About imipramine

Imipramine belongs to a group of medicines called tricyclic antidepressants. It is generally prescribed for the treatment of depression in adults. However, it is also used to treat a completely unrelated condition in children, known as nocturnal enuresis (night-time bedwetting).

The exact cause of depression is not known. Anyone can develop depression. It can develop for no apparent reason or it may be triggered by a life event such as a relationship problem, bereavement, or illness. Medicines like imipramine can help to ease the symptoms caused by depression.

Night-time bedwetting is common, particularly in young children. It often responds to reassurance and advice about drinking and toileting. For an older child, treatment with a medicine such as imipramine is sometimes also needed. Imipramine helps prevent bed-wetting by blocking certain nerve receptors in the wall of the bladder. This prevents a chemical called acetylcholine from acting on these receptors. Acetylcholine normally causes the bladder to empty, so by stopping it from working, imipramine reduces the need to go to the toilet. 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 may 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 or pharmacist knows:

• If you are pregnant, trying for a baby or breast-feeding.
• If you have a thyroid problem.
• If you have liver or kidney problems.
• If you have epilepsy or sugar diabetes.
• If you are troubled by constipation which lasts several days.
• If you have any difficulties passing urine, or have had prostate trouble.
• If you have a heart disorder.
• If you have ever had a mental health problem (such as bipolar disorder or psychosis).
• If you have glaucoma (increased pressure in your eyes).
• If you have been told you have phaeochromocytoma (a tumour on your adrenal gland).
• If you have porphyria (this is a rare inherited blood disorder).
• If you are taking other medicines, including those available to buy without a prescription, herbal and complementary medicines. This is especially important 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 this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about imipramine and a full list of side-effects which you may 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 before or after meals.
• If you forget to take a dose, take it as soon as you remember. However, if when you remember it is nearly time for your next dose, then leave out the forgotten dose. Do not take two doses together to make up for a missed dose.

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, 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 painkillers which can be bought from pharmacies.
• If you have diabetes you may need to check your blood 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 having any medical treatment, tell the person carrying out the treatment which medicines you are taking.
• A very few people who have taken imipramine have found that their skin has become more sensitive to sunlight than usual. Avoid strong sunlight and sunbeds until you know how your skin reacts.

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.
• 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.

If it's for depression:

• Take imipramine exactly as your doctor has told you to. It can cause drowsiness so your doctor may advise you to take a small dose to begin with, and then to gradually increase it as your body gets used to the medicine.
• You may feel that imipramine is not working for you straightaway. It can take a week or two after starting these tablets before the effect begins to build up, and 4-6 weeks before you feel the full benefit. It is important that you do not stop taking it after a week or so, thinking it is not helping.
• 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 this as soon as possible.
• If you drink alcohol, ask your doctor for advice. Your doctor is likely to recommend you do not drink alcohol while you are on this medicine. It will increase the risk of side-effects, such as feeling sleepy.
• There are several types of antidepressants. Each type works in a slightly different way. If you find that imipramine does not suit you, then let your doctor know, as another may be found that does.
• Your doctor will 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 if this is necessary.

Can imipramine cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

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

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