Medical Editor: John P. Cunha, DO, FACOEP
What Is Tofranil?
Tofranil (imipramine hydrochloride) is a tricyclic antidepressant used to treat symptoms of depression. Tofranil is available in generic form.
What Are Side Effects of Tofranil?
Common side effects of Tofranil include:
- dry mouth,
- blurred vision,
- headache,
- drowsiness,
- dizziness,
- constipation,
- nausea,
- vomiting,
- loss of appetite,
- diarrhea,
- stomach cramps,
- weight gain/loss,
- increased sweating,
- tingly feeling,
- weakness,
- lack of coordination,
- ringing in your ears,
- breast swelling (in men or women),
- decreased sex drive,
- impotence, or
- difficulty having an orgasm.
You may have suicidal thoughts while taking Tofranil, especially if you are younger than 24 years old. Tell your doctor if this occurs. Tell your doctor if you experience rare but very serious side effects of Tofranil including:
- easy bruising or bleeding,
- signs of infection (e.g., fever, persistent sore throat),
- severe stomach or abdominal pain,
- dark urine,
- yellowing of eyes or skin,
- feeling like you might pass out,
- new or worsening chest pain,
- pounding heartbeats or fluttering in your chest,
- sudden numbness or weakness,
- problems with vision, speech, or balance,
- fever,
- sore throat,
- unusual bleeding (nose, mouth, vagina, or rectum),
- purple or red pinpoint spots under your skin,
- confusion, hallucinations, unusual thoughts or behavior,
- painful or difficult urination, or
- seizures (convulsions).
Dosage for Tofranil
For outpatient adults, the initial dose of Tofranil is 75 mg/day, increased to 150 mg/day. Dosages over 200 mg/day are not recommended. Dose may vary for adolescent, geriatric, childhood, or hospitalized patients.
What Drugs, Substances, or Supplements Interact with Tofranil?
Tofranil may interact with SSRI antidepressants, cimetidine, clonidine, guanethidine, methylphenidate, or heart rhythm medications. Many other medications can interact with Tofranil. Tell your doctor all medications you use.
Tofranil During Pregnancy and Breastfeeding
Tofranil should be used only when prescribed during pregnancy. Infants born to mothers who have taken similar medications during pregnancy may have trouble urinating, prolonged sleepiness, shaking, and seizures. Consult your doctor. This medication passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breastfeeding.
Additional Information
Our Tofranil (imipramine hydrochloride) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
SLIDESHOW
Learn to Spot Depression: Symptoms, Warning Signs, Medication See SlideshowGet emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.
Call your doctor at once if you have:
- easy bruising, unusual bleeding, purple or red spots under your skin;
- tunnel vision, eye pain or swelling, or seeing halos around lights;
- a light-headed feeling, like you might pass out;
- new or worsening chest pain, pounding heartbeats or fluttering in your chest;
- sudden numbness or weakness, problems with vision, speech, or balance;
- fever, sore throat;
- confusion, hallucinations, unusual thoughts or behavior;
- painful or difficult urination;
- seizure (convulsions); or
- jaundice (yellowing of the skin or eyes).
Common side effects may include:
- increased blood pressure;
- tingly feeling, weakness, lack of coordination;
- dry mouth, nausea, vomiting; or
- breast swelling (in men or women).
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
QUESTION
Depression is a(n) __________ . See AnswerSIDE EFFECTS
Note – Although the listing which follows includes a few adverse reactions which have not been reported with this specific drug, the pharmacological similarities among the tricyclic antidepressant drugs require that each of the reactions be considered when Tofranil is administered.
Cardiovascular: Orthostatic hypotension, hypertension, tachycardia, palpitation, myocardial infarction, arrhythmias, heart block, ECG changes, precipitation of congestive heart failure, stroke.
Psychiatric: Confusional states (especially in the elderly) with hallucinations, disorientation, delusions; anxiety, restlessness, agitation; insomnia and nightmares; hypomania; exacerbation of psychosis.
Neurological: Numbness, tingling, paresthesias of extremities; incoordination, ataxia, tremors; peripheral neuropathy; extrapyramidal symptoms; seizures, alterations in EEG patterns; tinnitus.
Anticholinergic: Dry mouth, and, rarely, associated sublingual adenitis; blurred vision, disturbances of accommodation, mydriasis; constipation, paralytic ileus; urinary retention, delayed micturition, dilation of the urinary tract.
Allergic: Skin rash, petechiae, urticaria, itching, photosensitization; edema (general or of face and tongue); drug fever; cross-sensitivity with desipramine.
Hematologic: Bone marrow depression including agranulocytosis; eosinophilia; purpura; thrombocytopenia.
Gastrointestinal: Nausea and vomiting, anorexia, epigastric distress, diarrhea; peculiar taste, stomatitis, abdominal cramps, black tongue.
Endocrine: Gynecomastia in the male; breast enlargement and galactorrhea in the female; increased or decreased libido, impotence; testicular swelling; elevation or depression of blood sugar levels; inappropriate antidiuretic hormone (ADH) secretion syndrome.
Other: Jaundice (simulating obstructive); altered liver function; weight gain or loss; perspiration; flushing; urinary frequency; drowsiness, dizziness, weakness and fatigue; headache; parotid swelling; alopecia; proneness to falling.
Withdrawal Symptoms: Though not indicative of addiction, abrupt cessation of treatment after prolonged therapy may produce nausea, headache, and malaise.
Note – In enuretic children treated with Tofranil the most common adverse reactions have been nervousness, sleep disorders, tiredness, and mild gastrointestinal disturbances. These usually disappear during continued drug administration or when dosage is decreased. Other reactions which have been reported include constipation, convulsions, anxiety, emotional instability, syncope, and collapse. All of the adverse effects reported with adult use should be considered.
Read the entire FDA prescribing information for Tofranil (Imipramine)
© Tofranil Patient Information is supplied by Cerner Multum, Inc. and Tofranil Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.
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