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Tofranil (Imipramine)(im-IP-ra-meen) is a tricyclic antidepressant used to treat depression and certain types of ongoing pain. This medication may work to block the effect of a natural substance called Acetylcholine with respect to the bladder.
Anti-depressives such as Tofranil contain a black box warning such as the following:
Suicidality and Antidepressant Drugs
Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of Tofranil or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Tofranil is not approved for use in pediatric patients.
Do not use this medication with the following drugs, as the interactions may be severe and possibly fatal:
- Monoamine oxidase inhibitors (MAOIs). Do not take MAOIs within two weeks of using this medication; a serious or fatal reaction may occur.
A small number of people who take Tofranil or other antidepressants may suffer increasing depression or other mental/mood changes, including suicidal thoughts or attempts. Discuss with your physician the risks associated with taking this medication, even if you are taking it for something other than depression.
Inform your physician right away if you experience increased depression or other behavior or mood changes, including suicidal thoughts, anxiety, anger, or impulsiveness.
Before beginning treatment with Tofranil or any other antidepressants, a patient should be screened to determine risk for bipolar disorder; this should include providing the physician with a psychiatric history, including a family history of suicide, bipolar disorder, and depression.
This medication is not used to treat bipolar disorder.
Tofranil may interact with other medications. Tell your physician which prescription and nonprescription products you currently use. Here are some of the drugs that may be affected by their combined use with Tofranil:
- Methylphenidate hydrochloride
Tofranil may elevate a patient’s risk for serotonin toxicity, especially if the patient is also taking other drugs that raise serotonin levels, including ecstasy, St. John’s wort, or certain other antidepressants.
Seek medical attention immediately if you experience these symptoms:
- Rapid heartbeat
- Lack of coordination
- Severe dizziness
- Severe nausea, vomiting, or diarrhea
- Muscle twitching
- Abnormal agitation or restlessness
Why Is Tofranil Prescribed for Prostatitis?
Tofranil or other tricyclic antidepressants may be used to treat neuropathic pain in patients with prostatitis. This medication may be prescribed if you have urinary frequency and/or urgency.
How Should Tofranil Be Used?
Tofranil comes in tablets and is taken orally one to four times per day, as directed by your physician.
Dose is based on medical history and response to treatment. If you experience sleepiness in the daytime when taking Tofranil, your physician may ask you to take it before bedtime.
To lessen your risk for side effects, your physician may start you at a low dose, slowly increasing the dose.
Take this medication at the same time each day, and use it regularly to experience the most benefits from it.
Following your physician’s dosing instructions carefully.
It may take up to three weeks of treatment before you experience the benefits of this medication. It does not work immediately when beginning treatment.
Do not stop taking Tofranil abruptly and without consulting your physician.
Tell your physician if your symptoms persist or worsen.
Other Uses for Tofranil
Tofranil is used to treat depression, certain types of persistent pain, anxiety, and panic disorders. It may also be used to treatment enuresis (nighttime bedwetting) in children.
Do I Need to Follow Special Precautions?
Prior to beginning treatment, inform your physician if you are allergic to Tofranil or any other tricyclic antidepressants. This medication may include inactive ingredients that could cause an allergic reaction.
Discuss any other allergies you have with your physician.
Inform your physician if you have had a recent heart attack. This medication should not be used if a patient has had a recent heart attack.
Provide your physician with a complete medical history, particularly with regard to:
- Cardiovascular disease
- Elevated intraocular pressure
- Urinary retention
- Narrow-angle glaucoma
- Seizure disorders
- Breathing problems (asthma)
- Kidney problems
- Liver problems
- Problems urinating
- Certain kinds of tumors
This drug should be used very cautiously when administered to patients who have any of the above medical issues.
Be sure to know how you respond to Tofranil before driving or performing any dangerous activity, such as operating machinery, as this drug may cause dizziness or blurred vision.
Avoid the use of alcohol while taking this medication.
To reduce the risk of dizziness, stand up slowly after lying down or sitting.
Tofranil may cause QT prolongation, which causes fast, irregular heartbeat. This condition may rarely be serious or fatal. If you experience abnormal rhythms of the heart, severe dizziness, or fainting, seek medical attention immediately.
QT prolongation risk may be elevated if you have other medical conditions or are taking other medications that have a similar effect. Before taking Tofranil, inform your physician if you have heart problems or a family history of heart problems.
The risk of QT prolongation may be elevated if blood levels of potassium or magnesium are low. You also may be at increased risk if you take diuretics or experience extreme sweating, diarrhea, or vomiting.
Inform your physician if you are taking this medication before having surgery.
Avoid lengthy time in the sun or exposure to tanning beds or sunlamps, as this drug causes sun sensitivity. When outdoors, wear sunscreen and protective clothing.
If you have diabetes, monitor sugar levels in the blood frequently while taking this medication. Your physician may need to change the dose of your diabetes medication, or you may need to change your diet.
Inform your physician right away if you experience any of the following symptoms:
- Elevated thirst
- Increased urination
- Abnormal sweating
- Unusual hunger
Elderly patients may be more prone to side effects of this medication, including mood shifts and QT prolongation. Extra care should be taken with elderly patients while using this medication.
Tell your physician about any other prescription and nonprescription products you are using, including:
- High blood pressure medications
- Lanoxin (digoxin)
- Thyroid supplements
- Valproic acid
Read the labels of other medicines you take, as they may contain ingredients that could increase your heart rate or blood pressure.
Inform your physician if you smoke or have recently stopped smoking.
Do I Need to Follow a Special Diet When Taking Tofranil?
Avoid grapefruit or grapefruit products while taking Tofranil to avoid an interaction. Otherwise, continue your normal diet, unless otherwise directed by your physician.
What If I Forget a Dose?
If a dose is missed, take the medication as soon as you remember. However, if nearing the time when you are supposed to take the next dose, skip the missed dose and resume your regular schedule. If a dose is missed, do not double the dose.
Are There Side Effects When Taking Tofranil for Prostatitis?
Side effects may include:
- Abdominal pain
- Loss of appetite
- Dry mouth
- Bad taste
- Fluctuations in weight
- Weakness or clumsiness
- Blurred vision
- Ringing in ears
- Swelling of breasts
- Lessened sex drive, impotence, or problems reaching orgasm
If any of the above side effects persist or worsen, contact your physician promptly.
If you experience any of the following side effects, call your physician right away:
- Changes in mood or behavior, including impulsiveness, agitation, aggressiveness, irritability, worsening depression, hyperactivity, or suicidal thoughts
- Panic attacks
- Difficulty sleeping
- Rapid or abnormal heartbeat
- Chest pain
- Arm or shoulder pain
- Severe nausea
- Feeling of general illness
- Abrupt numbness or weakness, particularly on one side of body
- Abrupt headache or confusion
- Sudden vision, speech, or balance problems
- Shortness of breath
- Quick weight gain
- Unusual bruising or bleeding
- Muscle restlessness or weakness
- Lessening or more frequent urination
- Severe thirst, accompanied by headache, nausea, vomiting, and weakness
- Serious tingling or numbness
- Severe pain
Seek immediate medical attention if you experience any signs of an allergic reaction, including:
- Problems breathing or swallowing
- Swelling of the face, tongue, throat, or lips
Does Tofranil Have Special Storage Instructions?
This medication should be stored at room temperature in a tightly sealed container away from light and moisture. Keep this medication away from children and pets. Do not store in the bathroom.
Discard this product properly when it is expired. (Do not flush it down the toilet or rinse it down the drain.)
What Do I Do in the Case of an Accidental Overdose?
In case of a suspected overdose, contact an emergency room or poison control center immediately. For a local control center in the United States, call 1-800-222-1222. Canada residents: call a poison control center within your province.
Symptoms of an overdose may include:
- Abnormal heartbeat
- Severe sleepiness
- Blurred vision
- Stiff muscles
- Difficulty breathing
- Blue lips or fingernails
An overdose of Tofranil may be fatal.
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