Tofranil (Imipramine)

What is Generic Tofranil?

Tofranil represents a tricyclic antidepressant. It indiscriminately blocks the reuptake of monoamine neurotransmitters because of what they are accumulated in the synaptic cleft. This leads to increased physiological activity.

The drug also has thymoleptic action. It is characterized by co-stimulating activity, increases the tone of the organism and provokes a decrease in motor inhibition. The drug has peripheral and central m-anticholinergic and weak antihistamine, myotropic activity.

After ingestion it is rapidly biotransformed in the liver. Approximately 40% of Imipramine excreted during a day with urine as metabolites and 2.1% in the unchanged form. About 20% of the dosage is excreted with bile. The half-life may be from 4 to 24 hours.

In what kind of disease treatment Tofranil is helpful?

Typically doctors prescribe the use of Tofranil in the following cases:

• In depressive states of the different form: depression, major or typical depressions, bipolar disorder;
• In panic disorder;
• In incontinence in children from 6 years.

What should I tell my health care provider before I take Generic Tofranil?

Firstly Tofranil in any of its forms cannot be used in those cases when the patient is detected hypersensitivity or intolerance to the components in the composition of the drug. In addition, its use is impossible in the following cases:

• In a malfunction in the cardiovascular system;
• In recent occurred myocardial infarction;
• In manic episodes;
• In rhythm disturbance of the heart;
• Case of failure of the liver and kidneys;
• In angle-closure glaucoma;
• In urinary retention;
• In the case of patient’s intolerance of galactose, glucose as well as lactase deficiency;
• Up to 18 years in case of depression and panic disorder as well as up to 6 years from urinary incontinence at night.

Doctors strictly forbid treat with Imipramine during pregnancy and during breast-feeding because therapy can harm both mother and baby.

How should I take Tofranil?

For the best therapeutic effect physicians are advised to take Tofranil after eating and before going to bed. In some cases the daily dose can be divided into two installments at the insistence of the doctor. Keep in mind that medical treatment should not be delayed for more than 3 months. It is advised be lifted gradually.

Dosage information

Medical treatment lasts usually only 2 to 4 weeks, in very rare cases improving the patient’s condition are observed after 8 weeks. It is advised to start with small doses and to increase it gradually.

Adjust the dosage should be extremely cautious in old age, in children and adolescents.

The dosage and regime in depression should be as follows:

After 18 years it is 25 mg 1 to 3 times a day. At the end of the first week of treatment the dosage may reach up 150-200 ml per day (for outpatients);

After 18 years it is 75 mg per day and increased to 200 with a maximum of 300 ml (hospital treatment);

Patients in old age after 60 years should be assigned the lowest dose and increase it very carefully, keeping an eye on the general condition of the patient. Until the end of the 10th day the dose can be increased to 75 mg.

In panic disorder many patients observed the occurrence of side effects. It happens because of this treatment is initiated with the lowest dose. The maximum tolerated dose of 200 mg per day but usually is prescribed by the doctor 75 to 100 mg. Treatment with the positive dynamics of the disease lasts for six months but in some cases it may be extended. Physicians are advised to complete the reception of Tofranil gradually reducing the dose up to a complete elimination from the body.

What may interact with Tofranil?

• Joint reception of Imipramine with inhibitors of microsomal liver enzymes lowers metabolism;
• Monoamine oxidase inhibitors in combination can increase toxicity in the patient's body and in some cases lead to coma;
• Contraceptives for oral use significantly reduce the effectiveness of the drug and develop its toxicity;
• Combination with antipsychotic agents can cause increased side effects;
• The use of agents that depress the CNS in combination with Imipramine increases side effects;
• With quinidine occurs problems with conduction and arrhythmia;
• Phenytoin can lower anticonvulsant effect;
• Indirect anticoagulants in combination with Imipramine may be a serious impetus to the development of bleeding.

What should I watch for while taking Tofranil?

Before beginning the treatment it should be examined the following indicators:

• Arterial pressure;
• Indications of peripheral blood;
• The status of the kidneys and liver;
• Electrocardiogram.

In some patients may be noticed suicidal tendencies which will take place upon the occurrence of remission. Suicidal tendencies mostly manifest in children and young people up to 24 years.

In case of changes of the patient's state or his behavior there is an urgent need to consult with the doctor. In addition, it should be remembered that in the case of abrupt withdrawal of Imipramine patients may appear dizziness, nausea, vomiting, disturbed sleep and a feeling of anxiety. To avoid these negative symptoms you should cancel the drug slowly and gradually to let the body to get used to it.

It is also not advised to take at the same time Tofranil and carry out electroconvulsive therapy. In panic disorders in the early days of medical therapy, may develop severe anxiety, but this deviation lasts 2-3 days. Similar symptoms may occur in psychosis.

Tofranil is able to influence the production of tear fluid and significantly reduce it so during the treatment is disturbed vision and very quickly restored.

It is strictly forbidden to drink alcohol. This drug is able to affect the attention so you should not drive a car or do other activities that require concentration.

What side effects may I notice from Generic Tofranil?

Tofranil can cause negative symptoms which are difficult to distinguish from depressive symptoms such as sleep disturbance, fatigue, apathy, anxiety. Sometimes the treatment can cause a significant reduction in libido.

Doctors often say that in strong mental disorder or other reactions of the nervous system during medical treatment you should stop taking the drug. Extremely sensitive to the Imipramine patients in old age often observe problems with the cardiovascular system as well as a variety of mental disorders.

Instructions warn that the use of the drug may cause:

• Violation of the central nervous system: tremors, severe headaches, dizziness, insomnia, disorientation, anxiety and worry, various sleep disorders, fatigue, confusion, ataxia, increased initial violations of the psyche;
• Suffers cardiovascular system: tachycardia, arrhythmia, jumps in blood pressure, hypotension, a rapid heartbeat;
• Endocrine disruptors: galactorrhea, jumps of glucose level in the blood plasma, breast enlargement;
• Failure of the digestive system: constipation, nausea, vomiting, diarrhea, stomatitis, hepatitis;
• Failure of the bladder, a violation of urination;
• Can be observed leukopenia, thrombocytopenia, purpura and eosinophilia;
• Suffer organs of hearing and sight impaired;
• Various allergic reactions;
• Disturbed metabolism, the patient may rapidly gain or vice versa lose weight.

Where can I keep Tofranil?

This medicine should be kept in a well-protected from sunlight and reach of small children place. The optimal temperature is 15-25 ° C.