Drug Name
Tofranil (Imipramine)

Drug Uses
Tofranil is used for treating depression. It is also used in some children to help reduce bedwetting. It may also be used for other conditions as determined by your doctor.

How to use
Use Tofranil as directed by your doctor. Check the label on the medicine for exact dosing instructions.
Tofranil comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Tofranil refilled.
Take Tofranil by mouth with or without food.
Taking Tofranil at bedtime may help reduce side effects (eg, daytime drowsiness). Discuss this possibility with your doctor. It may take 1 to 3 weeks before you notice the effect of Tofranil . Continue to use Tofranil even if you feel well. Do not miss any doses.

Drug Class and Mechanism
Tofranil is a tricyclic antidepressant. It works by increasing the activity of certain chemicals in the brain that help elevate mood.

Missed Dose
If you miss a dose of Tofranil , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. If you take 1 dose daily at bedtime, do not take the missed dose the next morning.

Storage
Store Tofranil at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Keep Tofranil out of the reach of children and away from pets.

Warnings/Precautions
Do not use Tofranil if:

• you are allergic to any ingredient in Tofranil;
• you have taken furazolidone or a monoamine oxidase inhibitor (MAOI) (e.g., phenelzine) within the last 14 days, or if you are taking astemizole, droperidol, or terfenadine.
• you are recovering from a recent heart attack.

Contact your doctor or health care provider right away if any of these apply to you.

Some medical conditions may interact with Tofranil . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you drink alcohol-containing beverages daily or you have a history of alcohol abuse
• if you take thyroid medicine or you have a history of overactive thyroid, glaucoma, heart problems, kidney or liver problems, diabetes, seizures, the blood disease porphyria, or difficulty urinating
• if you have a history of suicidal thoughts or behavior, bipolar disorder, or any other mental disorders; you are undergoing electroshock therapy; or you are scheduled to have any surgery.

Some MEDICINES MAY INTERACT with Tofranil . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Azole antifungals (eg, fluconazole), cimetidine, duloxetine, flecainide, methylphenidate, mibefradil, phenothiazines (eg, chlorpromazine), propafenone, quinidine, selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine), or terbinafine because they may increase the risk of Tofranil 's side effects
• Arsenic, astemizole, droperidol, furazolidone, MAOIs (eg, phenelzine), pimozide, streptogramins (eg, dalfopristin), terfenadine, or tramadol because the risk of high blood pressure, serious heart problems (eg, irregular heartbeat), or seizures may be increased
• Barbiturates (eg, phenobarbital) or phenytoin because they may decrease Tofranil 's effectiveness
• Anticholinergics (eg, benztropine), carbamazepine, or sympathomimetics (eg, phenylephrine) because the risk of their side effects may be increased by Tofranil
• Clonidine, guanethidine, or guanfacine because their effectiveness may be decreased by Tofranil

Possible Side Effects
Check with your doctor if any of these most common side effects persist or become bothersome:

• dizziness; drowsiness; dry mouth; excitement; headache; impotence; nausea; nightmares; pupil dilation; sensitivity to sunlight; sweating; tiredness; upset stomach; vomiting; weakness; weight loss or gain.

Seek medical attention right away if any of these severe side effects occur:

• severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision or other vision changes; changes in sex drive; chest pain; confusion; constipation; fainting; fast, slow, or irregular heartbeat; fever; frequent or difficult urination; hallucinations; impulsive behavior or other unusual changes in behavior; jaw, neck, or muscle spasms; mental or mood changes (eg, increased anxiety, mood swings, agitation, irritability, nervousness, restlessness); panic attacks; ringing in the ears; seizures; severe dizziness or drowsiness; sore throat; stomach pain; suicidal thinking or behavior; swelling of the testicles; tremor; trouble sleeping; trouble walking or keeping your balance; twitching of the face or tongue; uncontrolled movements of arms and legs or stiffness; unusual bleeding or bruising; worsening of depression; yellowing of the skin or eyes.

More Information
Tofranil is to be used only by the patient for whom it is prescribed. Do not share it with other people.
If your symptoms do not improve or if they become worse, check with your doctor.