Imipramine Hydrochloride

What side effects are possible with this medication?

A side effect is an unwanted response to a medication when it is taken in normal doses. It can be mild or severe, temporary or permanent, but does not occur in everyone. The following side effects have been reported by at least 1% of people taking this medication. If you develop any of these side effects (or any other side effects not listed here) or they change in intensity, speak to your doctor or pharmacist for advice on managing them and on the risks and benefits of the medication.

blurred vision confusion or delirium constipation decreased sexual drive or ability diarrhea difficulty urinating dizziness drowsiness dry mouth fast or irregular heartbeat

headache heartburn increased or decreased appetite increased sweating nausea sleepiness tiredness or weakness trouble sleeping unpleasant taste vomiting weight gain or loss

Click here to learn about serious side effects that can potentially occur with any medication. These examples are provided for information purposes only and are not meant to be exhaustive. Always consult your doctor for sound medical advice specific to your particular medication and treatment.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online or by phone at 1-800-332-1088.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Alcohol: Avoid drinking alcohol while taking imipramine. Alcohol may exaggerate the effects of this medication.

Diabetes: Both elevation and lowering of blood sugar levels have been reported with imipramine use. If you have diabetes or hypoglycemia (low blood sugar), monitor your blood glucose levels closely while taking this medication.

Exposure to sunlight: With excessive exposure to sunlight, imipramine can make your skin more prone to burning.

Heart rhythm: Imipramine can cause abnormal heart rhythms, particularly when taken in high doses. Therefore, seniors and those with a history of heart disease should discuss with their doctor how this medication may affect their medical condition, how their medical condition or medications may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Medical conditions: Imipramine should be used with caution if you have a history of seizures, reduced liver function, reduced kidney function, heart conditions, glaucoma, thyroid disease, a history of mania or bipolar disorder, or if you have a history of difficulty urinating or cardiovascular disease. People undergoing electroconvulsive therapy (ECT) should not receive imipramine unless the benefits outweigh the risks.

Reduced alertness: Imipramine may impair the mental alertness or physical abilities required for performing daily activities. Be careful and avoid driving a car or operating machinery while taking this medication.

Suicidal thoughts or actions: Antidepressant medications, including imipramine may increase suicidal thoughts or actions in some children, teenagers, and young adults within the first few months of treatment. Depression and other serious mental illnesses are the most important causes of suicidal thoughts and actions. Some people may have a particularly high risk of having suicidal thoughts or actions. These include people who have (or have a family history of) bipolar illness (also called manic-depressive illness) or suicidal thoughts or actions.

Pay close attention to any changes, especially sudden changes, in mood, behaviors, thoughts, or feelings. This is very important when an antidepressant medication is started or when the dose is changed. Call your doctor right away to report new or sudden changes in mood, behavior, thoughts, or feelings. Keep all follow-up visits with your doctor as scheduled. Call your doctor between visits as needed, especially if you have concerns about symptoms.

Call your doctor right away if you or your family member has any of the following symptoms, especially if they are new, worse, or worry you:

• acting aggressive
• acting on dangerous impulses
• an extreme increase in activity and talking (mania)
• attempts to commit suicide
• being angry or violent
• feeling very agitated or restless
• new or worse anxiety
• new or worse depression
• new or worse irritability
• panic attacks
• other unusual changes in behavior or mood
• thoughts about suicide or dying
• trouble sleeping (insomnia)

Signs of fever and sore throat: Notify your doctor if you develop a fever and sore throat while on imipramine. Your doctor may want to perform some lab tests to ensure your blood cell counts are in a normal range.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking imipramine, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of this medication have not been established for children under 6 years of age.

Seniors: Use of this medication has not been well studied in people over the age of 65.

What other drugs could interact with this medication?

There may be an interaction between imipramine and any of the following:

alcohol anticholinergic medications (e.g., benztropine) barbiturates (e.g., secobarbital) carbamazepine cimetidine clonidine decongestants (e.g., pseudoephedrine) divalproex sodium, valproic acid flecainide MAO inhibitors (e.g., selegiline, tranylcypromine) methylphenidate

other antidepressants phenothiazines (e.g., chlorpromazine, thioridazine) phenytoin propafenone quinidine selective serotonin reuptake inhibitors (SSRIs; e.g., sertraline, fluoxetine, fluvoxamine, paroxetine) sympathomimetics (e.g., epinephrine, norepinephrine) thyroid medications (e.g., levothyroxine)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.