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Formulation : Tablet
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Indications

Tofranil is an antidepressant medication used to treat symptoms of depression. This medication can also be used to treat enuresis (bed-wetting) in children aged 6 years and older.

Imipramine is a tricyclic antidepressant that improves the availability of noradrenaline and serotonin in your brain by inhibiting their neuronal reuptake. The drug also offers some antihistaminic, alpha-adrenolytic, and anticholinergic that may help prevent bed-wetting in children. These actions allow Tofranil to relieve symptoms of depression by altering and balancing the chemicals in your brain.

Dosage and Administration

The dose of Tofranil that is prescribed will vary depending on the individual and condition being treated. Follow all your healthcare provider’s instructions and read packaging labels carefully to ensure the best response during treatment. Do not change your dose on your own.

  • Swallow tablets whole
  • Take with or without food at the same times each day
  • Do not suddenly stop taking Tofranil
  • Store at room temperature away from children and pets

To treat depression:

  • Most adults start by taking 25mg 1 to 3 times each day
  • Doses should gradually increase to between 150 and 200mg daily within the first week
  • After symptoms improve doses should be reduced to a maintenance dose ranging from 50 to 100mg each day
  • Older patients should start by taking 10mg once daily
  • Elderly doses should gradually increase during the first 10 days of treatment to between 30 and 50mg daily which should be maintained
  • Continue using Tofranil as prescribed, even if you feel well

To treat enuresis in children:

  • Children should start by taking 25mg once daily an hour before bed
  • After a week, if bed-wetting does not improve, doses can increase to 50mg in children under 12 years of age and up to 75mg each night in children over the age of 12
  • Children should not take more than 75mg once a night
  • Early night bedwetters may see more effective results if their dose is divided and taken both in the midafternoon and at night before bed
  • Gradually decrease dose to stop treatment as directed by your healthcare provider

Side Effects

Tofranil may cause some side effects to develop while altering the chemicals in your brain. Speak with your healthcare provider to learn more about any symptoms that you may have during treatment.

Common Tofranil side effects:

  • Increased blood pressure
  • Tingling, weakness, lack of coordination
  • Dry mouth, nausea, vomiting
  • Swollen breasts

Serious Side Effects

Some more serious adverse effects may occur during treatment with Tofranil. Contact your healthcare provider right away if you notice any of the following symptoms:

  • Easy bruising, unusual bleeding
  • Red or purple spots under your skin
  • Tunnel vision, eye pain or swelling, seeing halos around lights
  • Feeling light-headed or faint
  • New or worsening chest pain, pounding heartbeats, fluttering in your chest
  • Sudden numbness or weakness
  • Problems with your vision, speech, or balance
  • Fever, sore throat
  • Confusion, hallucinations, unusual thoughts or behaviours
  • Painful or difficult urination
  • Seizures
  • jaundice

Allergic Reactions

Do not use Tofranil if you are allergic to imipramine or any of the other listed tablet ingredients. Stop using this antidepressant medication and call your healthcare provider right away if you develop any of the following signs of an allergic reaction:

  • Hives
  • Difficulty breathing
  • Swelling of your face, lips, tongue, or throat

Cautions

Antidepressant medications like Tofranil have been found to increase suicidal thoughts and actions in some children, adolescents, and young adults when first starting treatment. Monitor your behaviour and report any changes to your healthcare provider.

Do not take Tofranil if you have taken a monoamine oxidase inhibitor (MAOI) within the last 2 weeks. To avoid dangerous drug interactions, do not start either medication before two weeks have elapsed after your last dose.

Do not use this antidepressant medication if you have recently had a heart attack.

Tell your healthcare provider if you have taken a selective serotonin reuptake inhibitor in the last 5 weeks. This includes citalopram, escitalopram, fluoxetine, and other medications.

To ensure your safety when taking Tofranil, tell your healthcare provider if you have ever had any of the following:

  • Heart disease, stroke, or seizures
  • Bipolar disorder, schizophrenia, or another mental illness
  • Kidney or liver disease
  • Overactive thyroid
  • Narrow-angle glaucoma
  • Difficulties urinating

Tofranil has been known to cause the development of serotonin syndrome, a condition when you produce too much serotonin.

Tell your healthcare provider if you are pregnant or plan to become pregnant during treatment with Tofranil. It is unclear how this antidepressant may affect an unborn baby.

Do not breastfeed while taking Tofranil.

Avoid drinking alcohol during treatment with Tofranil because it can cause an increase in adverse reactions to develop.

Avoid driving or performing hazardous tasks until you know how this medication will affect you; Tofranil may impair your thinking or reactions.

Some drugs may interact with Tofranil and cause unwanted side effects. Tell your healthcare provider about all the medicines you take, including over the counter medications, but especially any of the following:

  • Sleeping pills
  • Narcotic pain medications
  • Muscle relaxants
  • Other medications for anxiety, depression, or seizures
  • MAO inhibitors
  • Selective serotonin reuptake inhibitors
  • Serotonergic medicines (lithium, opioids, and others)
  • Medications that prolong QT intervals
  • Thioridazine
  • Barbiturates, benzodiazepines, or general anaesthetics
  • Terbinafine
  • Antihypertensive medications
  • Anticoagulant medicines
  • Quinidine antiarrhythmic drugs
  • Cimetidine, methylphenidate
  • Calcium channel blockers

Do not administer Tofranil to any child without medical advice.

Tofranil is not an approved treatment for depression in anyone under the age of 18 and should not be given to treat enuresis in any child under the age of 6.

Form and Strength

This antidepressant medication is available in tablet form.

Tofranil tablet strengths:

  • 10mg
  • 25mg
  • 50mg
  • 75mg

All Tofranil tablet strengths are available in quantities of 100.

FAQ

What to avoid when taking Tofranil?

You should avoid drinking alcohol during treatment with Tofranil because it can increase the side effects that you experience. Tofranil may also impair your thinking or reactions so you should avoid driving or performing dangerous activities until you know how this medication affects you. Follow all directions provided by your healthcare provider for the best results.

Can Tofranil be stopped abruptly?

You should not suddenly stop taking Tofranil because doing so could cause a relapse in your condition as well as withdrawal symptoms. Use this medication exactly as prescribed by your healthcare provider and gradually reduce your doses to safely stop taking Tofranil. If using this medication to treat bed-wetting, it is important to taper doses because if not relapses may not respond to this treatment.

Resources:

  1. https://www.drugs.com/mtm/tofranil.html
  2. https://dailymed.nlm.nih.gov/dailymed/medguide.cfm?setid=e6aba45c-9e3c-4d14-82ce-fda3ba771fe1
  3. https://www.medsafe.govt.nz/profs/datasheet/t/Tofraniltab.pdf
  4. https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=e6aba45c-9e3c-4d14-82ce-fda3ba771fe1&type=display

Additional information

Brand Name:

Tofranil

Scientific Name:

Imipramine

Other Names:

Imipramine, Tofranil

Strength(s):

10mg, 25mg, 50mg, 75mg

Quantities Available:

100, 200

Formulation:

Coated Tablet, Tablet