Imipramine is the prototype of the tricyclic class of antidepressants. It is a potent inhibitor of norepinephrine reuptake at noradrenergic nerve endings. It is also an inhibitor of 5-hydroxytrytamine (5-HT) reuptake but these effects are less marked than those on norepinephrine. Imipramine is a competitive antagonist at alfa-adrenoceptors but the effects are relatively weak.

Description

Presentation

    Pinor Tablet: Each tablet contains Imipramine HCl USP 25 mg.

Indications

    Treatment of depression, management of panic disorder, management of pain, management of enuresis, treatment of hyperactivity and attention deficit.

Dosage & Administration

    Depression: Initially up to 75 mg daily in divided doses increased gradually to 150-200 mg (up to 300 mg in hospital); up to 150 mg may be given as a single dose at bed time; Elderly: initially 10 mg daily, increased gradually to 30-50 mg daily; child not recommended for depression. Nocturnal enuresis: Child: 7 years, 25 mg; 8-11 years 25-50 mg, over 11 years, 50-75 mg at bedtime; max. period of treatment (Including gradual withdrawal) is 3 months;full physical examination is required before further course. Panic attack: Initially 10-25 mg/day, depending on how the medication is tolerated, raise the dose until the desired response is obtained. The daily doses required vary greatly from patient to patients, between 75-150 mg, if necessary it can be increased to 200 mg. Chronic painful condition: The dosage must be individualized (25-300 mg daily). A daily dose of 25-75 mg is generally sufficient.

Contrainidications

    Recent myocardial infarction, arrhythmias (particularly heart block), not indicated in manic phase, severe liver disease.

Warning & Precautions

    Cardiac diseases (particularly with arrhythmias), history with epilepsy, pregnancy and breast feeding, elderly, hepatic impairment (avoid if severe), thyroid disease, psychoses, angle-closure glaucoma, history of urinary retention, concurrent electro-convulsive therapy.

    Drowsiness may affect performances of skilled tasks (e.g. driving), alcohol induced Imipramine effect.

Side effects

    Dry mouth, less sedation, blurred vision (disturbances of accommodation, increased intraocular pressure), constipation, nausea, difficulty with micturation; cardiovascular side-effects, sweating, tremors, rashes and hypersensitivity reaction (including urticaria & photosensitivity), behavioral disturbances (particularly in children) hypomania or mania (particularly in elderly), interference with sexual function; blood sugar changes, increased appetite, weight gain (occasionally weight loss).

Drug interaction

    Imipramine should not be used in combination with Monoamine oxidase inhibitors (MAO), anticholinergic agents, antihypertensive agents, methylphenidate, levodopa, antipsychotic drug, cimetidine, barbiturates, and oral contraceptives.

Use in special groups

Packing

    Pinor Tablet: Each box contains 100's tablets in blister pack.