patients 6 yr and older has not been established. Do not exceed 2.5 mg/kg/day. Special Risk PatientsUse with caution in patients with history of seizures, urinary retention, ureteral spasm, angle-closure glaucoma or increased IOP, conduction disorders, with hyperthyroid or those receiving thyroid medication, hepatic or renal impairment, schizophrenia or paranoia. Hazardous TasksPatients should use caution while performing tasks requiring alertness. Cardiovascular disordersUse with extreme caution in patients with cardiovascular disorders. These patients require cardiac surveillance at all dose levels of the drug. OverdosageSymptomsConfusion, agitation, hallucinations, seizures, status epilepticus, clonus, choreoathetosis, hyperactive reflexes, positive Babinski sign, coma, cardiac arrhythmias, renal failure, flushing, dry mouth, dilated pupils, hyperpyrexia. Patient Information
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