Using Imipramine during pregnancy or breastfeeding

While some drugs are safe for use during pregnancy or breastfeeding, many antidepressants aren’t safe. Pregnant women and breastfeeding mothers should check with their doctors before using any antidepressant during their pregnancy or breastfeeding.

Imipramine and pregnancy

The studies conducted on Imipramine and pregnancy says that the medication does not cause any defects when given to pregnant animals. Though there are some reports that claim, there are chances of birth defects in human pregnancy, when the drug is used during pregnancy. Since there are no adequate studies available, you can check with your doctor if taking Imipramine is safe for you and your unborn baby. The doctor can determine the risks and benefits of the medication and prescribe you the right dosage accordingly.

In pregnant women use of Imipramine pamoate and Imipramine hydrochloride is not safe. This is based on certain studies conducted on animals and the study reports a few cases of birth defects in humans.

If you are pregnant and using Imipramine let your doctor know about your pregnancy and if the medication is necessary, your doctor can examine your current medical condition and decide whether using Imipramine during pregnancy is safe for you and your baby.

Imipramine and breastfeeding

Imipramine is secreted in breast milk in low amounts. Mothers should use Imipramine with extra caution while breastfeeding. You can check with your doctor for the risks and benefits of using Imipramine while breastfeeding. The doctor will prescribe you the drug only if the benefits are higher than the risks to your baby.

Mothers can also discontinue breastfeeding for some time while they are using Imipramine. According to the studies, very less amount of Imipramine was found in blood of babies who were breastfed. Studies also show that there were no harmful effects seen on the development of babies who were breastfed by mothers using Imipramine.

Before using Imipramine, you should discuss with your doctor if you can use Imipramine as everyone’s medical condition is different and your doctor can examine you and based on your current medical condition, he can suggest you whether to use Imipramine or not.

Some reports say that using Imipramine while breastfeeding can lead to drowsiness in baby. In case you notice drowsiness or a lot of weight loss, talk to your paediatrician and he can monitor the blood levels of your baby. Even mothers can stop using drug to see if baby’s health comes back to normal.

The levels of Imipramine in breast milk are low, but if the drug is used for a long term, there are chances that it can affect your baby’s health. Some mothers prefer stopping the drug during breastfeeding while other prefers low doses of Imipramine. You can also check with your doctor if he can replace Imipramine with other alternative medicines to treat depression. This can help you manage depression without causing harm to your baby. It is better to monitor your baby closely while taking Imipramine during breastfeeding and call your doctor immediately in case you notice unusual symptoms in your baby.

Using Imipramine can also lead to side effects

Using Imipramine bring in some side effects that you should know about. These side effects can be treated or prevented easily if they are identified in its early stages. Your doctor can help you know how to prevent or reduce the side effects safely while you are on Imipramine.

Major side effects of Imipramine that need immediate medical help

  • blurred vision
  • dry mouth
  • stomach or abdominal pain
  • cold sweats
  • dark urine
  • double vision
  • hearing loss
  • irritability
  • hostility
  • lethargy
  • hyperventilation
  • nightmares
  • restlessness
  • slow speech
  • sore throat
  • trouble sleeping
  • unusual behaviour
  • agitation
  • crawling, numbness, burning, prickling, itching or tingling feeling
  • chest discomfort or chest pain
  • confusion about time, identity or place
  • dribbling
  • light-headedness, fainting or dizziness while rising from a lying or sitting position
  • false beliefs
  • irregular, fast or pounding pulse or heart beat
  • decrease in frequency of urination
  • continuing buzzing, ringing noise in ears
  • hoarseness or cough
  • hearing, seeing or feeling things that doesn’t exist
  • feeling that others are controlling your behaviour or watching you
  • fever with/without chills
  • dry, flushed skin
  • general feeling of weakness or tiredness
  • inability to move facial, arms and leg muscles
  • side pain or lower back pain
  • muscle spasms
  • muscle trembling
  • muscle stiffness
  • purple or pinpointed red spots on skin
  • redness of arms, neck or face
  • swelling of hands, ankles, legs or face
  • uncontrolled face, back and neck movements
  • weakness in feet, hands, arms or legs
  • yellow skin or eyes

Symptoms of Overdose

 

  • clammy or cold skin
  • disorientation
  • bluish colour of palms, nail beds, skin, lips and fingernails.
  • weak or fast pulse
  • troubled breathing
  • decreased responsiveness or awareness
  • severe sleepiness
  • hallucinations
  • slow, shallow, fast or irregular breathing

Minor Side effects

Some side effects do not need medical attention as they disappear with time. Once your body gets used to the medication minor side effects disappear on their own. But if these side effects continue for a long and bother you, speak to your doctor as you need immediate medical attention.

Occurrence not known

  • black tongue
  • peculiar taste
  • severe sunburn
  • dilated, bigger or enlarged pupils
  • decreased ability or interest in sexual intercourse
  • difficulty with bowel movement
  • welt or hives
  • increased urge or urinating at night
  • increased eye sensitivity to light
  • enlargement of breasts
  • increase in sexual drive, ability, desire or performance
  • discoloration or redness of skin
  • swollen testicles
  • breast soreness and swelling in both males and females
  • excess flow of milk from breasts
  • waking at night to urinate
  • painful, tender or swollen lymph glands on the side of neck or face

Make sure you know about these possible side effects and contact your health care provider in case you notice any unexpected symptoms.

 

 

Treating depression and bedwetting with Imipramine

Imipramine is normally used to treat depression. It is also helpful in reducing bedwetting in children. Imipramine is an antidepressant (tricyclic) and works by enhancing certain chemicals present in the brain that helps boost your mood.
The generic name is Imipramine and brand name is Tofranil. Avoid using Imipramine if
1. You are allergic to any of the ingredient present in Imipramine
2. You have used MAOIs or linezolid in last 14 days.
3. You are regaining health after a heart attack
Important Information
Some medical conditions can interact with Imipramine. Speak to your doctor if you have any medical conditions like
1. If you are pregnant or planning to get pregnant or a lactating mother.
2. If you are using any non-prescription/prescription medicine, dietary supplement or herbal preparation
3. If you have a history of alcohol addiction or you consume alcohol
4. If you take thyroid medicine or had overactive thyroid in the past or having glaucoma, liver or kidney problems, heart problems seizures, diabetes, porphyria or problems urinating.
5. If you have a history of bipolar disorder, suicidal behaviour or thoughts, mental disorder or undergoing electroshock treatment/or if any surgery is scheduled.
6. If you are using any medicine that consists of methylene blue.
Make sure you read the label carefully and follow the instructions. Use Imipramine orally without food or with food. Check with your doctor if you can take Imipramine during bedtime to reduce possible side effects. To get the desired results it can take 1-3 weeks. Continue using Imipramine even if you are feeling better and do not miss any of Imipramine doses. In case you miss a dose, take the missed dose as soon as it strikes you. If it is time for your next dose, then do not take the missed dose and get back to your normal dosing schedule. Do not take two doses at one time.
Do not take alcohol with Imipramine as it can lead to blurred vision, dizziness and drowsiness. Use Imipramine with extra caution. Do not perform the tasks that are unsafe like driving as it needs extra alertness.
Discuss with your doctor before you consume alcohol or any other medicines with Imipramine.
Serotonnin syndrome is caused due to consumption of Imipramine. The risk is higher if you use Imipramine with other drugs like MAOIs and triptans. Symptoms include coma, hallucination, fever, confusion, tremor, irregular heartbeat, nausea, vomiting and excessive sweating.
Young adults, teenagers and children who use Imipramine are at higher risk of developing suicidal actions or thoughts. This can even be worse if the patient has a history of suicidal actions or thoughts. Get in touch with your health care provider if you notice worsened, new or sudden symptoms like restless, panic attacks, irritable behaviour, depressed moods, and unusual mood fluctuations.
Imipramine also makes you suffer from sunburns easily so avoid, sunlamps, sun or tanning booths till the time you know how your body responds to Imipramine.
Is Imipramine addictive?
It is not addictive. But once the treatment is stopped after a long period can lead to malaise, nausea and headache.

Imipramine dosage for depression and bedwetting (in children)

Imipramine is used to treat depression and bedwetting problems in children. Let us understand the dosage of Imipramine for both these problems.
Depression
Lowest possible dosagesare recommended for adolescents and elderly patients. Lower dosages are also prescribed to patients who are not hospitalized as compared to those who are hospitalized and are under constant supervision. Initial Dosage should be low with a gradual increase in the dosage, depending upon the patient’s tolerance to the drug and clinical response. Following suspens ion and maintenance, medication might be needed for a prolonged period with the lowest dose that will maintain suspension.
Normal Adult Dose- For hospitalized patients
Initial dose – 100mg/daily in split doses, which can be slowly increased to 200mg/daily as needed. If there is no response even after two weeks, increase the dosage to 250-300/mg/daily.
For patients who are not hospitalized
Initial dose – 75mg/daily in split doses, which can be slowly increased to 150mg/daily
Dosages above 200mg/day are not suggested.
Maintenance dose: 50-150/mg/day
Geriatric patients and Adolescents
Initial dose: 30-40mg/day. It is not necessary to increase the dosage to 100mg/day
Childhood Bedwetting
Initial Dose: Oral dose of 25mg/day can be given as a part of trial in children aged 6 years and above. Medication should be taken one hour before going to bed. If the child doesn’t respond satisfactorily within 1 week, the dosage can be increased to 50mg to be taken at night in children below 12 years and can receive up to 75 mg during night.
A dosage of 75 mg prescribed on a daily basis will not enhance the efficacy, but can lead to side effects. Evidences say that the drug is more effective in children who wet their bed early night if the drug is given earlier in split amounts that is 25mg during mid afternoon and repeated during bedtime.
The Dosage should be decreased slowly than discontinuing it suddenly as this can lead to failure of drug treatment.
A daily dose of 2.5mg/kg per day should not be increased.

People aged 65 and above shouldn’t take a dose of Imipramine that exceeds 100mg/day. Taking higher doses can lead to loss of balance, confusion, bladder problems and chances of falling in patients aged 65 or above.
If your doctor suggests you Imipramine for pain management he will suggest you the right dosage based on weight or other factors. Still you should avoid taking Imipramine dose of more than 300mg/day

Make sure you check with your doctor before you start using Imipramine for depression, pain management or bedwetting problems in children. Your doctor can determine the right dosage based on your current medical condition and other medications that you are using.
Do not expect instant results after you take Imipramine as it takes nearly 1-3 weeks to get desired results. Follow the dosing instructions carefully and in case you have any concerns or doubts speak to your doctor immediately. Do not take extra dose to make up for the missed dose. In case you notice any unusual symptoms, speak to your doctor immediately.

Drug Interactions that can reverse the effects of Imipramine

Combination of some medicines should not be used, in other cases two medications can be used together even if there are chances of interactions, but with some precautions. In such cases your doctor might change the dose or suggest you some other precautions, which are essential. When you are using Imipramine with other medications, then let you doctor know the list of medicines you are using currently.

Below is the list of some medicines that can interact with Imipramine. You doctor may decide on whether you should use this medication or change the current medicines you are using

  • Cisapride
  • Metoclopramide
  • Linezolid
  • Levomethadyl
  • Grepafloxacin
  • Dronedarone
  • Cisapride
  • Procarbazine
  • Safinamide
  • Ranolazine
  • Ziprasidone
  • Terfenadine
  • Saquinavir

Other Interactions

Some medications should not be taken at the time of eating or eating some specific foods as interaction can occur. Using tobacco or alcohol with some specific medications can lead to interactions.

 

Using Imipramine with tobacco or alcohol is not recommended as it can lead to some side effects. In some cases it is unavoidable so your doctor can change frequency or dose of the medication and give you special instructions about use of alcohol, tobacco or certain food items.

Imipramine and hepatic enzyme inhibitors

In case of Imipramine its plasma concentration can increase when Imipramine is used in combination with hepatic enzyme inhibitors like fluoxetine or cimetidine and can decrease if used with hepatic enzyme inducers like phenytoin, barbiturates. In such cases dosage adjustments for Imipramine is necessary.

Imipramine  and Anticholinergic drugs

When Imipramine and anticholinergic drugs are taken together, the atropine effects become stronger. Careful dosage adjustment and close supervision is needed.

Imipramine and MAOIs

Using Imipramine and MAOIs can lead to severe drug interaction. Avoid using MAO Inhibitor like, linezolid phenelzine, procarbazine, selegiline, tranylcypromine, moclobemide,isocarboxazid, selegiline,methylene blue, rasagiline during Imipramine treatment. Most MAOIs should be avoided for at least 2 weeks prior and post Imipramine treatment.

The medications that influence the Imipramine removal from your body and can also affect how Imipramine works for you are alcohol, some specific drugs for heart rhythm like propafenone, flecainide etc., barbiturates, HIV protease inhibitors, antiseizure drugs, trazodone, terbinafine.

theophylline,iIoniazid (INH) tramadol can increase the risk of seizures when combined with Imipramine.

Imipramine is quite similar to desipramine so do not use medications that comprise of desipramine while you are taking Imipramine.

Cigarette smoking reduces blood levels of Imipramine, so let your doctor know if you smoke or stopped smoking recently.

You should also check the label on certain medicines you buy for cold, cough as they contain ingredients that cause drowsiness or decongestants that can increase your blood pressure or heart rate. Ask your doctor how to use these drugs safely.

Also speak to your doctor if you are taking anti-anxiety medications, anti-seizure medications or medication for motion sickness.

You should help your doctor know about all other medicines you are using to know the possible drug interactions. Do make a list of additional medications before you visit your doctor.

Knowing about Antidepressants – Imipramine

The medication is basically used to treat depression. It is used for treating bed-time during night time in children along with other therapies as well. This medication used for depression improves appetite, sleep, mood, energy level and help you take interest in your daily life. It also helps your children control bed wetting during night.

Usage

You can take the medication orally with food or without food, normally 1-4 times per day as advised by the doctor. You dosage solely depends on your medical condition. In children, the dosage is based on body weight of the child. When you use Imipramine for bed wetting problem in children, the medication needs to be taken an hour prior going to bed.

You need to follow the instructions of your doctor carefully to get maximum benefit of the drug. If you do not take the right dose, you might not see results instead you will increase the risk of getting side effects. The medication doesn’t work right from the time you start taking it. It takes about 3 weeks before you could see the expected results, if you are using it to treat depression.

For bedwetting problem in children, this medication might not work better, and need different dosing; in that case you need to speak to your doctor.

Side Effects- Imipramine

Blurred vision, headache, drowsiness, dry mouth, nausea, constipation, dizziness, appetite loss, vomiting, weight loss/gain, increased sweating, diarrhea and stomach cramps.

There are some serious side effects associated with the use of Imipramine. In case you notice such side effects, ask for medical help immediately. They are depression, unusual milk production in breasts, restlessness, sexual problems, painful breasts, painful periods (menstrual), ringing sound in ears, muscle stiffness, tremors, tingling of feet, hands, swollenness legs and arms and urinating problems.

Some of the side effects which are rare are: severe abdominal pain, infection signs, bleeding, easy bruising, dark urine, yellow skin/eyes. Some people also experience allergic reaction like swelling of throat, face or tongue, itching, rash, breathing trouble.

Precautions

You should not use this medication if you have any medical condition. In order to be safe, speak to the doctor before you start using the medication. Discuss with your doctor if you have breathing problems, glaucoma in family history, diabetes, heart problems, liver or kidney problems

Also speak to your doctor if

  1. You are pregnant, nursing mother or planning pregnancy.
  2. If you are using medicine for thyroid problems.
  3. If you consume alcohol or suffer from alcohol abuse
  4. If you are using medicine that contains ethylene blue
  5. If you are allergic to some substances, food or medicines.
  6. If you have bipolar disorder, or about to have surgery.
  7. If you are using any herbal or dietary supplement or taking non prescription or prescription drugs.

Also people suffering with diabetes should keep a check on their blood sugar levels. Extreme caution is needed when the medication is used for children. To avoid side effects it is always better to follow doctor’s instructions carefully.