imipramine, Tofranil, Tofranil-PM (cont.)

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Medical and Pharmacy Editor:

DRUG INTERACTIONS: Other medications and drugs that slow the brain's processes, such as alcohol, barbiturates, benzodiazepines, for example, lorazepam (Ativan), diazepam (Valium), temazepam (Restoril), oxazepam (Serax), clonazepam (Klonopin), zolpidem (Ambien), and narcotics, may add to the effect of imipramine on the brain.

Reserpine, given to patients taking TCAs, can cause agitation and anxiety. Imipramine and other TCAs should not be used with monoamine oxidase inhibiting drugs, for example, isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and procarbazine (Matulane), since high fever, convulsions and even death can occur.

Concurrent use of cimetidine (Tagamet) can increase imipramine blood levels by reducing elimination of imipramine from the body and possibly lead to imipramine- related side effects. Other drugs which share this effect include propafenone (Rythmol), flecainide (Tonocard), quinidine (Quinidex, Quinaglute), methylphenidate (Ritalin), and fluoxetine (Prozac).

PREGNANCY: Use of imipramine during pregnancy has not been adequately evaluated.

NURSING MOTHERS: Available evidence suggests that imipramine may be excreted in breast milk and may be harmful to the infant.



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