Other names used:
Imipramine is a type of medicine called a tricyclic antidepressant (TCA). This type of medicine acts on nerve cells in the brain.
In the brain there are numerous different chemical compounds called neurotransmitters. These act as chemical messengers between the nerve cells. Serotonin and noradrenaline are neurotransmitters and they have various functions that we know of.
Imipramine works by preventing serotonin and noradrenaline from being reabsorbed back into the nerve cells in the brain. This helps prolong the mood lightening effect of any released noradrenaline and serotonin. In this way, imipramine helps relieve depression.
- Depression (also known as major depression or clinical depression) in adults
- Bed-wetting in children.
Contraindications and Cautions:
You should not use this drug in:
- Severe liver disease
- People who have recently had a heart attack
- Defect of the heart's electrical message pathways resulting in decreased function of the heart (heart block)
- Irregular heart beats (arrhythmias)
- Closed angle glaucoma
- Manic episodes of bipolar affective disorder (manic depression)
- People who have taken a monoamine oxidase inhibitor antidepressant (MAOI) in the last three weeks.
- This medicine is not recommended for treating depression in children, or for treating bedwetting in children under seven years of age.
You should use this drug with caution in:
- Elderly people
- Liver disease
- Kidney disease
- Heart disease
- History of epilepsy
- People with a predisposition to seizures, eg due to alcohol/drug withdrawal, brain damage, other medicines
- Psychotic illness, eg schizophrenia
- Bipolar affective disorder (manic depression)
- People receiving electroconvulsive therapy (ECT)
- History of increased pressure within the eye, eg glaucoma
- History of difficulty passing urine (urinary retention)
- Enlarged prostate gland (prostatic hypertrophy)
- Overactive thyroid gland (hyperthyroidism)
- People taking thyroid medication for an under active thyroid gland (hypothyroidism)
- Tumor of the adrenal gland (phaeochromocytoma)
- Low blood pressure (hypotension)
- Hereditary blood disorders called porphyrias.
- This medicine may cause drowsiness and could reduce your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you and you are sure it won't affect your performance.
- It is recommended that you avoid drinking alcohol while taking this medicine because it may enhance drowsiness.
- This medicine can occasionally cause your blood pressure to drop when you move from a lying down or sitting position to sitting or standing, especially when you first start taking the medicine. This may make you feel dizzy or unsteady. To avoid this try getting up slowly. If you do feel dizzy, sit or lie down until the symptoms pass.
- Antidepressants may cause the amount of sodium in the blood to drop - a condition called hyponatraemia. This can cause symptoms such as drowsiness, confusion, muscle twitching or convulsions. Elderly people may be particularly susceptible to this effect. You should consult your doctor if you develop any of these symptoms while taking this medicine so that your blood sodium level can be checked if necessary.
- People who wear contact lenses should be aware that this medicine can sometimes cause dry eyes, and that wearing contact lenses during treatment may therefore irritate the surface of the eye. If you experience this, consult your doctor.
- This medicine can cause a dry mouth, which may increase the risk of tooth decay with long-term use of the medicine. It is therefore important to visit your dentist regularly for check-ups.
- During long-term treatment with this medicine your doctor may want to monitor your heart and liver function and take blood tests to monitor the levels of blood cells in your blood. You should let your doctor know if you experience symptoms such as a fever or sore throat while you are taking this medicine.
- Changes in behavior have been seen in children taking this medicine to treat bed-wetting. For further information talk to your doctor or pharmacist.
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
- weakness or tiredness
- excitement or anxiety
- dry mouth
- skin more sensitive to sunlight than usual
- changes in appetite or weight
- 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 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
The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe. Especially pay attention to the following drugs:
- 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.
- Vitamins, nutritional supplements, and herbal products you are taking or plan to take. 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.
DO NOT SHARE THIS MEDICINE with others. DO NOT USE THIS MEDICINE for other health conditions. KEEP THIS PRODUCT, as well as syringes and needles, if needed during treatment, out of the reach of children. Do not reuse needles, syringes, or other materials.