Imipramine is used to treat depression. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. This can be by accident or on purpose. If you are due to have any medical treatment, tell the person carrying out the treatment that you are taking imipramine, as it can interfere with some anaesthetics. This content does not have an Arabic version. from the best health experts in the business. The risk of suicidal thinking and behavior should be balanced with the clinical need for therapy and patients should be monitored closely; instruct families and caregivers to communicate any changes in behavior with the prescriber. For many the biggest problem once they start reducing is finding that there is no going back because a higher dose that worked before no longer works. 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. Imipramine can cause drowsiness and dizziness. This is very important because imipramine can cause . OVERVIEW Introduction Imipramine is a tricyclic antidepressant that continues to be widely used in the therapy of depression. Imipramine overdose occurs when someone takes more than the normal or recommended amount of this medicine. You may become suicidal, especially at the beginning of your treatment and any time that your dose is increased or decreased. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Below are symptoms of an imipramine overdose in different parts of the body. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Szydlik H, Zukowski W, Gruszka S, Podleski W. Act Nerv Super (Praha). Store in a cool, dry place, away from direct heat and light. DO NOT use it to treat or manage an actual overdose. Imipramine, sold under the brand name Tofranil, among others, is a tricyclic antidepressant (TCA) mainly used in the treatment of depression.It is also effective in treating anxiety and panic disorder.Imipramine may also be used off-label for nocturnal enuresis and chronic pain. Imipramine may make your skin sensitive to sunlight. sharing sensitive information, make sure youre on a federal A systems approach toward adopting an electronic medical record may provide a practical method for automated monitoring of all patients in general, and patients at risk of nephrotoxicity in particular. New Pharmacological Agents to Aid Smoking Cessation and Tobacco Harm Reduction: What Has Been Investigated, and What Is in the Pipeline? All rights reserved. and transmitted securely. It treats depression by increasing the amounts of certain natural substances in the brain that are needed to maintain mental balance. Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. ECG monitoring of enuretic children given imipramine. seizure (convulsions); or. Make your tax-deductible gift and be a part of the cutting-edge research and care that's changing medicine. This medication may be prescribed for other uses. If you or someone you are with has an overdose, call the local emergency number (such as 911), or the local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. G Psichiatr Neuropatol. You should not use imipramine if you are allergic to it, or if: Do not use imipramine if you have used an MAO inhibitor in the past 14 days. Bluish color of fingernails, lips, skin, palms, or nail beds cold, clammy skin decreased awareness or responsiveness difficult or troubled breathing disorientation fast, weak pulse hallucinations irregular, fast, slow, or shallow breathing Aronson JK. Also, while you feel depressed, you may have distressing thoughts, and think about harming yourself or ending your life. Do not drive a car or operate machinery until you know how this medication affects you. Most drugs that are eliminated renally do not require dosage adjustment until the creatinine clearance falls below 50 mL per minute.46 The preferred formula advocated by the U.S. Food and Drug Administration to guide drug dosing in adults is the Cockcroft-Gault formula because it has been used in nearly all pharmacokinetic studies to generate drug-dosing guidelines.45,47 Compared with the MDRD, the Cockcroft-Gault equation tends to overestimate the GFR and may yield different results depending on the patient.41 For example, the estimated GFR of a 64-year-old, 190-lb (86-kg) woman with a serum creatinine level of 1.3 mg per dL (110 mol per L; normal: 0.8 to 1.4 mg per dL [70 to 120 mol per L]) is 59 mL per minute using the Cockcroft-Gault formula and 44 mL per minute per 1.73 m2 according to the MDRD. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, tranylcypromine, and others. All rights reserved. Imipramine can make you feel sleepy. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. HHS Vulnerability Disclosure, Help There is a problem with Drug information provided by: Merative, Micromedex. Imipramine can be harmful in large amounts. 1968;96(1):109-30. This is so your doctor can check on your progress. Taking imipramine together with medicines used during surgery may increase the risk of side effects. Imipramine tablets are also used to prevent bedwetting in children. The most commonly reported side effects were tremors, increased weight, dry mouth, and constipation. Ask your pharmacist any questions you have about refilling your prescription. For additional information visit Linking to and Using Content from MedlinePlus. The information within all other sections is proprietary to Everyday Health. government site. Would you like email updates of new search results? Our report describes the serious dose-related cardiac and central nervous system toxic effects of imipramine. Z Kinder Jugendpsychiatr Psychother. Imipramine pamoate is not approved for use in pediatric patients. Imipramine is in a class of medications called tricyclic antidepressants. Your doctor may tell you not to take imipramine. Most drugs found to cause nephrotoxicity exert toxic effects by one or more common pathogenic mechanisms. Symptoms of overdose may include: severe dizziness, fast/irregular heartbeat, fainting, hallucinations, seizures. Manufacturer's PIL, Imipramine Tablets 10 mg and 25 mg; Accord-UK Ltd, The electronic Medicines Compendium. Try to avoid strong sunlight until you know how your skin reacts, or use a sun cream with a high sun protection factor. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Decreased effective circulating blood volume results from sequestration of fluid into third-space compartments and is associated with sepsis, heart failure, ascites, or pancreatitis.7,36, Certain drugs are inherently nephrotoxic and include aminoglycosides, amphotericin B, cisplatin, contrast dye, and cyclosporine.7,34 For others, such as those associated with chronic interstitial nephritis and crystal deposition, nephrotoxicity is dose dependant or related to prolonged duration of treatment.24 Combination therapy with multiple nephrotoxins can result in synergistic nephrotoxicity, thus increasing the risk of renal injury.7 Specific preventive measures unique to some of these drugs are highlighted in Table 3.7,1013,2024,32,37,38, Contrast-induced nephropathy is reported to be the third most common cause of acute renal failure in hospitalized patients.2 The exact incidence, however, varies depending on study design, type and dose of contrast used, and presence of acute renal failure risk factors and other comorbidities.37 The risk of contrast-induced nephropathy is highest in patients with chronic kidney disease (i.e., a GFR of less than 60 mL per minute per 1.73 m2), especially in the presence of diabetes.39 Other risk factors include dehydration, heart failure, age older than 70 years, and concurrent use of nephrotoxic drugs.37 Patients with risk factors for contrast-induced nephropathy, especially those who have multiple risk factors, require prophylactic interventions before imaging.37 Prophylactic interventions studied have included normal saline or sodium bicarbonate infusions and acetylcysteine before and after imaging.38,40 However, the role of acetylcysteine has yet to be defined because clinical trial results have been inconsistent.37. This risk is higher if you or anyone in your family has or has ever had bipolar disorder (mood that changes from depressed to abnormally excited) or mania (frenzied, abnormally excited mood) or has thought about or attempted suicide. bipolar disorder (manic-depression), schizophrenia or other mental illness; easy bruising, unusual bleeding, purple or red spots under your skin; 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; confusion, hallucinations, unusual thoughts or behavior; jaundice (yellowing of the skin or eyes). I have to visit the toilet almost every 5 min. I am a 32 year old guy with a terrible condition. This article is for information only. If you suspect that someone (especially if it is a child) might have taken imipramine by accident, go to the accident and emergency department of your local hospital straightaway. Imipramine should not be used to treat bed-wetting in a child younger than 6 years old. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. information highlighted below and resubmit the form. If you buy any medicines 'over the counter', check with a pharmacist that they are suitable to take with imipramine. Our report describes the serious dose-related cardiac and central nervous system toxic effects of imipramine. The usefulness of this therapy carries with it, however, the risk of accidental overdose by younger siblings of these enuretic patients. Patients with any of these risk factors, especially those who have more than one risk factor (e.g., a patient with diabetes and heart failure), should be closely monitored for changes in renal function when a medication is added or a dosage is increased. Acute interstitial nephritis, altered intraglomerular hemodynamics, chronic interstitial nephritis, glomerulonephritis, Amitriptyline (Elavil*), doxepin (Zonalon), fluoxetine (Prozac), Chronic interstitial nephritis, glomerulonephritis, rhabdomyolysis, Diphenhydramine (Benadryl), doxylamine (Unisom), Acute interstitial nephritis, crystal nephropathy, Amphotericin B (Fungizone*; deoxycholic acid formulation more so than the lipid formulation), Beta lactams (penicillins, cephalosporins), Acute interstitial nephritis, glomerulonephritis (ampicillin, penicillin), Crystal nephropathy, tubular cell toxicity, Acute interstitial nephritis, crystal nephropathy (ciprofloxacin [Cipro]), Adefovir (Hepsera), cidofovir (Vistide), tenofovir (Viread), Altered intraglomerular hemodynamics, chronic interstitial nephritis, thrombotic microangiopathy, Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, Clopidogrel (Plavix), ticlopidine (Ticlid), Carmustine (Gliadel), semustine (investigational), Chronic interstitial nephritis, tubular cell toxicity, Cocaine, heroin, ketamine (Ketalar), methadone, methamphetamine, Lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), Absolute or effective intravascular volume depletion, Underlying renal insufficiency (glomerular filtration rate < 60 mL per minute per 1.73 m, Underlying renal insufficiency; intravascular volume depletion; age older than 60 years; concomitant use of ACE inhibitors, ARBs, NSAIDs, cyclosporine (Neoral), or tacrolimus (Prograf), Use analgesics with less prostaglandin activity (acetaminophen, aspirin, sulindac [Clinoril], nabumetone [Relafen; brand not available in the United States]), Correct volume depletion before initiation of drug, especially if used on a chronic basis, Monitor renal function and vital signs following initiation or dose escalation, especially if used in at-risk patients, As above, plus: excessive dose, concomitant use with other nephrotoxic drugs or drugs that inhibit cyclosporine or tacrolimus metabolism, Monitor serum drug concentrations and renal function, Underlying renal insufficiency, duration of therapy > 10 days, trough concentrations > 2 mcg per mL, concomitant liver disease, hypoalbuminemia, Monitor serum drug levels and renal function two to three times per week, Amphotericin B (Fungizone; brand not available in the United States), Underlying renal insufficiency, rapid infusion, large daily dosage, deoxycholate formulations more so than lipid formulations, prolonged duration of therapy, Saline hydration before and after dose administration, Consider administering as a continuous infusion over 24 hours, Underlying renal insufficiency, age older than 70 years, diabetes, heart failure, volume depletion, repeated exposures, Use low-osmolar contrast in the lowest dose possible and avoid multiple procedures in 24 to 48 hours, 0.9% saline or sodium bicarbonate (154 mEq per L) infusion before and after procedure, Withhold NSAIDs and diuretics at least 24 hours before and after procedure, Monitor renal function 24 to 48 hours postprocedure, History of chronic pain, age older than 60 years, female sex, cumulative consumption of analgesic > 1 gram per day for more than two years, Avoid long-term use, particularly of more than one analgesic, Use alternate agents in patients with chronic pain, Maintain drug levels within the therapeutic range, Acyclovir (Zovirax), methotrexate, sulfa antibiotics, triamterene (Dyrenium), Volume depletion, underlying renal insufficiency, excessive dose, intravenous administration. Heart rhythm disturbances can be fatal. 16th ed. Do not suddenly stop taking this medicine without first checking with your doctor. Imipramine comes as a tablet and a capsule to take by mouth. You should not stop using imipramine suddenly. [Neurobiological changes in suicide attempts with drugs]. Compared with 30 years ago, the average patient today is older, has more comorbidities, and is exposed to more diagnostic and therapeutic procedures with the potential to harm kidney function. Portions of this document last updated: May 01, 2023. Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies or colds, sedatives, tranquilizers, or sleeping medicines, prescription pain medicine or narcotics, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics. Stopping treatment suddenly can sometimes cause problems and your doctor may want you to reduce your dose gradually over a number of weeks when this becomes necessary. An imipramine overdose can be very serious. Imipramine is a prescription medicine used to treat depression. If you have any problems with the way your liver works, or if you have any problems with the way your kidneys work. Complications such as pneumonia, muscle damage from lying on a hard surface for a prolonged period of time, or brain damage from lack of oxygen may result in permanent disability. 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). A.D.A.M. Federal government websites often end in .gov or .mil. 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