Tofranil

Generic Name: Imipramine hydrochloride
Product Name: Tofranil

Indication

• Major depression
• Nocturnal enuresis
• Panic disorder
• Urinary urge incontinence
• Second line treatment in attention deficit hyperactivity disorder (ADHD)

Action

Tricyclic antidepressants (TCA’s) exert their effects by inhibiting reuptake of noradrenaline and serotonin into presynaptic terminals.

Dose advice

Depression, Panic disorder:

• 25-75mg daily, increasing by 25-50mg every 2-3 days to 75-150mg daily. Maximum 300mg daily.Urinary urge incontinence:
• 10-25mg 1-3 times daily

(ADHD):

• Child > 5 years, 10mg twice daily, increased slowly as clinically indicated in increments of 0.5mg/kg to a daily maximum of 3mg/kg, given in 2 or 3 divided doses.
• In ADHD, serum concentrations do not correlate with therapeutic effects, but may be monitored to minimize toxicity.

Nocturnal enuresis:

• Child 7-10 years: 10-20mg, 30-60 minutes before bedtime; maximum period of treatment is 3 months.
• Child >10 years: 25-50mg 30-60 minutes before bedtime; maximum period of treatment is 3 months.
• Do not use for enuresis in children < 7 years.

Schedule

S4

Common side effects

• Sedation
• Dry mouth
• Blurred vision
• Constipation
• Weight gain
• Orthostatic hypotension
• Urinary hesitancy or retention
• Reduced gastrointestinal motility
• Anticholinergic delirium (particularly in the elderly and in Parkinson’s disease)
• Impotence
• Loss of libido
• Other sexual adverse effects
• Tremor
• Dizziness
• Sweating
• Agitation
• Insomnia

Uncommon side effects

• Slowed cardiac conduction
• T wave inversion or flattening (particularly at high doses)
• Arrhythmias
• Sinus tachycardia
• Nausea
• Hyperglycaemia
• Gynaecomastia in males
• Breast enlargement and galactorrhoea in females
• Allergic skin reactions
• Manic episodes

Rare:

• Blood dyscrasias
• Hepatitis
• Parlytic ileus
• SIADH with hyponatraemia
• Seizures

For further information talk to your doctor.