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imipramine
generic
Black Box Warnings .
Suicidality
incr. suicidality risk in children, adolescents, and young adults w/ major depressive or other psychiatric disorders; weigh risk vs. benefit; in short-term studies of antidepressants vs. placebo, suicidality risk not incr. in pts >24 yo, and risk decr. in pts 65 yo and older; depression and certain other psychiatric disorders themselves assoc. w/ incr. suicide risk; observe all pts for clinical worsening, suicidality, or unusual behavior changes; advise families and caregivers of need for close observation and communication w/ prescriber; not approved for peds use
Adult Dosing .
Dosage forms: CAP: 75 mg, 100 mg, 125 mg, 150 mg; TAB: 10 mg, 25 mg, 50 mg
depression
- [150-300 mg PO qhs]
- Start: 25-75 mg PO qhs, incr. by 25-50 mg/day q3-4 days; Max: 300 mg/day; Info: max 100 mg/day in elderly pts; may give in divided doses; taper dose gradually to D/C
generalized anxiety disorder, tx-resistant (off-label)
- [75-200 mg/day PO divided tid]
- Start: 25 mg PO tid; Max: 300 mg/day; Info: max 100 mg/day in elderly pts; taper dose gradually to D/C
pain, chronic (off-label)
- [0.2-3 mg/kg/dose PO qhs]
- Start: 0.2-0.4 mg/kg/dose PO qhs, may incr. dose by 50% q2-3 days; Max: 300 mg/day; Info: max 100 mg/day in elderly pts; taper dose gradually to D/C
confusional arousals (off-label)
- [10-50 mg PO qhs]
- Info: taper dose gradually to D/C
sleep terrors (off-label)
- [10-50 mg PO qhs]
- Info: taper dose gradually to D/C
sleepwalking (off-label)
- [10-50 mg PO qhs]
- Info: taper dose gradually to D/C
nocturnal enuresis (off-label)
- [25-75 mg PO qhs]
- Info: taper dose gradually to D/C
IBS (off-label)
- [50-100 mg PO qhs]
- Start: 10 mg PO qhs, titrate slowly; Max: 100 mg/day; Info: taper dose gradually to D/C
renal dosing
- [no adjustment]
- renal impairment: no adjustment
- HD/PD: no adjustment; no supplement
hepatic dosing
- [see below]
- significant impairment: not defined, caution advised
Peds Dosing .
- Dosage forms: TAB: 10 mg, 25 mg, 50 mg
nocturnal enuresis
- [6-12 yo]
- Dose: 10-50 mg PO qhs; Start: 10 mg PO qhs, may incr. by 10 mg/day q1-2wk; Max: 50 mg/day; Info: taper dose gradually to D/C
- [13 yo and older]
- Dose: 10-75 mg PO qhs; Start: 10 mg PO qhs, may incr. by 10-25 mg/day q1-2wk; Max: 75 mg/day; Info: taper dose gradually to D/C
pain, chronic (off-label)
- [6 yo and older]
- Dose: 0.2-3 mg/kg/dose PO qhs; Start: 0.2-0.4 mg/kg/dose PO qhs, may incr. dose by 50% q2-3 days; Max: 100 mg/day; Info: taper dose gradually to D/C
renal dosing
- [not defined]
- renal impairment: consider adult renal dosing for guidance
- HD/PD: consider adult renal dosing for guidance
hepatic dosing
- [see below]
- significant impairment: not defined, caution advised