Imipramine: Price, Dosage & Where to Buy

Imipramine is a tricyclic antidepressant used to relieve the symptoms of depression, and it requires a prescription in the United Kingdom. It is available as a generic medicine and in oral tablet forms, while treatment response and tolerability are assessed by the prescriber because improvement may not be evident immediately after treatment begins.

Imipramine belongs to the tricyclic antidepressant group. These medicines reduce the reuptake of chemical messengers, particularly noradrenaline and serotonin, by nerve cells in the brain. This makes those messengers available for longer at the connections between nerve cells and changes signalling involved in mood regulation.

The effects on mood develop gradually rather than immediately. Tricyclic antidepressants also affect other receptors, which helps explain effects such as dry mouth, constipation, blurred vision and drowsiness.

Imipramine is indicated for the relief of symptoms of depression. The label states that endogenous depression, a term used for depression arising predominantly from internal factors, is more likely to improve than other depressive states. The antidepressant effect may not be evident for one to three weeks.

After symptoms have improved, maintenance treatment may be required for a longer period to maintain that improvement. Imipramine pamoate is not approved for treating bipolar depression.

The label lists oral tablets and film-coated tablets in strengths of 10 mg, 25 mg and 50 mg, and imipramine pamoate capsules of 75 mg. The dosing schedules for pamoate capsules are distinguished from the tablet strengths. The usual starting dose is 75 mg/day for adult outpatients receiving imipramine pamoate.

The label lists increases to 150 mg/day and, if necessary, 200 mg/day, according to response and tolerability. The usual starting dose is 100 to 150 mg/day for hospitalised adults receiving imipramine pamoate. The label lists an adult maintenance dosage of 75 to 150 mg/day.

The label lists an initial total daily dosage of 25 to 50 mg using imipramine hydrochloride tablets for adolescent and geriatric patients. The label lists once-daily administration, preferably at bedtime, or a divided-dose schedule in some patients. Treatment is adjusted by the prescriber according to clinical response and intolerance, with gradual dose reduction described after maintenance treatment.

The label specifies storage of imipramine pamoate capsules at 20°C to 25°C in a tight container with a child-resistant closure. Keep the medicine out of the sight and reach of children.

A missed dose should not be compensated for with a double dose. The appropriate next step depends on the prescribed schedule and how close it is to the next dose, so check the dispensing leaflet or ask a pharmacist. Repeated missed doses or abrupt stopping after prolonged treatment should be discussed with the prescriber.

Animal reproduction studies have produced inconclusive results, and there are no well-controlled studies in pregnant women. Congenital malformations have been reported with imipramine use, but a causal relationship has not been established.

Fetal risk cannot be excluded, so use during pregnancy is justified only when the clinical condition clearly outweighs the potential risk. The label does not specify breastfeeding information; discuss this with a doctor or pharmacist.