Anyone considering the use of imipramine hydrochloride or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. The risk appears to be greater with amoxapine and the tertiary amines (amitriptyline, doxepin, imipramine, trimipramine) than with the secondary amines (desipramine, nortriptyline, protriptyline). Taking imipramine together with medicines used during surgery may increase the risk of side effects. , imipramine and amitriptyline), mirtazapine, oral selegiline or other MAOIs (e. However, although imipramine partially inhibited the CYP2D6-mediated metabolism of venlafaxine, resulting in higher plasma concentrations of venlafaxine and lower plasma concentrations of ODV, the total concentration of active compounds (venlafaxine plus ODV) was not affected. However, elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require an adjustment in the dose for patients receiving imipramine. Check with your doctor right away if you start having a fever or sore throat while taking imipramine. , imipramine and amitriptyline); bupropion hydrochloride; meperidine and analgesic agents such as tramadol, methadone, and propoxyphene; the antitussive agent dextromethorphan; St. The following information includes only the average doses of imipramine. Make sure you know how you react to imipramine before you drive, use machines, or do anything else that could be dangerous if you are drowsy or not alert. In one case report, plasma levels of imipramine and its metabolite, desipramine, increased approximately fourfold in a 64-year-old woman following the addition of bupropion 225 mg/day. Similarly, a 62-year-old woman with no history of seizures developed a generalized tonic-clonic seizure in association with toxic trimipramine plasma levels following the addition of bupropion. Imipramine appears to have the greatest propensity to induce these effects, while secondary amines such as nortriptyline may do so less frequently. Imipramine did not affect the pharmacokinetics of venlafaxine and ODV. Tertiary amines such as amitriptyline and trimipramine tend to exhibit greater anticholinergic effects than other agents in the class. Check with your doctor before taking any of the above while you are using imipramine. Several-fold increases in the effects of norepinephrine and, to a lesser extent, epinephrine and phenylephrine were reported in healthy subjects pretreated with desipramine, imipramine, or nortriptyline. Primary Nocturnal Enuresisnortriptyline, imipramine, desmopressin, Pamelor, DDAVP, Aventyl Hydrochloride, More. Imipramine hydrochloride is not approved for use in pediatric patients. Plasma levels of desipramine were increased twofold more than the imipramine levels, which is consistent with the fact that desipramine is primarily metabolized by CYP450 2D6 while imipramine is also metabolized by other CYP450 isoenzymes. Various TCAs have been implicated including amitriptyline, desipramine, imipramine, nortriptyline, and protriptyline. 6% has been reported in patients treated with imipramine dosages > 200 mg/day. If used together, your doctor may change the dose or how often you use imipramine, or give you special instructions about the use of food, alcohol, or tobacco.
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