Article Contents ::
Details About Generic Salt :: Imipramine
Main Medicine Class:: #N/A Sub Medicine Class :: #N/A
| 1D. ANTI-DEPRESSANTS in 1. NERVOUS SYSTEM |
| IMIPRAMINE |
| TCA | ANTI-DEPRESSANT, ANXIOLYTIC |
| PK: A: Well absorbed D: Extensive M: Hepatic E: Urine |
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Indications & Dose: DEPRESSION PO Adult Outpatients: Initially 75mg/day may increase gradually to 150mg/day, max 200 mg/day, Inpatients: Initially 100-150mg/day may increase gradually to 200mg/day, if no response may further increase to 250-300mg/day after 2wks, max 300mg/day Elderly Outpatients: Initially 25-50mg HS may increase q7days, max 100mg/day, Inpatients: Initially 25-50mg HS may increase q3days, max 100mg/day | GOOD MEMORY AND LEARNING PO Child 6-18 yr: 10-30mg BID | NOCTURNAL ENURESIS PO Child 6-7yrs (20-25kg): 25mg; 8-11 yrs (25-35kg): 25-50mg; 11 yrs (35-54kg): 50-75mg. Doses should be taken before HS for 3months | PANIC DISORDER PO Adult Initially 10mg/day, increased by 75-150mg/day if required, max 200mg/day |
| Contra: Hypersensitivity, concurrent use of MAOI, acute recovery phase of MI
Precautions: CVD, renal/hepatic impairment, history of seizures, thyroid dysfunction, pheochromocytoma, glaucoma, avoid abrupt withdrawal ADR: Serious: MI, heart block, seizures, arrhythmias, paralytic ileus, hypoglycemia, ECG changes, hypotension, palpitations, blurred vision, tinnitus, blood disorders, hepatitis, flushing, syncope, EPS, hypersensitivity reactions, Others: fatigue, agitation, confusion, hallucinations, drowsiness, nasal congestion, diarrhea, urinary retention, menstrual irregularities, galactorrhea, erectile dysfunction, testicular swelling, libido changes, hyperglycemia, hyperthermia, diaphoresis, photosensitivity, urticaria, pruritus, alopecia, increased appetite, drug fever DDI: Serious Guanethidine antihypertensive effects are abolished by drug, Clonidine effects decreases, Alcohol impaires complex psychomotor skills, SSRIs/Chlorpromazine increases drug level, Neuromuscular blockers/GA increases risk of arrhythmias & hypotension, Levodopa/Carbidopa leads to hypertensive crises, Dihydroergotamine leads to serotonin syndrome, MAOIs leads to very toxic & fatal reactions like serotonin syndrome, Phenytoin level increases, Quinidine reduces drug clearance Diet: Monitor: BP, pulse rate, ECG in older adults, evaluate mental status, suicide ideation, blood levels |