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Action/Kinetics:
Moderate anticholinergic and sedative effects; high orthostatic hypotensive effects. Biotransformed into its active metabolite, desmethylimipramine (desipramine).
Effective plasma level of imipramine and desmethylimipramine: 200-350 ng/mL.
t
1/2: 11-25 hr.
Time to reach steady state: 2-5 days.
Uses:
Symptoms of depression; endogenous depression is more likely to be helped. Enuresis in children 6 years or older.
Additional Side Effects:
High therapeutic dosage may increase frequency of seizures in epileptic clients and cause seizures in nonepileptic clients. Elderly and adolescent clients may have low tolerance to the drug.
Laboratory Test Alterations:
Metanephrine (Pisano test);
Urinary 5-HIAA.
Additional Drug Interactions:
Possible
imipramine plasma levels when taken with St. John's wort; R/T
metabolism
How Supplied:
Imipramine hydrochloride:
Tablet: 10 mg, 25 mg, 50 mg.
Imipramine pamoate:
Capsule: 75 mg, 100 mg, 125 mg, 150 mg
Dosage
?Tablets, Capsules
Depression.
Hospitalized clients: 50 mg b.i.d.-t.i.d. Can be increased by 25 mg every few days up to 200 mg/day. After 2 weeks, dosage may be increased gradually to maximum of 250-300 mg/day at bedtime.
Outpatients, initial: 75 mg/day, increased to 150 mg/day. Maximum dose for outpatients is 200 mg. Decrease when feasible to maintenance dosage: 50-150 mg/day at bedtime.
Adolescent and geriatric clients, initial: 30-40 mg/day up to maximum of 100 mg/day.
Childhood enuresis.
Age 6 years and over: 25 mg/day 1 hr before bedtime. If satisfactory effect is not seen in 1 week, increase dose to 50 mg/day up to 12 years of age and to 75 mg/day in children over 12 years of age. Dose should not exceed 2.5 mg/kg/day.
