Imipramine (HCl)

Imipramine (HCl) was recognized as an antidepressant in 1950s and is the prototype drug of tricyclic antidepressants of the class dibenzazepine class. Tricyclic antidepressant is used for almost four decades. Chemically itclosely related to the phenothiazines. itthe first of the tricyclic antidepressants to be used. Imipramine (HCl) has characteristic three ring nucleus. itprepared by chemical synthesis. italso used in the treatment of childhood enuresis, anxiety in panic syndrome, and chronic pain.

Brands
TOFRANIL IMIDOL IMIPRAMIN IMIPROL IMIPROL IMIPRAL IMIPRAMINE DEPNA IMIRA
Adult Dose
Dose: 75 mg
Single Dose: 75 (75)
Frequency: 24 hourly
Route: PO
Instructions: Gradually increased to 150 to 200mg
Neonatal
Dose:
Single Dose:
Frequency:
Route:
Instructions: Not recommended in this age group
Paedriatic
Dose: 25 mg
Single Dose: 25 (25)
Frequency: As recommended.
Route: For children 6 to 7 years (20-25kg)
Instructions:
Characteristics
. It is of Synthetic origin and belongs to Tricyclic amines. It belongs to Amine uptake inhibitor pharmacological group on the basis of mechanism of action and also classified in Psychotherapeutic Drugs and Antidepressant pharmacological group.The Molecular Weight of Imipramine (HCl) is 316.90. It is strongly acidic drug and Its pKa is 9.4.
Contraindications
Imipramine (HCl) is contraindicated in conditions like Epilepsy,Mania,Prostatic hypertrophy,Narrow-angle glaucoma,Bundle branch block,Post myocardial infarction,Hypersensitivity,Urinary retention.
Effects
The severe or irreversible adverse effects of Imipramine (HCl), which give rise to further complications include Tachycardia, Oedema, Bundle branch blockage, Postural hypotension, Tachycardia.Imipramine (HCl) produces potentially life-threatening effects which include Agranulocytosis. which are responsible for the discontinuation of Imipramine (HCl) therapy.The signs and symptoms that are produced after the acute overdosage of Imipramine (HCl) include Hypotension, Tachycardia, Cardiac arrhythmias, Convulsions, Coma, Mydriasis, Hyperreflexia, Sinus tachycardia.The symptomatic adverse reactions produced by Imipramine (HCl) are more or less tolerable and if they become severe, they can be treated symptomatically, these include Drowsiness, Fatigue, Restlessness, Constipation, Abdominal pain, Dry mouth, Blurred vision, Urticaria, Photosensitivity, Impotence, Sleep disturbance, Hypotension, Weight gain, Tremor, Hepatotoxicity, Impairment of memory, Agitation, Cutaneous vasculitis, Eosinophilia, Loss of accomodation, Leukopenia, Urinary hesitancy, Urinary RetentionX, Urinary retention, Increased anxiety, Delayed ejaculation, Enlarged prostate gland, Dry mouth.
Indications
Imipramine (HCl) is primarily indicated in conditions like Anorexia nervosa, Attention deficit disorders, Bulimia nervosa, Depression, Enuresis, Headache, Hyperactivity, Hypercalcaemia, Neuropathic pain, Neurosis, Obsessional states, Osteolytic lesions, Pain, Panic disorders, Phobias.
Interactions
Imipramine (HCl) is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAdrenalineCoadministration increase pressure response to adrenaline and cardiac arrythmias.imipramine should be coadminister with great care.AlcoholAlprazolamThe steady state plasma concentrationis increased by AlprazolamAntazolineIncreased antimuscarinic and sedative effects when antihistamines (e.g Antazoline) given with tricyclic antidepressants (e.g Imipramine)Apraclonidine (HCl)Bethanidine (Sulphate)Bretylium (Tosylate)Chlorpromazine (HCl)Cimetidine (HCl)Debrisoquine (Sulphate)Diltiazem (HCl)EthinyloestradiolFosphenytoinGestodeneGlyceryl TrinitrateGuanethidineHaloperidolLabetalolLabetalol with Imipramine may lead to an increase in tremor.LevodopaLoprazolamTheoretical potential for LOPRAZOLAM increasing the SEDATIVE effect of IMIPRAMINE.ModerateMay need to avoid combinationMethylphenidate (HCl)Methylphenidate (HCl)Mibefradil (Di HCl)ModafinilConcomitant use may increase the toxicity of modafinil.NabiloneConcurrent use may increase the efficacy of nabilone.Concurrent use should be avoided, or you may need dosage adjustments or special tests during treatment.Nitroglycerindelayed dissolution of glyceryl trinitrate tablets due to dry mouth in patients taking imipramine and atropien. Noradrenaline (Acid Tartrate)PerphenazineQuinidineRiboflavin (Vitamin B2)Tricyclic antidepressants may reduce levels of riboflavin in the body. In addition to raising levels of the vitamin in the body, taking riboflavin may also improve the effects of these antidepressantsTestosterone (Esters)VORICONAZOLEAdditive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Risks
Drug should not be given to Pregnant Mothers, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Tab Store in a well closed container, at room temperature.
Warnings
Imipramine HCl should be used with caution (if it contains tartrazine) in patients with aspirin hypersensitivity, because it may produce allergic reaction (including bronchial asthma). Monitor ECG before initiating large doses. Avoid concurrent administration with electric shock therapy because may increase the hazards of therapy. Perform periodic leukocytes (white blood cells) counts and liver function tests. Photosensitization may occur so caution patients to take protective measures sunscreen e.t.c. against exposure to UV light or sun light. Following prolong therapy in high doses, abrupt discontinuation should be avoided because it could precipitate the symptoms of cholinergic rebound such as nausea, vomiting and diarrhea. IM injection should be administered cautiously in the patient receiving imipramine.
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