Imipramine

IMPORTANT WARNING:

Imipramine tablets and capsules are used to treat depression. Imipramine tablets are also used to prevent bedwetting in children. Imipramine is in a class of medications called tricyclic antidepressants. It treats depression by increasing the amounts of certain natural substances in the brain that are needed to maintain mental balance. There is not enough information to explain how imipramine prevents bedwetting.

Imipramine comes as a tablet and a capsule to take by mouth. When imipramine tablets or capsules are used to treat depression, they are usually taken one or more times a day and may be taken with or without food. When imipramine tablets are used to prevent bedwetting in children, they are usually taken one hour before bedtime. Children who wet the bed early in the evening may be given one dose in the mid-afternoon and another dose at bedtime. Try to take imipramine at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take imipramine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor may start you on a low dose of imipramine and gradually increase your dose.

It may take 1-3 weeks or longer for you to feel the full benefit of imipramine. Continue to take imipramine even if you feel well. Do not stop taking imipramine without talking to your doctor. Your doctor will probably want to decrease your dose gradually.

Imipramine is also used occasionally to treat eating disorders and panic disorders. Talk to your doctor about the possible risks of using this medication for your condition.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Before taking imipramine,

• tell your doctor and pharmacist if you are allergic to imipramine or any other medications.
• tell your doctor if you are taking a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate), or if you have stopped taking an MAO inhibitor within the past 14 days. Your doctor will probably tell you not to take imipramine. If you stop taking imipramine, you should wait at least 14 days before you start to take an MAO inhibitor.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants (blood thinners) such as warfarin (Coumadin); antihistamines; cimetidine (Tagamet); flecainide (Tambocor); levodopa (Sinemet, Larodopa); lithium (Eskalith, Lithobid); medication for high blood pressure, mental illness, nausea, seizures, Parkinson's disease, asthma, colds, or allergies; methylphenidate (Ritalin); muscle relaxants; propafenone (Rhythmol); quinidine; sedatives; selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft); sleeping pills; thyroid medications; and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Your doctor may tell you not to take imipramine if you have taken fluoxetine in the past 5 weeks.
• tell your doctor if you have recently had a heart attack. Your doctor may tell you not to take imipramine.
• tell your doctor if you are being treated with electroshock therapy (procedure in which small electric shocks are administered to the brain to treat certain mental illnesses), and if you have or have ever had glaucoma (an eye condition), an enlarged prostate (a male reproductive gland), difficulty urinating, seizures, an overactive thyroid gland, or liver, kidney, or heart disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking imipramine, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking imipramine.
• you should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
• remember that alcohol can add to the drowsiness caused by this medication.
• tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of this medication.
• plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Imipramine may make your skin sensitive to sunlight.

Unless your doctor tells you otherwise, continue your normal diet.

Take the missed dose as soon as you remember it. However, if it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule.

Imipramine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea

• drowsiness

• weakness or tiredness

• excitement or anxiety

• nightmares

• dry mouth

• skin more sensitive to sunlight than usual

• changes in appetite or weight

• constipation

• difficulty urinating

• frequent urination

• blurred vision

• changes in sex drive or ability

• excessive sweating

Some side effects can be serious. If you experience any of the following symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately:

• jaw, neck, and back muscle spasms

• slow or difficult speech

• shuffling walk

• uncontrollable shaking of a part of the body

• fever, sore throat, or other signs of infection

• difficulty breathing or swallowing

• severe rash

• yellowing of the skin or eyes

• irregular heartbeat

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].

Imipramine may cause other side effects. Tell you doctor if you have any unusual problems while you are taking this medication.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Last Reviewed - 09/01/2010