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Imipramine: Brands, Price & Uses in Bangladesh
Imipramine is a tricyclic antidepressant (TCA) indicated for the following: Depression (established/FDA-approved use): Treatment of symptoms of depression, including endogenous depression, in adults.
About Imipramine
Indications of Imipramine
Imipramine is a tricyclic antidepressant (TCA) indicated for the following:
- Depression (established/FDA-approved use): Treatment of symptoms of depression, including endogenous depression, in adults. Clinical improvement may take 1-3 weeks.
- Nocturnal enuresis in children (established/FDA-approved use, short-term adjunct): As an adjunct in the treatment of nocturnal enuresis (bedwetting) in children aged 6 years and older, after organic causes (e.g. structural, infectious, or endocrine abnormalities) have been excluded. Not intended as sole or long-term therapy.
- Off-label uses (not FDA-approved, based on limited evidence/clinical practice): Chronic neuropathic pain, panic disorder, and attention-deficit/hyperactivity disorder (ADHD) in patients who have not responded to standard therapies. These uses require individualized physician judgment.
Boxed Warning
Imipramine and other antidepressants carry an FDA boxed warning for increased risk of suicidal thinking and behavior in children, adolescents, and young adults under 25 years of age, particularly during the early weeks of treatment or after dose changes. Close clinical monitoring is required.
Dosage & Administration of Imipramine
Depression (Adults)
| Setting | Initial Dose | Usual/Maximum Dose |
|---|---|---|
| Outpatient | 75 mg/day in divided doses | Up to 150-200 mg/day; may be given as a single bedtime dose once stabilized |
| Hospitalized | 100-150 mg/day | May increase gradually up to 250-300 mg/day if response inadequate after 2 weeks |
Depression (Adolescents and Elderly)
Start at a lower dose of 25-50 mg/day; usual maximum around 100 mg/day, adjusted based on tolerability and response.
Nocturnal Enuresis (Children 6 years and older)
| Age | Typical Dose (at bedtime) |
|---|---|
| 6-11 years | 25 mg/day, may increase to 50 mg/day if needed after 1 week; not to exceed 2.5 mg/kg/day |
| 12 years and older | 25-75 mg/day at bedtime; not to exceed 2.5 mg/kg/day |
Treatment should be periodically reassessed; not intended as long-term therapy without re-evaluation. Imipramine should be tapered gradually rather than stopped abruptly to avoid discontinuation symptoms.
Renal/Hepatic Impairment
Use with caution and reduced dosing in patients with hepatic impairment, as Imipramine is extensively hepatically metabolized; specific validated dose adjustments are not well established, so close monitoring is advised.
Side Effects of Imipramine
Common side effects of Imipramine include:
- Dry mouth, constipation, blurred vision (anticholinergic effects)
- Drowsiness/sedation
- Orthostatic hypotension and dizziness
- Tachycardia (increased heart rate)
- Weight gain
- Sweating
- Tremor
Less common but serious effects include cardiac conduction abnormalities and arrhythmias, seizures, urinary retention, and increased risk of suicidal thinking/behavior in younger patients (see Precautions and Warnings). If severe or persistent side effects occur while taking Imipramine, contact a physician promptly.
Contraindications of Imipramine
Imipramine is contraindicated in the following situations:
- Known hypersensitivity to Imipramine or other tricyclic antidepressants.
- Concurrent use of, or use within 14 days of discontinuing, a monoamine oxidase inhibitor (MAOI).
- Acute recovery phase following myocardial infarction.
Frequently Asked Questions about Imipramine
What is Imipramine used for?
Imipramine is primarily used to treat depression in adults and, at lower doses, as a short-term adjunct treatment for nocturnal enuresis (bedwetting) in children aged 6 and older after other causes have been ruled out.
Is there a risk of suicidal thoughts with Imipramine?
Yes. Imipramine carries a boxed warning for increased risk of suicidal thinking and behavior in children, adolescents, and young adults under 25, particularly during early treatment or after dose changes. Close monitoring by a caregiver or physician is essential.
Can Imipramine be taken with other antidepressants like MAOIs?
No. Imipramine must not be taken with, or within 14 days of stopping, a monoamine oxidase inhibitor (MAOI), as this combination can cause a life-threatening serotonin syndrome.
Is Imipramine safe during pregnancy?
Imipramine does not have a well-established safety profile in pregnancy; some reports of congenital malformations exist, though causality is unconfirmed. It should be used in pregnancy only if the benefit clearly outweighs potential risk to the fetus, and only under medical supervision.
What should I do if I miss a dose or suspect an overdose of Imipramine?
If a dose of Imipramine is missed, take it as soon as remembered unless it is close to the next dose; do not double up. If overdose is suspected, this is a medical emergency due to serious cardiac and neurological risks — seek immediate emergency medical attention or contact poison control right away.
Can children take Imipramine long-term for bedwetting?
Imipramine for nocturnal enuresis is intended only as a short-term adjunct measure, with periodic reassessment by a physician; it is not meant for indefinite long-term use in children.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.