Imipramine is a tricyclic antidepressant (TCA) used for major depression and, at lower doses, for childhood bedwetting (nocturnal enuresis). It works on brain chemicals that lift mood and reduce urinary reflexes. This page gives straight answers: who might use it, typical dose ranges, common side effects and the safety checks you should know about.
Doctors usually start low and go slow. For adults with depression, typical starting doses are 25–50 mg at bedtime, increasing every few days to a usual range of 75–150 mg daily. Some people need higher doses (up to 200–300 mg) but higher doses raise risk of side effects and must be supervised. For children with bedwetting, doses are commonly 10–25 mg at night, sometimes up to 50 mg, and only after behavior measures have been tried. Always follow your prescriber—dosing varies by age, weight and other health issues.
Take imipramine at night if it makes you sleepy. If it upsets your stomach, take it with food. If you miss a dose, take it when you remember unless it’s close to the next dose—don’t double up.
Common side effects are driven by anticholinergic effects: dry mouth, constipation, blurred vision, and difficulty urinating. Sedation and dizziness are frequent, especially at the start. You may also notice weight gain or changes in appetite.
More serious concerns: imipramine can affect heart rhythm (fast heartbeat, low blood pressure when standing, or QT prolongation). People over 40 or with heart disease often need a baseline ECG and periodic checks. It can lower seizure threshold, so it’s risky for people with epilepsy. Overdose can be life-threatening—call emergency services immediately if you suspect it.
Drug interactions matter. Don’t use imipramine with an MAOI (within 14 days) because of the risk of severe reactions. Combining with SSRIs, certain antipsychotics, or drugs that affect heart rhythm needs careful monitoring. Avoid alcohol— it increases drowsiness and can worsen side effects.
Mood monitoring is important: if you or someone close notices worsening depression or new suicidal thoughts—especially in young people—contact your prescriber right away. Don’t stop imipramine suddenly; withdrawal can cause flu-like symptoms, irritability, and sleep trouble. Your doctor will give a tapering plan.
Quick practical tips: keep regular follow-ups, report severe constipation or difficulty peeing, mention any heart or seizure history before starting, and carry a list of your medicines to avoid risky interactions. If you’re pregnant or breastfeeding, discuss risks and benefits—sometimes there are safer options.
Imipramine can help, but it needs respect. With the right dose and monitoring, many people get real benefit. If you have specific concerns about dosing, side effects, or interactions with other meds you take, ask your healthcare provider or pharmacist for tailored advice.
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