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Imipramine is a tetracyclic antidepressant used to treat depression. It is thought to increase the activity of certain chemicals in the brain that help elevate mood. Imipramine may also be administered in some children to help reduce bedwetting.

In such cases it is obligatory to consult with your doctor or health care provider before taking this drug.

You should not use Imipramine in the following cases: you are allergic to any ingredient in Imipramine or to similar medicines; you have taken furazolidone or a monoamine oxidase (MAO) inhibitor (eg, phenelzine) within the last 14 days, or if you are taking astemizole, dofetilide, droperidol, terfenadine, or cisapride; you are recovering from a recent heart attack.

In such cases it is obligatory to consult with your doctor or health care provider before taking this drug.

Before using Imipramine

Before using Imipramine you should tell your doctor if you have any medical conditions listed below: you are pregnant, planning to become pregnant, or are breast-feeding a baby; you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement; you have allergies to medicines, foods, or other substances; you drink alcohol-containing beverages daily or you have a history of alcohol abuse; you take thyroid medicine or you have a history of overactive thyroid, glaucoma, heart problems, kidney or liver problems, diabetes, seizures, the blood disease porphyria, or difficulty urinating; you have a history of suicidal thoughts or behavior, bipolar disorder, or any other mental disorders; you are undergoing electroshock therapy; or you are scheduled to have any surgery.

Be aware that Imipramine may interact with some medicines. Consult with your health care provider in case you are taking any other drugs, especially any of the following: azole antifungals (eg, fluconazole), cimetidine, duloxetine, flecainide, methylphenidate, mibefradil, phenothiazines (eg, chlorpromazine), propafenone, quinidine, selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine), or terbinafine because the side effects of Imipramine may be increased; arsenic, astemizole,cisapride, dofetilide, droperidol, furazolidone, MAO inhibitors (eg, phenelzine), pimozide, quinolone antibiotics (eg, ciprofloxacin), streptogramins (eg, dalfopristin), terfenadine, tramadol, or ziprasidone because the risk of high blood pressure, serious heart problems (eg, irregular heartbeat), or seizures may be increased; barbiturates (eg, phenobarbital) or phenytoin because the effectiveness of Imipramine may be decreased; anticholinergics (eg, benztropine), carbamazepine, or sympathomimetics (eg, phenylephrine) because side effects may be increased by Imipramine; clonidine, guanethidine, or guanfacine because effectiveness may be decreased by Imipramine.

It may not be a complete list of all interactions with other drugs. To prevent any complications you should check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Imipramine

Use this medicine as recommended by your physician. Imipramine may be taken orally with or without food. Taking Imipramine at bedtime may help reduce side effects (eg, daytime drowsiness). Discuss such possibility with your physician.

You should know that improvement in your depression may start in several weeks (1-3 weeks). Do not stop taking Imipramine even if you feel better.

In case you miss a dose of Imipramine, take it as soon as possible. If it is almost time for your next intake, skip the missed dose and take it according to your regular dosing schedule. Do not take double doses to catch up. In case you take 1 dose daily at bedtime, do not take the missed dose the next morning.

Important safety information

Be careful when driving, operating machinery, or performing other hazardous activities as Imipramine usage may lead to drowsiness, dizziness, or blurred vision. Try to avoid such activities. Alcohol and certain other medicines (eg, sedatives, tranquilizers, depressants) may increase the risk of unfavorable reactions while taking Imipramine. Dizziness may be increased by alcoholic beverages, hot weather, exercise, and fever. It is recommended to sit up or stand slowly, especially in the morning to prevent dizziness or fainting. You should sit or lie down at the first sign of dizziness, lightheadedness, or weakness.

Try not to become overheated in hot weather or during exercise or other activities, as heatstroke may take place.

Children and teenagers who take Imipramine may be at increased risk for suicidal thoughts or actions. Adults may also be affected. The risk may be greater in patients who have had suicidal thoughts or actions in the past. The risk may also be greater in patients who have had bipolar (manic-depressive) illness, or if their family members have had it.

Look after patients who use Imipramine closely. Contact the doctor immediately in case new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Consult with your doctor immediately in case any signs of suicidal thoughts or actions take place.

Your sensitivity to sunlight may be increased by Imipramine. Try to avoid prolonged exposure to the sun and other ultraviolet light (eg, tanning beds). Use sunscreens and wear protective clothing if you are not able to avoid such exposure.

Notify the doctor or dentist that you are using Imipramine before you undergo any medical or dental treatments, emergency care, or surgery.

Lab tests, including blood counts, may be performed while you are using Imipramine. It is important to control your progress or to check for side effects. Follow all doctor and lab appointments strictly.

The ELDERLY may be more sensitive to the effects of Imipramine. Use Imipramine with caution in this group.

You should use Imipramine with extreme caution in CHILDREN younger than 6 years of age, as safety and effectiveness in this group have not been proved.

PREGNANCY and BREAST-FEEDING

It is not clear whether Imipramine is deleterious to the fetus. In case you become pregnant while taking Imipramine, consult with your doctor and discuss the benefits and risks of using Imipramine while pregnancy. It is not clear whether Imipramine passes into breast milk. Avoid breast-feeding a baby while taking this medicine.

Do not suddenly stop taking Imipramine, as you may have WITHDRAWAL symptoms, such as headache, nausea, and tiredness.

Possible side effects of Imipramine

You should consult with your doctor in case you have any of side effects especially bothersome listed below: dizziness; drowsiness; dry mouth; excitement; headache; impotence; nausea; nightmares; pupil dilation; sensitivity to sunlight; sweating; tiredness; upset stomach; vomiting; weakness; weight loss or gain.

Seek emergency immediately in case you have any of these severe side effects: severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision or other vision changes; changes in sex drive; chest pain; confusion; constipation; fainting; fever; frequent or difficult urination; hallucinations; impulsive behavior or other unusual changes in behavior; fast, slow, or irregular heartbeat; jaw, neck, or muscle spasms; mental or mood changes (eg, increased anxiety, mood swings, agitation, irritability, nervousness, restlessness); panic attacks; ringing in the ears; seizures; severe dizziness or drowsiness; sore throat; stomach pain; suicidal thinking or behavior; swelling of the testicles; tremor; trouble sleeping; trouble walking or keeping your balance; twitching of the face or tongue; uncontrolled movements of arms and legs or stiffness; unusual bleeding or bruising; worsening of depression; yellowing of the skin or eyes.

What is the expiration date of the pills?

This information is mentioned on each blister. The expiration date is 2 years from the date of manufacture.