What exactly is Tofranil?

Tofranil is a tricyclic antidepressant and brand name of the drug imipramine. It works by restoring balance to chemicals in the brain that helps regulate mood. The medication has been approved for treating depression in adults and nocturnal enuresis in children 6 and older. The medication is also sometimes used to treat symptoms of hyperactivity and impulsivity in patients with attention deficit hyperactivity disorder when traditional medications are ineffective.

Is there a generic version of Tofranil available?

Yes, the generic version of Tofranil is called imipramine and is available for purchase.

When did the U.S. Food and Drug Administration (FDA) approve the medication?

Tofranil was first approved by the FDA in 1984.

What are the major differences between Tofranil and other medications used to treat ADHD?

Most traditional ADHD medications are stimulants. They can be very effective in treating symptoms, but they can be habit-forming. When stimulants are not effective, tricyclic antidepressants (TCAs) like Tofranil are sometimes prescribed. Tofranil can be effective for adults with ADHD and also in treating symptoms of depression and anxiety that often accompany ADHD. However, because it an antidepressant, it takes 2 to 4 weeks for TCAs like Tofranil to reach maximum efficacy.

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Can children take Tofranil?

Very small doses of Tofranil are sometimes prescribed for nocturnal enuresis (involuntary urination), but the effectiveness and safety of the medication for treating other conditions in children such as ADHD has not been established.

Are there potential interaction issues for people taking Tofranil and any other drugs?

Do not take Tofranil if you have taken an MAO inhibitor in the past two weeks, as a dangerous interaction effect could occur. There are also hundreds of drugs which are known to interact with Tofranil in major, moderate, or mild ways, so let your doctor know what other medications you are taking before you begin taking the medication. Some of these can include but are not limited to SSRIs, anticholinergic drugs, decongestants, local anesthetics, and methylphenidate.

Are there any other medical conditions that would make someone ineligible for Tofranil therapy?

Talk to your doctor if you have glaucoma, seizures, heart disease, diabetes, kidney problems, liver problems, or a history of other mental illness, suicidal thoughts, or substance use.

What is the typical dose that would be prescribed to someone taking Tofranil?

The typical dosage ranges between 75 mg and 150 mg daily, and doses above 200 mg are not recommended.

What do I do if I miss a dose?

Take the dose of Tofranil when you remember, but skip the missed dose if it is almost time for your next dose. You should never take extra doses of the medication to make up for missed doses.

What are Tofranil’s common side effects?

Common side effects of Tofranil can include:

  • nausea
  • changes in appetite
  • constipation
  • dry mouth
  • fatigue
  • drowsiness
  • nightmares
  • sensitivity to sunlight
  • trouble urinating
  • changes in sex drive
  • sweating

If you experience major side effects, report them to your doctor immediately and stop using the medication. Major side effects can include but are not limited trouble speaking, tremors, trouble breathing or swelling, irregular heartbeat, rash, yellowing of skin or eyes, muscle spasms, or shuffling walk. You can report side effects to the FDA at 1-800-FDA-1088 or online.

Are there any possible psychiatric side effects that come from taking Tofranil?

Anxiety or agitation are possible side effects of Tofranil. Sometimes antidepressants can cause or increase suicidal thoughts in children or adults. If you have a personal history or family history of bipolar disorder, talk to your doctor about the risks.

Is it safe for a woman who is pregnant, about to become pregnant, or nursing to take Tofranil?

Studies have found that taking antidepressants while pregnant can lead to abnormalities and increase the risk of premature delivery. The drug can be transferred via breast milk but it is unknown whether it is harmful to the nursing infant. Therefore, talk to your doctor if you are pregnant, planning to become pregnant, or are nursing before you take Tofranil.

Can symptoms occur if Tofranil is discontinued?

Withdrawal symptoms of Tofranil can include but are not limited to flu-like symptoms, sleep problems, crying spells, and lack of coordination. It is not recommended that antidepressant use is stopped abruptly, so talk to your doctor before you discontinue use and seek medical attention if necessary.

What should I do if I overdose on Tofranil?

An overdose of Tofranil could be fatal, so seek help immediately or call the Poison Help Line at 1-800-222-1222 if you overdose. Overdose symptoms can include confusion, agitation, seizures, depression, hallucinations, slow breathing, trouble urinating, blurred vision, dilated pupils, low blood pressure, irregular or rapid heartbeat, and coma.

Is Tofranil habit-forming?

Tofranil is not habit-forming, but withdrawal symptoms can occur, so talk to your doctor before you discontinue use.

How much does Tofranil cost?

According to goodrx.com, 30 tablets of 25 mg Tofranil cost approximately $430. The cost of the generic version imipramine is around $10.

Are there any disadvantages to Tofranil?

The biggest disadvantage of Tofranil is that it can cause suicidal thoughts in people taking the medication. Patients are also advised not to drink alcohol while taking the medication. Unlike many other medications used to treat ADHD, the drug takes several weeks for the effects to be felt. Also, common side effects of the medication may outweigh the benefits.

DISCLAIMER: The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other healthcare providers.  This article mentions drugs that were FDA-approved and available at the time of publication and may not include all possible drug interactions or all FDA warnings or alerts. The author of this page explicitly does not endorse this drug or any specific treatment method. If you have health questions or concerns about interactions, please check with your physician or go to the FDA site for a comprehensive list of warnings.

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Last Updated: Feb 21, 2018