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Precautions and Warnings With Imipramine Hydrochloride

Specific Precautions and Warnings With Imipramine Hydrochloride

Precautions and warnings to be aware of prior to taking imipramine hydrochloride include the following:
  • Antidepressants (including imipramine) may increase the risk of suicidal thinking or behavior (see Depression and Suicide). Therefore, if you notice any changes in symptoms or new symptoms, talk to your healthcare provider immediately. Some of these symptoms may include:
    • Anxiety
    • Hostility
    • Agitation
    • Panic
    • Restlessness
    • Hallucinations
    • Extreme hyperactivity
  • Before prescribing imipramine for depression, your healthcare provider should make sure that you do not have bipolar disorder instead. Sometimes, the symptoms of bipolar disorder and depression are similar, and imipramine can cause problems in people with bipolar disorder.
  • The medication may cause a worsening of schizophrenia. If you have this condition, discuss this with your healthcare provider before taking imipramine.
  • For people taking imipramine, caution should be used when driving, operating heavy machinery, or performing other tasks that require concentration, especially when first starting the drug or switching dosages. The medication may affect a person's mental or physical ability to perform these tasks. Make sure that you know how the drug affects you before performing any tasks that require mental or physical concentration.
  • Imipramine can interact with certain medications (see Drug Interactions With Imipramine Hydrochloride).
  • Imipramine may enhance the effects of alcohol, barbiturates, and other medicines that affect the brain. This can lead to an increased risk for drowsiness, dizziness, suicidal thoughts, and other overdose symptoms. Talk with your healthcare provider about drinking alcohol while taking the medication.
  • The medication may not be safe for use during pregnancy. Discuss the benefits and risk of using imipramine during pregnancy with your healthcare provider (see Imipramine and Pregnancy).
  • Imipramine passes through breast milk and may cause harm to your baby. Therefore, if you are breastfeeding or plan to start, talk with your healthcare provider about what makes most sense for your particular situation (see Imipramine and Breastfeeding).
  • Special care should be used when taking imipramine if you have a history of seizures, bladder problems, or glaucoma, as the drug can make these conditions worse.
  • Talk to your healthcare provider before taking imipramine if you have any heart problems, as it can affect the heart and its electrical system. Your healthcare provider should check your heart rhythm using an electrocardiogram (EKG or ECG) if you are taking high doses.
  • Talk to your healthcare provider before taking imipramine if you have hyperthyroidism (overactive thyroid) or take thyroid medication.
  • Imipramine can decrease your level of white blood cells, which can increase your risk of infections. If you are taking the medication, let your healthcare provider know if you have signs of an infection, such as a fever or sore throat.
  • Taking the drug while receiving electroshock or electroconvulsive therapy (ECT) can increase your risk of side effects. Talk to your healthcare provider about these risks before starting treatment.
  • Imipramine may cause a dry mouth. Sucking on hard candy, chewing gum, or melting bits of ice in your mouth can provide relief.
  • Elderly people appear to be more sensitive to imipramine, which can increase their risk of side effects (such as delirium and confusion). A healthcare provider will likely start elderly people on lower doses of the drug and monitor them more closely.
  • When used in children, the maximum dose of imipramine is 2.5 mg per kg each day (about 1.1 mg per pound each day). Higher doses may put your child at increased risk for an irregular heart rhythm (arrhythmia).
  • If you have diabetes, when starting imipramine or changing dosages, make sure to check your blood sugar levels more often. There have been reports of increased or decreased blood sugar levels in people with diabetes who take imipramine.
  • Do not treat yourself for the common cold, a cough, or allergies without first talking to your healthcare provider. Some of these medicines can increase the risk for developing imipramine side effects.
  • Do not stop taking the drug without first discussing it with your healthcare provider. Stopping it abruptly may increase the risk for withdrawal symptoms (see Imipramine Withdrawal).
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Imipramine HCl

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