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Generic Name: imipramine (im IP ra meen)
Brand Name: Tofranil

What is Tofranil (imipramine)?

Imipramine is a tricyclic antidepressant. Imipramine affects chemicals in the brain that may be unbalanced in people with depression.

Imipramine is used to treat symptoms of depression. Imipramine is sometimes used to treat bed-wetting in children ages 6 and older.

Imipramine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about Tofranil (imipramine)?

You should not take this medicine if you recently had a heart attack.

Do not use this medicine if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

What should I discuss with my healthcare provider before taking Tofranil (imipramine)?

You should not use imipramine if you are allergic to it, or if:

  • you recently had a heart attack; or

  • you are allergic to other antidepressants (amitriptyline, amoxapine, clomipramine, desipramine, doxepin, nortriptyline, protriptyline, or trimipramine).

Do not use imipramine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

To make sure imipramine is safe for you, tell your doctor if you have:

  • heart disease, a history of heart attack, stroke, or seizures;

  • bipolar disorder (manic-depression), schizophrenia or other mental illness;

  • kidney or liver disease;

  • overactive thyroid, adrenal gland tumor (pheochromocytoma);

  • diabetes (imipramine may raise or lower blood sugar);

  • narrow-angle glaucoma;

  • problems with urination; or

  • a condition for which you are being treated with electroconvulsive therapy (ECT).

Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Imipramine can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

Older adults may be more sensitive to the effects of this medicine.

Do not give this medicine to a child without medical advice. Imipramine is not approved to treat depression in anyone younger than 18 years old. Imipramine should not be used to treat bed-wetting in a child younger than 6 years old.

How should I take Tofranil (imipramine)?

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended.

If you need surgery, tell the surgeon ahead of time that you are using imipramine. You may need to stop using the medicine for a short time.

It may take up to 3 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.

Call your doctor if your symptoms do not improve, or if they get worse.

You should not stop using imipramine suddenly. Follow your doctor's instructions about tapering your dose.

Store at room temperature away from moisture, heat, and light. Keep the bottle tightly closed when not in use.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of imipramine can be fatal.

Overdose symptoms may include extreme drowsiness, fast or irregular heart rate, fainting, or seizure (convulsions).

What should I avoid while taking Tofranil (imipramine)?

Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with imipramine. Check your food and medicine labels to be sure these products do not contain alcohol.

Imipramine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Avoid exposure to sunlight or tanning beds. Imipramine can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Tofranil (imipramine) side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

  • blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;

  • a light-headed feeling, like you might pass out;

  • new or worsening chest pain, pounding heartbeats or fluttering in your chest;

  • sudden numbness or weakness, problems with vision, speech, or balance;

  • fever, sore throat;

  • confusion, hallucinations, unusual thoughts or behavior;

  • painful or difficult urination;

  • seizure (convulsions); or

  • jaundice (yellowing of the skin or eyes).

Common side effects may include:

  • tingly feeling, weakness, lack of coordination;

  • dry mouth, nausea, vomiting, constipation, diarrhea;

  • vision changes, ringing in your ears;

  • breast swelling (in men or women); or

  • decreased sex drive, impotence, or difficulty having an orgasm.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Tofranil (imipramine)?

Taking this medicine with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking imipramine with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Many drugs can interact with imipramine. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any you start or stop using, especially:

  • any other antidepressant;

  • cimetidine (Tagamet);

  • clonidine;

  • guanethidine;

  • bladder or urinary medicines such as darifenacin, fesoterodine, oxybutynin, tolterodine, solifenacin;

  • bronchodilators such as aclidinium, ipratropium, tiotropium, or umeclidinium;

  • cold or allergy medicine;

  • diet pills, stimulants, ADHD medication (such as Ritalin or Adderall);

  • medication for Parkinson's disease;

  • medication to treat excess stomach acid, stomach ulcer, motion sickness, or irritable bowel syndrome; or

  • seizure medicine such as phenytoin or phenobarbital.

Many drugs can interact with imipramine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all medicines you use, and those you start or stop using during your treatment with imipramine. Give a list of all your medicines to any healthcare provider who treats you.

Where can I get more information?

  • Your pharmacist can provide more information about imipramine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 11.01.

Date modified: October 14, 2016
Last reviewed: September 07, 2016