Anti Depressants

Tofranil (Imipramine)

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Tofranil (Imipramine) is a tricyclic antidepressant used to treat depression. It may also be used to treat other conditions as determined by your doctor.

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About Tofranil (Imipramine):

Product Type: Anti Depressants

Brand name: Tofranil Generic name: Imipramine What is the most important information I should know about tofranil? Do not use tofranil if you have recently had a heart attack or if you have used an MAO inhibitor such as isocarboxazid (Marplan) phenelzine (Nardil) rasagiline (Azilect) selegiline (Eldepryl Emsam) or tranylcypromine (Parnate) within the past 14 days. You may have suicidal thoughts or behavior when you start taking an antidepressant especially if you are under 18 years old. You will need to be monitored for worsening symptoms of depression or suicidal thoughts. Your doctor should check you at regular visits during the first 12 weeks of treatment or whenever your dose is changed. Contact your doctor promptly if you have any of the following side effects especially if they are new symptoms or if they get worse: mood changes anxiety panic attacks trouble sleeping irritability agitation aggressiveness severe restlessness mania (mental and/or physical hyperactivity) thoughts of suicide or hurting yourself. What is tofranil? Tofranil is in a group of drugs called tricyclic antidepressants. Tofranil affects chemicals in the brain that may become unbalanced. Tofranil is used to treat symptoms of depression. Tofranil may also be used for purposes other than those listed in this medication guide. What should I discuss with my healthcare provider before taking tofranil? Do not use this medication if you are allergic to tofranil or if you have recently had a heart attack. Do not use tofranil if you have used an MAO inhibitor such as isocarboxazid (Marplan) phenelzine (Nardil) rasagiline (Azilect) selegiline (Eldepryl Emsam) or tranylcypromine (Parnate) within the past 14 days. Serious life-threatening side effects can occur if you take tofranil before the MAO inhibitor has cleared from your body. Before taking tofranil tell your doctor if you are allergic to any drugs or if you have: • heart disease; • a history of heart attack stroke or seizures; • bipolar disorder (manic-depression); • kidney or liver disease; • overactive thyroid; • diabetes (tofranil may raise or lower blood sugar); • adrenal gland tumor (pheochromocytoma); • glaucoma; or • problems with urination. If you have any of these conditions you may not be able to use tofranil or you may need a dosage adjustment or special tests during treatment. You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication especially if you are under 18 years old. While you are taking tofranil you will need to be monitored for worsening symptoms of depression and/or suicidal thoughts during the first weeks of treatment or whenever your dose is changed. In addition to you watching for changes in your own symptoms your family or other caregivers should be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment. Contact your doctor promptly if you have any of the following side effects especially if they are new symptoms or if they get worse: mood changes anxiety panic attacks trouble sleeping irritability agitation aggressiveness severe restlessness mania (mental and/or physical hyperactivity) thoughts of suicide or hurting yourself. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Tofranil can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Older adults may be more likely to have side effects from this medication. Do not give this medication to anyone under 18 years old without the advice of a doctor. How should I take tofranil? Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from this medication. Follow the directions on your prescription label. If you need to have any type of surgery tell the surgeon ahead of time that you are taking tofranil. You may need to stop using the medicine for a short time. Do not stop using tofranil without first talking to your doctor. You may need to use less and less before you stop the medication completely. Stopping this medication suddenly could cause you to have unpleasant side effects. It may take up to 3 weeks of using this medicine before your symptoms improve. For best results keep using the medication as directed. Talk with your doctor if your symptoms do not improve after 3 weeks of treatment. Store tofranil at room temperature away from moisture and heat. What happens if I miss a dose? Take the missed dose as soon as you remember. If it is almost time for your next dose skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose. What happens if I overdose? Seek emergency medical attention if you think you have used too much of this medicine. An overdose of tofranil can be fatal. Symptoms of an tofranil overdose may include uneven heartbeats extreme drowsiness agitation vomiting blurred vision sweating muscle stiffness swelling shortness of breath blue lips or fingernails feeling light-headed fainting seizure (convulsions) or coma. What should I avoid while taking tofranil? Avoid drinking alcohol. It can cause dangerous side effects when taken together with tofranil. Avoid using other medicines that make you sleepy (such as cold medicine pain medication muscle relaxers medicine for seizures or other antidepressants). They can add to sleepiness caused by tofranil. Grapefruit and grapefruit juice may interact with tofranil. Discuss the use of grapefruit products with your doctor before increasing or decreasing the amount of grapefruit products in your diet. Tofranil can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid exposure to sunlight or artificial UV rays (sunlamps or tanning beds). Tofranil can make your skin more sensitive to sunlight and sunburn may result. Use a sunscreen (minimum SPF 15) and wear protective clothing if you must be out in the sun. What are the possible side effects of tofranil? Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face lips tongue or throat. Call your doctor at once if you have any of these serious side effects: • fast pounding or uneven heart rate; • chest pain or heavy feeling pain spreading to the arm or shoulder nausea sweating general ill feeling; • sudden numbness or weakness especially on one side of the body; • sudden headache confusion problems with vision speech or balance; • feeling short of breath even with mild exertion; • swelling rapid weight gain; • confusion hallucinations or seizure (convulsions); • easy bruising or bleeding unusual weakness; • restless muscle movements in your eyes tongue jaw or neck; • urinating more or less than usual; • extreme thirst with headache nausea vomiting and weakness; • skin rash bruising severe tingling numbness pain or muscle weakness. Less serious side effects may be more likely to occur such as: • nausea vomiting stomach pain loss of appetite; • constipation or diarrhea; • dry mouth unpleasant taste; • weight changes; • weakness lack of coordination; • feeling anxious restless dizzy drowsy or tired; • sleep problems (insomnia) nightmares; • blurred vision headache ringing in your ears; • breast swelling (in men or women); or • decreased sex drive impotence or difficulty having an orgasm. Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. What other drugs will affect tofranil? Before taking tofranil tell your doctor if you have used an SSRI antidepressant in the past 5 weeks such as citalopram (Celexa) escitalopram (Lexapro) fluoxetine (Prozac Sarafem) fluvoxamine (Luvox) paroxetine (Paxil) or sertraline (Zoloft). Before taking tofranil tell your doctor if you are currently using any of the following drugs: • cimetidine (Tagamet); • clonidine (Catapres); • guanethidine (Ismelin); • methylphenidate (Concerta Ritalin Daytrana); or • heart rhythm medications such as flecainide (Tambocor) propafenone (Rhythmol) or quinidine (Cardioquin Quinidex Quinaglute). If you are using any of these drugs you may not be able to use tofranil or you may need dosage adjustments or special tests during treatment. There are many other medicines that can interact with tofranil. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins minerals herbal products and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you

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Anti Depressants: Anafranil (Clomipramine HCI) Anafranil (Clomipramine HCI) is a tricyclic antidepressant used to treat depression and obsessive-compulsive disorder. Buy Anafranil (Clomipramine HCI) and other Anti Depressants products online at Medstore. About Anafranil (Clomipramine HCI): Product Type: Anti Depressants Brand name: Anafranil Generic name: Clomipramine HCI What is the most important information I should know about Anafranil? • While you are taking Anafranil you may need to be monitored for worsening symptoms of depression and/ or suicidal thoughts at the start of therapy or when doses are changed. This concern about the increased risk of suicidal thoughts or behaviors may be greater if you are 18 years of age or younger and are taking Anafranil. In patients younger than 18 years the period of risk may extend beyond start of therapy or when doses are changed. Your doctor may want you to monitor for the following symptoms: anxiety panic attacks difficulty sleeping irritability hostility impulsivity severe restlessness and mania (mental and/ or physical hyperactivity). These symptoms may be associated with the development of worsening symptoms of depression and/ or suicidal thoughts or actions. Contact your healthcare provider if you develop any new or worsening mental health symptoms during treatment with Anafranil. Do not stop taking Anafranil. • It may be 4 weeks or more before you start to feel better but do not stop taking Anafranil without first talking to your doctor. • Use caution when driving operating machinery or performing other hazardous activities. Anafranil may cause drowsiness or dizziness. If you experience drowsiness or dizziness avoid these activities. • Dizziness is likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall. • Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking Anafranil. What is Anafranil? • Anafranil is in a class of drugs called tricyclic antidepressants. Anafranil affects chemicals in the brain that may become unbalanced and cause obsessive-compulsive disorder. • Anafranil is used to relieve symptoms of obsessive-compulsive disorder such as recurrent thoughts or feelings and repetitive actions. • Anafranil may also be used for purposes other than those listed in this medication guide. What should I discuss with my healthcare provider before taking Anafranil? • Do not take Anafranil if you have taken a monoamine oxidase inhibitor such as isocarboxazid (Marplan) phenelzine (Nardil) or tranylcypromine (Parnate) within the last 14 days. • Before taking Anafranil tell your doctor if you have liver disease kidney disease asthma thyroid disease diabetes stomach or intestinal problems high blood pressure or heart disease had a heart attack in the last 6 weeks an enlarged prostate or difficulty urinating glaucoma or seizures. • You may not be able to take Anafranil or you may require a dosage adjustment or special monitoring during therapy if you have any of the conditions listed above. • While you are taking Anafranil you may need to be monitored for worsening symptoms of depression and/ or suicidal thoughts at the start of therapy or when doses are changed. This concern about the increased risk of suicidal thoughts or behaviors may be greater if you are 18 years of age or younger and are taking Anafranil. In patients younger than 18 years the period of risk may extend beyond start of therapy or when doses are changed. Your doctor may want you to monitor for the following symptoms: anxiety panic attacks difficulty sleeping irritability hostility impulsivity severe restlessness and mania (mental and/ or physical hyperactivity). These symptoms may be associated with the development of worsening symptoms of depression and/ or suicidal thoughts or actions. Contact your healthcare provider if you develop any new or worsening mental health symptoms during treatment with Anafranil. Do not stop taking Anafranil. • Anafranil is in the FDA pregnancy category C. This means that it is not known whether Anafranil will harm an unborn baby. Do not take Anafranil without first talking to your doctor if you are pregnant or could become pregnant during treatment. • Anafranil passes into breast milk and may affect a nursing baby. Do not take Anafranil without first talking to your doctor if you are breast-feeding a baby. How should I take Anafranil? • Take Anafranil exactly as directed by your doctor. If you do not understand these directions ask your pharmacist nurse or doctor to explain them to you. • Take each dose with a full glass (8 oz) of water. • Anafranil may be taken several times a day or in one daily dose (usually at bedtime). Follow your doctor's instructions. • Grapefruit and grapefruit juice may interact with Anafranil. The interaction could lead to potentially dangerous effects. Discuss the use of grapefruit and grapefruit juice with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor. • It may be 4 weeks or more before you start to feel better but do not stop taking Anafranil without first talking to your doctor. • Store Anafranil at room temperature away from moisture and heat. What happens if I miss a dose? • Take the missed dose as soon as you remember. If it is almost time for the next regularly scheduled dose skip the missed dose and take the next one as directed. Do not take a double dose of this medication unless otherwise directed by your doctor. What happens if I overdose? • Seek emergency medical attention. • Symptoms of a Anafranil overdose include seizures confusion drowsiness agitation hallucinations and low blood pressure (dizziness fatigue fainting). What should I avoid while taking Anafranil? • Use caution when driving operating machinery or performing other hazardous activities. Anafranil may cause drowsiness or dizziness. If you experience drowsiness or dizziness avoid these activities. • Dizziness is likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall. • Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking Anafranil. • Grapefruit and grapefruit juice may interact with Anafranil. The interaction could lead to potentially dangerous effects. Discuss the use of grapefruit and grapefruit juice with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor. • Do not stop taking Anafranil suddenly. This could cause symptoms such as nausea headache and malaise. What are the possible side effects of Anafranil? • If you experience any of the following serious side effects stop taking Anafranil and contact your doctor immediately or seek emergency medical treatment: an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips face or tongue; or hives); seizures; a fast or irregular heartbeat; a heart attack; high blood pressure (blurred vision severe headache); difficulty urinating; or fever with increased sweating muscle stiffness or severe muscle weakness. • Other less serious side effects may be more likely to occur. Continue to take Anafranil and talk to your doctor if you experience drowsiness or dizziness; dry mouth and eyes; constipation; mild tremor; sweating; mild agitation weakness or headache; ringing in the ears; nausea; or loss of weight or appetite. • Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. What other drugs will affect Anafranil? • Do not take Anafranil if you have taken a monoamine oxidase inhibitor such as isocarboxazid (Marplan) phenelzine (Nardil) or tranylcypromine (Parnate) within the last 14 days. • Anafranil may increase the effects of other drugs that cause drowsiness including other antidepressants alcohol antihistamines sedatives (used to treat insomnia) pain relievers anxiety medicines and muscle relaxants. Tell your doctor about all medicines that you are taking and do not take any other prescription or over-the-counter medicines without first talking to your doctor. • Drugs other than those listed here may also interact with Anafranil. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines including herbal products. 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