Tofranil (Imipramine Hydrochloride)
Tofranil (imipramine) Dosage and Side Effects
TOFRANIL is the generic name of a prescription drug used to treat depression. It may also be prescribed off-label as a non-narcotic medicine to relieve chronic pain.
Warnings and Precautions
Like all antidepressants, TOFRANIL carries a black-box warning because some people may become severely depressed and suicidal while taking the drug.
Talk to your doctors about the risks of suicide ideation before taking TOFRANIL or any other antidepressant.
You shouldn't take TOFRANIL if:
- You're allergic to TOFRANIL or any of the drug's inactive ingredients
- You just had a heart attack
Ask your doctor about TOFRANIL if you:
- Have glaucoma or other issues with increased pressure in the eye
- Have seizures
- Suffer from hormonal disorders like diabetes or thyroid disease
- Have Parkinson's disease
- Have mood disorders, like schizophrenia or bipolar disorder
- Live in an extremely warm climate
- Have heart conditions, including congestive heart failure (CHF) or a slow or irregular heartbeat
- Just had a heart attack
- You're younger than 25 or older than 65
Also, don't expect to notice a big difference in your mood when you first start taking TOFRANIL.
Regardless of the dose prescribed, TOFRANIL — like most antidepressants — can take up to three or four weeks before you either notice a change or see the maximum effect of the dose you're taking.
Common Side Effects of TOFRANIL
You should tell your doctor if any of the following side effects are severe or don't go away:
- Difficulty sleeping
- Dry mouth
- Increased appetite
- Nausea, vomiting
- Racing or fast heartbeat
- Rash or itching
- Blurry vision
Serious Side Effects of TOFRANIL
You should stop using this medicine and call your doctor if you experience any of the following serious side effects:
- Dizziness upon standing, fainting
- Stroke, heart attack, or changes in heart rhythm
- Parkinson's-like signs, such as hand tremors, pill-rolling of the hands, or dragging of the feet
- Blood abnormalities, like low white blood cell count and low levels of platelets, white blood cells, and red blood cells
- Suicidal thoughts
- Syndrome of inappropriate antidiuretic hormone (SIADH)
Interactions with this medication
You should tell your doctor about all prescription, non-prescription, illegal, recreational, herbal, nutritional, or dietary drugs you're taking.
Don't take TOFRANIL if you are taking the following drugs:
- KlorCon (potassium phosphate)
- Drugs for bowel preparation, like potassium phosphate or potassium citrate
- Drugs for irregular heartbeat like dronedarone, Norpace or Norpace CR (disopyramide), and procainamide
- Parnate (tranylcypromine)
- Zyvox (linezolid)
- Emsam (selegiline transdermal)
Like most TCAs, TOFRANIL interacts with many drugs, so please discuss any concerns with your doctor or pharmacist before taking it.
Other drugs that interact with TOFRANIL include:
- Cordarone, Nexterone, or Pacerone (amiodarone)
- Drugs for irregular heartbeat, like Tikosyn (dofetilide), dobutamine, and Betapace or Betapace AF (sotalol)
- Tagamet (cimetidine)
- Ephedra and ephedrine
- Epi-Pen, Epi-Pen, Jr. (epinephrine)
- Methadose and Dolophine (methadone)
- Biaxin (clarithromycin)
TOFRANIL and Alcohol
Impramine and alcohol can both cause dry mouth, dry eyes, dizziness, and confusion.
Drinking alcohol while taking TOFRANIL may worsen these side effects, so you might want to avoid, or at least limit, alcohol while taking TOFRANIL.
TOFRANIL and Grapefruit Juice
Try to avoid eating grapefruit and drinking grapefruit juice while taking TOFRANIL.
Grapefruit juice slows down how quickly the body is able to break down the TOFRANIL, which could cause TOFRANIL levels in the blood to rise dangerously high.
Proper Use of this medication
Generic imipramine is available in tablet form in the same doses as those found in TOFRANIL and TOFRANIL PM.
The brand name TOFRANIL comes in 10 milligram (mg), 25 mg, and 50 mg tablets, while the injection comes in vials containing 12.5 mg of TOFRANIL per milliliter of liquid (12.5 mg/ml).
Generic imipramine for injection is no longer available.
TOFRANIL -PM tablets come in strengths of 75 mg, 100 mg, 125 mg, and 150 mg.
The dose of TOFRANIL varies based on the condition your doctor is treating.
For depression, your doctor may start you at a dose ranging anywhere from 25 mg to 75 mg a day for 3 to 4 days, and slowly increase the dose based on how you respond to treatment.
Unless your doctor has told you otherwise, you shouldn't take more than 300 mg of TOFRANIL a day.
People 65 and older generally shouldn't take more than 100 mg of TOFRANIL a day.
Higher doses of TOFRANIL may cause confusion, bladder problems, loss of balance, and possibly increase the risk of falling in people ages 65 and over.
If your doctor prescribes TOFRANIL for pain management, your doctor will determine how much you should take based on your weight and other factors.
Still, you shouldn't take more than 300 mg of TOFRANIL day.
If you think you or someone else might have overdosed on TOFRANIL, contact an emergency room at 911 or a poison control center.
Missed Dose of TOFRANIL
If you miss a dose of TOFRANIL, try to take it as soon as you remember.
However, if it's almost time for your next dose, skip the missed dose and continue on your regular dosing schedule.
Don't take extra doses to make up for a missed one.
Other related products
The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.