Pharm
Imipramine
search
Imipramine
, Tofranil
Indications
Panic Disorder
Pediatric
Major Depression
Attention Deficit Hyperactivity Disorder
Nocturnal Enuresis
(not first line agent)
Dosing
Gene
ral
Adult: 25-50 mg PO qhs
Dosing
Nocturnal Enuresis
in children
Consider other measures for
Nocturnal Enuresis
first
Consider baseline EKG before starting medication
Initial dose
Age 6-8 years: 25 mg PO one hour before bedtime
Age 8-12 years: 50 mg PO one hour before bedtime
Age over 12 years: 75 mg PO one hour before bedtime
Maximum dosing: up to 0.9 to 1.5 mg/kg
Discontinue after 3-6 months (some guidelines suggest maximum of 3 months)
Taper to one half dose nightly for 2 weeks
Taper to one half dose every other night for 2 weeks
Efficacy
Nocturnal Enuresis
Response in up to 60% of children
Relapse is common soon after stopping medication
Pharmacokinetics
Obtain serum levels in pediatric population
Avoid as full dose
Antidepressant
Serum Half Life: 11 to 25 hours
Therapeutic plasma level: 200 to 350
Adverse effects
See
Tricyclic Antidepressant
s
Significant adverse effects
Anticholinergic Symptoms
Drowsiness
Sleep
problems
Gastrointestinal upset
Orthostatic Hypotension
Cardiac Arrhythmia
Weight gain
Precautions
See
Tricyclic Antidepressant
s
Serious cardiotoxicity in overdosage
References
Thiedke (2003) Am Fam Physician 67:1499-510 [PubMed]
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