Imipramine Hydrochloride
Brand Names: Tofranil
Methodology & AI Transparency ⓘ
Imipramine Hydrochloride Key Takeaways
Translated by Sarah Jenkins (AI RN Plain-English Translator) at a 7th-grade reading level
- 1 What it does: Indications and usage: Depression -For the relief of symptoms of depression.
- 2 Real-world patient consensus: Zero-PHI community consensus: 89% favorable across 11 logged regimens (Tofranil).
- 3 Typical cash cost range: Uninsured 30-day outlay compares $6.22 wholesale mail-order against $34.50 retail pharmacy pricing.
- 4 Top reported side effects / signs: Primary clinical safety signals tracked in FAERS for Imipramine Hydrochloride include orthostatic hypotension (3.2%), palpitations (2%), nausea (8.3%).
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Imipramine Hydrochloride Mechanism, CYP450 Pathways & DailyMed Monograph
Indications and usage: Depression -For the relief of symptoms of depression. Endogenous depression is more likely to be a l l eviated than other depressive states. One to three weeks of treatment may be needed before optimal therapeutic effects are evident. Childhood Enuresis -May be useful as temporary adjunctive therapy in reducing enuresis in children aged 6 years and older, after possible organic causes have been excluded by appropriate tests. In patients having daytime symptoms of frequency and urgency, examination should include voiding cystourethrography and cystoscopy, as necessary.
CLINICAL PHARMACOLOGY The mechanism of action of imipramine hydrochloride is not definitely known. However, it does not act primarily by stimulation of the central nervous system. The clinical effect is hypothesized as being due to potentiation of adrenergic synapses by blocking uptake of norepinephrine at nerve endings. The mode of action of the drug in contro ll ing childhood enuresis is thought to be apart from its antidepressant effect.
Pharmacokinetic profiling of Imipramine Hydrochloride demonstrates an elimination half-life of Steady-state plasma equilibrium reached over 6–17 hour t½ intervals for Imipramine Hydrochloride with Approximately 60% to 72% enteral uptake across labeled Imipramine Hydrochloride strengths systemic bioavailability; clearance proceeds via predominantly hepatic biotransformation with renal elimination of polar imipramine hydrochloride conjugates, reaching clinical onset within maximum serum exposure occurs 2–5 hours after imipramine hydrochloride dosing.
Titration schedules for Imipramine Hydrochloride (10 mg/1 Tablet → 25 mg/1 Tablet, Film Coated → 50 mg/1 Tablet, Film Coated → 50 mg/1 Tablet → 10 mg/1 Tablet, Film Coated) require excluding contraindications the concomitant use of monoamine oxidase inhibiting compounds is contraindicated.; hyperpyretic crises or severe convulsive seizures may occur in patients receiving such combinations.; the potentiation of adverse effects can be serious, or even fatal.; real-world patient logs highlight nausea (8.3% of reports), headache (7% of reports), dizziness (6.1% of reports) alongside a 89.00% Worth-It consensus.
Reconcile eGFR-adjusted medications before escalating Imipramine Hydrochloride in polypharmacy regimens.
Unstandardized herbal extracts may interact pharmacodynamically with Imipramine Hydrochloride maintenance therapy.
Standard Adult Titration & Dosages
Absolute & Relative Contraindications
- CONTRAINDICATIONS The concomitant use of monoamine oxidase inhibiting compounds is contraindicated.
- Hyperpyretic crises or severe convulsive seizures may occur in patients receiving such combinations.
- The potentiation of adverse effects can be serious, or even fatal.
Logged Side-Effect Incidence (11 Reports)
Imipramine Hydrochloride Real-World Side Effects: openFDA FAERS vs. Patient Micro-Logs
Peer-Reviewed Human Clinical Trials & Meta-Analyses (Imipramine Hydrochloride)
| Study & Plain-English Finding | Sample (N) | Rigor | Primary Source |
|---|---|---|---|
| When Antidepressants Aren't Enough: Can Adding SAMe Help Lift Stubborn Depression? SAMe may provide relief of depression symptoms similar to imipramine or escitalopram. General hospital psychiatry • 2024-01-15 • Meta-Analysis | N = 1,522 | 99/100 | PMID 38199136 ↗ |
| New Insights on Effect of concurrent anxiety on response to sertraline and imipramine in patients: What a 426-Participant Study Found Despite the chronicity of depressive illness, acute treatment with both sertraline and imipramine significantly improved psychosocial and quality of life measures. Depression and anxiety • 2001-01-15 • Randomized Controlled Trial | N = 426 | 93/100 | PMID 11233456 ↗ |
| Can This Approach Help? Inside the Latest Research on Gold-standard blind switch study of imipramine or sertraline treatment of More than 50% of chronically depressed antidepressant nonresponders benefited from a switch from imipramine to sertraline, or vice versa, despite a high degree of chronicity. Archives of general psychiatry • 2002-03-15 • Randomized Controlled Trial | N = 117 | 88/100 | PMID 11879161 ↗ |
| Sertraline vs. Imipramine to prevent relapse: Which Works Better for Chronic depression? Most chronic depression patients who remit with 12 weeks of sertraline or imipramine treatment maintain full symptom relief during 16 weeks of continuation treatment. Journal of affective disorders • 2001-06-15 • Randomized Controlled Trial | N = 147 | 88/100 | PMID 11426506 ↗ |
Imipramine Hydrochloride Public Price Transparency Ledger
| Dispensing Channel / Benchmark | Verification Source | Reference Cost | Details |
|---|---|---|---|
| Pharmacy Acquisition Cost (CMS NADAC) | CMS Medicaid NADAC Weekly National Survey | $0.0651/unit (~$1.95/30u) | Wholesale baseline |
| Mark Cuban Cost Plus Drugs (Mail-Order Generic) | Public Wholesale Price List (NADAC + 15% + pharmacy fee) | $6.22 / mo | Formulary listing ↗ |
| Average U.S. Walk-In Retail Cash Price | Chain Pharmacy Uninsured Cash Index | $34.50 / mo | Before coupon/insurance |
| Patient-Logged Out-of-Pocket Average | 11 Anonymous DotMD Community Micro-Logs | $7.50 / mo | View logs ↓ |
| Hims & Hers Direct Cash Pharmacy (Licensed Telehealth Cash Program) | State-licensed clinician review • ~2d mail fulfillment | $49.00/mo program | Program details |
| Sesame Direct Cash-Pay Prescriber Network (Licensed Telehealth Cash Program) | State-licensed clinician review • ~1d mail fulfillment | $29.00 consult | Program details |
Imipramine Hydrochloride Federal Verification & Benchmark Summary
| Metric | Verified Benchmark | Source |
|---|---|---|
| Imipramine Hydrochloride RxNorm Concept ID | 835564 | U.S. National Library of Medicine (RxNorm) |
| CMS NADAC Pharmacy Acquisition Unit Cost | $0.0651 / unit | CMS Medicaid NADAC Weekly Feed |
| Walk-In Chain Pharmacy Cash Average | $34.50 / mo | U.S. Uninsured Retail Cash Index |
| Public Mail-Order Wholesale Benchmark | $6.22 / mo (Cost Plus Drugs) | Mark Cuban Cost Plus Public API |
| Real-World Patient Consensus | 89.00% Worth It (11 anonymous logs) | DotMD Zero-PHI Patient Ledger |
Imipramine Hydrochloride Patient Community, Cohort Filters & Dosage Logs
Deterministic Imipramine Hydrochloride reference combining NIH RxNorm (835564), Medicaid NADAC ($0.0651/unit), and anonymous cohort outcomes (89% Worth It).
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Filter Imipramine Hydrochloride community threads and patient logs by age, biological sex, dosage, and treatment duration.