| PINOR
Imipramine
Description:
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. The relative activity
of Imipramine at the noradrenergic and 5-HT reuptake site is
7:3. The active metabolite of Imipramine (Desmethyl Imipramine)
is considerably less potent as an inhibitor of 5-HT reuptake
than of norepinephrine reuptake. Imipramine is a competitive
antagonist at α-adrenoceptors but the effects are relatively
weak.
Composition:
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 30-50mg daily;
child not recommended for depression. Nocturnal enuresis: Child:
7 years, 25 mg; 8-11 years 20-50 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.
Contraindications:
Recent myocardial infarction, arrhythmias (particularly
heart block), not indicated in manic phase, severe liver disease.
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).
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.
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.
Warnings:
Drowsiness may affect performances of skilled
tasks (e.g. driving), alcohol induced Imipramine effect.
Overdosage:
The signs and symptoms of overdose are similar
to those reported with other tricyclic antidepressants. Cardiac
abnormalities and neurological disturbances are the main complications.
Treatment is symptomatic and supportive.
Packing:
Each box contains 5X10’s tablets in blister pack. |
