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Imipramine Brand Names- Tofranil | Tofranil-PM
What is Imipramine
Imipramine is a tertiary amine tricyclic antidepressant (TCA) that is metabolized to an active metabolite, desipramine.
Tertiary amines are generally more sedating and have greater anticholinergic effects than secondary amines.
Imipramine is used for the treatment of adults with major depressive disorder (MDD), and is also effective in treating nocturnal enuresis in children.
Imipramine is also used clinically for other conditions such as neuropathic pain. Imipramine was first FDA-approved as an antidepressant in 1959.
Use of imipramine for nocturnal enuresis was approved in 1973. Safety and efficacy have not been established in pediatric patients less than 6 years old for enuresis and the drug is not FDA-approved for the treatment of depression in pediatric patients; usual dosing for adolescents (e.g., age 13 years and older) is suggested within the product labels.
An injectable form of the drug is no longer marketed.
The FDA requires a boxed warning detailing the increased risk of suicidality in children, adolescents, and young adults in product labels.
A Patient Medication Guide (MedGuide) should accompany all prescriptions for antidepressants.
Indications
- attention-deficit hyperactivity disorder (ADHD)
- bulimia nervosa
- depression
- diabetic neuropathy
- enuresis
- overactive bladder (OAB)
- panic disorder
- social phobia (social anxiety disorder)
- urinary incontinence
Side Effects
- abdominal pain
- agitation
- agranulocytosis
- alopecia
- anorexia
- anxiety
- appetite stimulation
- ataxia
- blurred vision
- breast enlargement
- confusion
- constipation
- cycloplegia
- delirium
- depression
- diabetes mellitus
- diarrhea
- dizziness
- drowsiness
- dysarthria
- dysgeusia
- dyspepsia
- edema
- EEG changes
- ejaculation dysfunction
- elevated hepatic enzymes
- eosinophilia
- erythema
- fatigue
- fever
- flushing
- galactorrhea
- glossitis
- goiter
- gynecomastia
- hallucinations
- headache
- heart failure
- hepatic failure
- hepatitis
- hyperhidrosis
- hypertension
- hyperthermia
- hyperthyroidism
- hyponatremia
- hypothyroidism
- ileus
- impotence (erectile dysfunction)
- increased urinary frequency
- insomnia
- jaundice
- leukopenia
- libido decrease
- mania
- memory impairment
- mydriasis
- myocardial infarction
- nausea
- nightmares
- ocular hypertension
- orgasm dysfunction
- orthostatic hypotension
- palpitations
- paresthesias
- parotitis
- peripheral neuropathy
- petechiae
- photosensitivity
- PR prolongation
- pruritus
- psychosis
- purpura
- pyrosis (heartburn)
- QT prolongation
- rash
- restlessness
- seizures
- serotonin syndrome
- SIADH
- sinus tachycardia
- skin hyperpigmentation
- stomatitis
- stroke
- suicidal ideation
- testicular swelling
- thrombocytopenia
- tinnitus
- tongue discoloration
- tremor
- urinary retention
- urticaria
- vasculitis
- ventricular tachycardia
- vomiting
- weakness
- weight gain
- withdrawal
- xerostomia
- yawning
Monitoring Parameters
- blood pressure
- ECG
- heart rate
- LFTs
- serum imipramine concentrations
- thyroid function tests (TFTs)
Contraindications
- abrupt discontinuation
- acute myocardial infarction
- agranulocytosis
- alcoholism
- anticholinergic medications
- bipolar disorder
- bradycardia
- breast-feeding
- carbamazepine hypersensitivity
- cardiac arrhythmias
- cardiac disease
- children
- closed-angle glaucoma
- coadministration with other CNS depressants
- congenital heart disease
- contact lenses
- coronary artery disease
- diabetes mellitus
- driving or operating machinery
- electroconvulsive therapy (ECT)
- ethanol ingestion
- females
- geriatric
- heart failure
- hepatic disease
- hypertension
- hyperthyroidism
- hypocalcemia
- hypokalemia
- hypomagnesemia
- hypothyroidism
- ileus
- increased intraocular pressure
- leukopenia
- long QT syndrome
- malnutrition
- mania
- MAOI therapy
- myocardial infarction
- neonates
- pheochromocytoma
- pregnancy
- prostatic hypertrophy
- QT prolongation
- radiographic contrast administration
- schizophrenia
- seizure disorder
- seizures
- suicidal ideation
- sunlight (UV) exposure
- surgery
- thyroid disease
- tobacco smoking
- tricyclic antidepressant hypersensitivity
- urinary retention
Interactions
- Abarelix
- Abiraterone
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Codeine
- Acetaminophen; Dextromethorphan
- Acetaminophen; Dextromethorphan; Doxylamine
- Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
- Acetaminophen; Dextromethorphan; Phenylephrine
- Acetaminophen; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Dichloralphenazone; Isometheptene
- Acetaminophen; Diphenhydramine
- Acetaminophen; Guaifenesin; Phenylephrine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Pentazocine
- Acetaminophen; Propoxyphene
- Acetaminophen; Pseudoephedrine
- Acetaminophen; Tramadol
- Acetazolamide
- Acetylcholine Chloride
- Acrivastine; Pseudoephedrine
- Albendazole
- Alfentanil
- Alfuzosin
- Alosetron
- Alprazolam
- Amantadine
- Ambenonium Chloride
- Amifampridine
- Amiodarone
- Amitriptyline; Chlordiazepoxide
- Amlodipine; Celecoxib
- Amobarbital
- Amoxapine
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amphetamine
- Amphetamine; Dextroamphetamine
- Amphetamines
- Anagrelide
- Anticholinergics
- Apalutamide
- Apomorphine
- Apraclonidine
- Aprepitant, Fosaprepitant
- Aripiprazole
- Arsenic Trioxide
- Artemether; Lumefantrine
- Articaine; Epinephrine
- Asenapine
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Oxycodone
- Atazanavir
- Atazanavir; Cobicistat
- Atomoxetine
- Atropine
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Atropine; Difenoxin
- Atropine; Diphenoxylate
- Atropine; Edrophonium
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Azelastine
- Azelastine; Fluticasone
- Azithromycin
- Baclofen
- Barbiturates
- Bedaquiline
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Belladonna; Opium
- Benzhydrocodone; Acetaminophen
- Benzodiazepines
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Benzphetamine
- Benztropine
- Bepridil
- Bethanechol
- Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Boceprevir
- Brexpiprazole
- Brimonidine
- Brimonidine; Brinzolamide
- Brimonidine; Timolol
- Brivaracetam
- Brompheniramine
- Brompheniramine; Carbetapentane; Phenylephrine
- Brompheniramine; Dextromethorphan; Guaifenesin
- Brompheniramine; Dextromethorphan; Phenylephrine
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Brompheniramine; Pseudoephedrine
- Bupivacaine
- Bupivacaine Liposomal
- Bupivacaine; Lidocaine
- Buprenorphine
- Buprenorphine; Naloxone
- Bupropion
- Bupropion; Naltrexone
- Buspirone
- Butabarbital
- Butorphanol
- Cannabidiol
- Capsaicin; Metaxalone
- Carbamazepine
- Carbetapentane; Chlorpheniramine
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbetapentane; Guaifenesin
- Carbetapentane; Guaifenesin; Phenylephrine
- Carbetapentane; Phenylephrine
- Carbetapentane; Phenylephrine; Pyrilamine
- Carbetapentane; Pseudoephedrine
- Carbetapentane; Pyrilamine
- Carbidopa; Levodopa
- Carbidopa; Levodopa; Entacapone
- Carbinoxamine
- Carbinoxamine; Dextromethorphan; Pseudoephedrine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Carbinoxamine; Phenylephrine
- Carbinoxamine; Pseudoephedrine
- Cariprazine
- Carisoprodol
- Celecoxib
- Cenobamate
- Ceritinib
- Cetirizine
- Cetirizine; Pseudoephedrine
- Cevimeline
- Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
- Chlophedianol; Guaifenesin; Phenylephrine
- Chlorcyclizine
- Chlordiazepoxide
- Chlordiazepoxide; Clidinium
- Chloroquine
- Chlorpheniramine
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dextromethorphan
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Phenylephrine
- Chlorpheniramine; Pseudoephedrine
- Chlorpromazine
- Chlorthalidone; Clonidine
- Chlorzoxazone
- Cholestyramine
- Cholinergic agonists
- Cimetidine
- Cinacalcet
- Ciprofloxacin
- Cisapride
- Citalopram
- Clarithromycin
- Clemastine
- Clobazam
- Clofazimine
- Clonazepam
- Clonidine
- Clorazepate
- Clozapine
- Cobicistat
- Cocaine
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- COMT inhibitors
- Conjugated Estrogens
- Conjugated Estrogens; Bazedoxifene
- Conjugated Estrogens; Medroxyprogesterone
- Crizotinib
- Cyclizine
- Cyclobenzaprine
- Cyproheptadine
- Dacomitinib
- Dantrolene
- Darifenacin
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Dasatinib
- Degarelix
- Delavirdine
- Desflurane
- Desloratadine; Pseudoephedrine
- Desmopressin
- Desvenlafaxine
- Deutetrabenazine
- Dexchlorpheniramine
- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dexmethylphenidate
- Dextroamphetamine
- Dextromethorphan
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Guaifenesin
- Dextromethorphan; Guaifenesin; Phenylephrine
- Dextromethorphan; Guaifenesin; Potassium Guaiacolsulfonate
- Dextromethorphan; Guaifenesin; Pseudoephedrine
- Dextromethorphan; Promethazine
- Dextromethorphan; Quinidine
- Diazepam
- Dicyclomine
- Dienogest; Estradiol valerate
- Diethylpropion
- Diethylstilbestrol, DES
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diltiazem
- Dimenhydrinate
- Diphenhydramine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Diphenhydramine; Phenylephrine
- Disopyramide
- Disulfiram
- Dofetilide
- Dolasetron
- Dolutegravir; Rilpivirine
- Donepezil
- Donepezil; Memantine
- Dopamine
- Doxylamine
- Doxylamine; Pyridoxine
- Dronabinol
- Dronedarone
- Droperidol
- Drospirenone; Estradiol
- Drospirenone; Ethinyl Estradiol
- Drospirenone; Ethinyl Estradiol; Levomefolate
- Duloxetine
- Edrophonium
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elagolix; Estradiol; Norethindrone acetate
- Elbasvir; Grazoprevir
- Eliglustat
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Encorafenib
- Enflurane
- Entacapone
- Entrectinib
- Enzalutamide
- Ephedrine
- Epinephrine
- Eribulin
- Erythromycin
- Erythromycin; Sulfisoxazole
- Escitalopram
- Esketamine
- Eslicarbazepine
- Esomeprazole
- Esomeprazole; Naproxen
- Estazolam
- Esterified Estrogens
- Esterified Estrogens; Methyltestosterone
- Estradiol
- Estradiol Cypionate; Medroxyprogesterone
- Estradiol; Levonorgestrel
- Estradiol; Norethindrone
- Estradiol; Norgestimate
- Estradiol; Progesterone
- Estrogens
- Estropipate
- Eszopiclone
- Ethanol
- Ethinyl Estradiol
- Ethinyl Estradiol; Desogestrel
- Ethinyl Estradiol; Ethynodiol Diacetate
- Ethinyl Estradiol; Etonogestrel
- Ethinyl Estradiol; Levonorgestrel
- Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
- Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
- Ethinyl Estradiol; Norelgestromin
- Ethinyl Estradiol; Norethindrone
- Ethinyl Estradiol; Norethindrone Acetate
- Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
- Ethinyl Estradiol; Norgestimate
- Ethinyl Estradiol; Norgestrel
- Ethosuximide
- Etomidate
- Everolimus
- Ezogabine
- Fedratinib
- Felbamate
- Fenfluramine
- Fenofibric Acid
- Fentanyl
- Fexofenadine; Pseudoephedrine
- Fingolimod
- Flavoxate
- Flecainide
- Fluconazole
- Flumazenil
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluphenazine
- Flurazepam
- Fluvoxamine
- food
- Fosamprenavir
- Foscarnet
- Fospropofol
- Gabapentin
- Galantamine
- Gallium Ga 68 Dotatate
- Gemifloxacin
- Gemtuzumab Ozogamicin
- Gilteritinib
- Givosiran
- Glasdegib
- Glycopyrrolate
- Glycopyrrolate; Formoterol
- Goserelin
- Granisetron
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guaifenesin; Phenylephrine
- Guaifenesin; Pseudoephedrine
- Guanabenz
- Guanfacine
- Guanidine
- Guselkumab
- Halofantrine
- Halogenated Anesthetics
- Haloperidol
- Halothane
- Histrelin
- Homatropine; Hydrocodone
- Hydantoins
- Hydrochlorothiazide, HCTZ; Methyldopa
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydromorphone
- Hydroxychloroquine
- Hydroxyzine
- Hyoscyamine
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Ibutilide
- Idelalisib
- Iloperidone
- Imatinib
- Indacaterol; Glycopyrrolate
- Inotuzumab Ozogamicin
- Iobenguane I 131
- Isavuconazonium
- Isoflurane
- Isoniazid, INH
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Itraconazole
- Ivosidenib
- Ketamine
- Ketoconazole
- Labetalol
- Lacosamide
- Lamotrigine
- Lapatinib
- Lasmiditan
- Lefamulin
- Lemborexant
- Lenvatinib
- Leuprolide
- Leuprolide; Norethindrone
- Levetiracetam
- Levocetirizine
- Levodopa
- Levofloxacin
- Levomethadyl
- Levomilnacipran
- Levorphanol
- Levothyroxine
- Levothyroxine; Liothyronine (Porcine)
- Levothyroxine; Liothyronine (Synthetic)
- Lidocaine
- Lidocaine; Prilocaine
- Linezolid
- Liothyronine
- Lisdexamfetamine
- Lithium
- Lofexidine
- Lomefloxacin
- Long-acting beta-agonists
- Loperamide
- Loperamide; Simethicone
- Lopinavir; Ritonavir
- Loratadine; Pseudoephedrine
- Lorazepam
- Lorcaserin
- Loxapine
- Luliconazole
- Lumacaftor; Ivacaftor
- Lumateperone
- Macimorelin
- Magnesium Salts
- Mannitol
- Maprotiline
- Meclizine
- Mefloquine
- Melatonin
- Mepenzolate
- Meperidine
- Meperidine; Promethazine
- Mephobarbital
- Mepivacaine
- Mepivacaine; Levonordefrin
- Meprobamate
- Mesoridazine
- Mestranol; Norethindrone
- Metaxalone
- Methadone
- Methamphetamine
- Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
- Methocarbamol
- Methohexital
- Methscopolamine
- Methsuximide
- Methyldopa
- Methylene Blue
- Methylphenidate
- Methyltestosterone
- Metronidazole
- Metyrapone
- Metyrosine
- Midazolam
- Midostaurin
- Mifepristone
- Milnacipran
- Minocycline
- Mirabegron
- Mirtazapine
- Mitotane
- Modafinil
- Molindone
- Monoamine oxidase inhibitors
- Morphine
- Morphine; Naltrexone
- Moxifloxacin
- Nabilone
- Nalbuphine
- Naproxen; Pseudoephedrine
- Nefazodone
- Neostigmine
- Nicotine
- Nilotinib
- Nitroglycerin
- Non-Ionic Contrast Media
- Norepinephrine
- Norfloxacin
- Obeticholic Acid
- Octreotide
- Ofloxacin
- Olanzapine
- Ombitasvir; Paritaprevir; Ritonavir
- Ondansetron
- Oritavancin
- Orphenadrine
- Osilodrostat
- Osimertinib
- Oxaliplatin
- Oxazepam
- Oxcarbazepine
- Oxybutynin
- Oxycodone
- Oxymorphone
- Ozanimod
- Paliperidone
- Panobinostat
- Paroxetine
- Pasireotide
- Pazopanib
- Peginterferon Alfa-2b
- Pentamidine
- Pentazocine
- Pentazocine; Naloxone
- Pentobarbital
- Perampanel
- Perphenazine
- Perphenazine; Amitriptyline
- Phendimetrazine
- Phenobarbital
- Phentermine
- Phentermine; Topiramate
- Phenylephrine
- Phenylephrine; Promethazine
- Physostigmine
- Pilocarpine
- Pimavanserin
- Pimozide
- Pitolisant
- Porfimer
- Posaconazole
- Pralidoxime
- Pramipexole
- Pramlintide
- Pregabalin
- Prilocaine
- Prilocaine; Epinephrine
- Primaquine
- Primidone
- Procainamide
- Procarbazine
- Prochlorperazine
- Promethazine
- Propafenone
- Propantheline
- Propofol
- Propoxyphene
- Pseudoephedrine
- Pyridostigmine
- Quazepam
- Quetiapine
- Quinidine
- Quinine
- Racepinephrine
- Ranolazine
- Rasagiline
- Remifentanil
- Reserpine
- Ribociclib
- Ribociclib; Letrozole
- Rifampin
- Rifapentine
- Rilpivirine
- Risperidone
- Ritonavir
- Rivastigmine
- Rolapitant
- Romidepsin
- Ropinirole
- Rufinamide
- Safinamide
- Saquinavir
- Scopolamine
- Secobarbital
- Segesterone Acetate; Ethinyl Estradiol
- Selpercatinib
- Serotonin-Receptor Agonists
- Sertraline
- Sevoflurane
- Short-acting beta-agonists
- Sibutramine
- Simeprevir
- Siponimod
- Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
- Solifenacin
- Sorafenib
- Sotalol
- Sparfloxacin
- St. John’s Wort, Hypericum perforatum
- Sufentanil
- Sunitinib
- Suvorexant
- Tacrine
- Tacrolimus
- Tamoxifen
- Tapentadol
- Tedizolid
- Telaprevir
- Telavancin
- Telithromycin
- Telotristat Ethyl
- Temazepam
- Terbinafine
- Terfenadine
- Tetrabenazine
- Tetracaine
- Thalidomide
- Thiethylperazine
- Thiopental
- Thioridazine
- Thiothixene
- Thyroid hormones
- Tiagabine
- tobacco
- Tolcapone
- Tolterodine
- Topiramate
- Toremifene
- Tramadol
- Trandolapril; Verapamil
- Trazodone
- Triazolam
- Triclabendazole
- Trifluoperazine
- Trihexyphenidyl
- Triprolidine
- Triptorelin
- Trospium
- Valerian, Valeriana officinalis
- Valproic Acid, Divalproex Sodium
- Vandetanib
- Vardenafil
- Vasopressin, ADH
- Vemurafenib
- Venlafaxine
- Verapamil
- Verteporfin
- Vigabatrin
- Vilazodone
- Voriconazole
- Vorinostat
- Vortioxetine
- Yohimbine
- Zaleplon
- Ziconotide
- Ziprasidone
- Zolpidem
- Zonisamide
