Imipramine tablets and liquid medicine

About imipramine

Imipramine belongs to a group of medicines called tricyclic antidepressants. It is generally prescribed for the treatment of depression in adults. It is also used to treat night-time bedwetting in children, which is a completely unrelated condition to depression.

The exact cause of depression is not known. It can develop for no apparent reason, or it may be triggered by a life event such as a relationship problem, bereavement, or illness. People with depression have a consistently low mood and other symptoms severe enough to interfere with normal day-to-day activities. Medicines like imipramine can help to ease the symptoms caused by depression, such as sleep disturbance and a loss of appetite. Imipramine is thought to work by interfering with certain brain chemicals (called neurotransmitters) which may be involved in causing the symptoms of depression.

Night-time bedwetting is common in children, particularly in young children. It often responds to reassurance and advice about drinking and toileting. For an older child, treatment with a medicine like imipramine is sometimes also needed. Imipramine will be prescribed by a doctor specialising in the care of children with this problem. It is not suitable for children under 6 years of age.

Before taking imipramine

Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you (or if appropriate, your child) start taking imipramine it is important that your doctor knows:

• If you are pregnant or breastfeeding.

• If you have any problems with the way your liver works, or if you have any problems with the way your kidneys work.

• If you have any of the following conditions: epilepsy, diabetes, increased pressure in your eye (glaucoma), an overactive thyroid gland, or a heart condition.

• If you have had problems with constipation.

• If you have any difficulties passing urine, or if you have had prostate trouble.

• If you have ever had a mental health problem (in particular, bipolar disorder or psychosis).

• If you have either of the following rare conditions: a tumour on your adrenal gland, called phaeochromocytoma, or an inherited blood disorder called porphyria.

• If you are taking any other medicines. This includes any medicines which are available to buy without a prescription, as well as herbal and complementary medicines. It is especially important that you tell your doctor if you have recently taken a medicine for depression, known as a monoamine-oxidase inhibitor (MAOI).

• If you have ever had an allergic reaction to a medicine.

How to take imipramine

• Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about imipramine and will provide you with a full list of the side-effects which you could experience from taking it.

• It is usual to take imipramine once a day, at bedtime. Some doctors, however, may recommend smaller doses taken two or three times a day, for depression. Your doctor will tell you which is right for you and your dose will also be on the label of the pack to remind you.

• You can take imipramine either with or without food.

Getting the most from your treatment

• Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.

• If you buy any medicines 'over the counter', check with a pharmacist that they are suitable to take with imipramine. This is because a number of medicines can increase the risk of side-effects from imipramine, including some strong painkillers, flu remedies and antihistamines which can be bought from pharmacies.

• If you have diabetes you may need to check your blood sugar (glucose) more frequently. This is because imipramine may affect the levels of sugar in your blood. Your doctor will advise you about this.

• If you are due to have any medical treatment, tell the person carrying out the treatment that you are taking imipramine, as it can interfere with some anaesthetics.

• A few people who take imipramine find that their skin becomes more sensitive to sunlight than usual. Try to avoid strong sunlight until you know how your skin reacts, or use a sun cream with a high sun protection factor. Do not use sunbeds.

• If you suspect that someone (especially if it is a child) might have taken imipramine by accident, go to the accident and emergency department of your local hospital straightaway. This is very important because imipramine can cause serious problems when it is taken accidentally or in overdose. Take the container with you to show what has been taken, even if the pack is now empty.

If it's for depression

• Take imipramine exactly as your doctor tells you to. It can cause drowsiness so your doctor may advise you to take a small dose to begin with, and then that you gradually increase it as your body becomes used to the medicine.

• When you start taking imipramine for depression, you may feel that it is not working for you straightaway. It can take a week or two for the effect to build up and 4-6 weeks before you feel the full benefit. It is important that you do not stop taking it thinking it is not helping. Also, while you feel depressed, you may have distressing thoughts, and think about harming yourself or ending your life. If this happens, it is very important that you tell your doctor about it straightaway.

• There are several types of antidepressants - each type works in a slightly different way and can have different side-effects. If you find that imipramine does not suit you then let your doctor know, as another antidepressant may be found that does.

• Your doctor will recommend that you do not drink alcohol while you are on imipramine. This is because it increases the risk of side-effects, such as feeling sleepy.

• If you forget to take a dose, take it as soon as you remember (unless it is nearly time for your next dose, in which case leave out the missed dose and take the next dose as normal). Do not take two doses together to make up for a forgotten dose.

• Your doctor may ask you to carry on taking imipramine even after you feel better. This is to help stop your depression from returning. It is normal for a course of treatment to last for around six months after your symptoms have eased.

• Continue to take imipramine unless your doctor tells you otherwise. Stopping treatment suddenly can sometimes cause problems and your doctor may want you to reduce your dose gradually over a number of weeks when this becomes necessary.

If it's for bedwetting

• Check the label on the pack carefully to make sure you are giving the correct dose. The dose will depend upon your child's age. The medicine should be taken at bedtime.

• If you forget a dose, leave out the missed dose but make sure that you remember to give the next dose when it is due. Never give two doses together to make up for a forgotten dose.

• A course of treatment with imipramine is likely to last for no longer than three months. Towards the end of the course, your child's doctor will gradually reduce the dose so that the treatment isn't stopped abruptly. After this, the doctor will review your child's progress, and then continue the treatment only if it is necessary.

Can imipramine cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with imipramine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

If you experience any other symptoms which you think may be due to the medicine, speak with your doctor or pharmacist for further advice.

How to store imipramine

• Keep all medicines out of the reach and sight of children.

• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines