Imipramine

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, any other medications, or any of the ingredients in imipramine tablets or capsules. Ask your doctor or pharmacist for a list of the ingredients.

• tell your doctor if you are taking a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan), linezolid (Zyvox), methylene blue, 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, Jantoven); 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 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 breastfeeding. 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.

• talk to your doctor about the risks and benefits of taking imipramine if you are 65 years of age or older. Older adults should not usually take imipramine because it is not as safe and effective as other medications that can be used to treat the same condition.

• you should know that imipramine may cause angle-closure glaucoma (a condition where the fluid is suddenly blocked and unable to flow out of the eye causing a quick, severe increase in eye pressure which may lead to a loss of vision). Talk to your doctor about having an eye examination before you start taking this medication. If you have nausea, eye pain, changes in vision, such as seeing colored rings around lights, and swelling or redness in or around the eye, call your doctor or get emergency medical treatment right away.

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

  • 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 or SPECIAL PRECAUTIONS sections, call your doctor immediately or get emergency medical treatment:

  • 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 (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

• Imipramine may cause other side effects. Tell your 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).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call 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.