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| Drug class description : | Tricyclic antidepressants (TCADs) . |
| Generic Name : | Generic |
| Drug description : | Tablets. |
| Presentation : | Tablets, coated, imipramine hydrochloride 10 mg , 25 mg . Available from Cox, Cross-Pharma (25mg only), Hillcross, Regent. |
| Indications : | Depressive illness. |
| Adult Dosage : | Initially, 25mg up to three times Initially, 25mg up to three times daily, increasing to 150-200mg by the end of the first week of therapy. Usual maintenance dose, 50-100mg daily. Hospitalised patients, dose may be increased to 100mg three times daily; usual maintenance dose 100mg daily. |
| Elderly Dosage : | Initially, 10mg daily, increasing to 30-50mg daily. |
| Contra Indications : | Acute myocardial infarction, heart block, disorders of cardiac rhythm, coronary insufficiency, severe liver disease, mania. Pregnancy and lactation. |
| Special Precautions : | Cardiovascular disease, liver disorders, hyperthyroidism, tumours of adrenal medulla, epilepsy, diabetes, glaucoma, urinary retention, constipation, renal disease. Monitor cardiac and hepatic function during long term therapy. Psychoses, patients with suicidal tendencies. Reduce doses for the elderly. |
| Interactions : | With or within 21 days of MAOIs. Carbamazepine, phenytoin, neuroleptics. Barbiturates, other antidepressants, alcohol, anticholinergics, local anaesthetics containing adrenaline (epinephrine) or noradrenaline (norepinephrine), cimetidine, oestrogens, quinidine, antihypertensives. |
| Adverse Reactions : | Anticholinergic effects such as dry mouth, constipation, urinary retention, blurred vision and changes in accommodation, palpitations and tachycardia. Tinnitus, drowsiness, nervousness or insomnia. Tremor, orthostatic hypotension, dizziness, sweating, weakness and fatigue, ataxia, epileptiform seizures, occasional extrapyramidal symptoms and gastric irritation. Weight loss or gain. Allergic skin reactions, jaundice and blood disorders (test blood regularly). Conduction defects and cardiac arrhythmias. Endocrine effects such as changes in libido, impotence, gynaecomastia and galactorrhoea. Changes in blood patients may switch over into mania and schizophrenic symptoms activated, especially in the elderly. Withdrawal symptoms. |
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