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Tofranil

Tofranil
Tofranil is a tricyclic antidepressant that is used to treat the symptoms of depression and help patients elevate their mood.

Brand: Imipramine

Availability: In Stock
Average Delivery Time: 9 Days
Exp. Date: April 2024
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Tofranil 75 mg
180 pills - 75 mg
+ 4 free Viagra 100 mg, 3% discount for future orders
$165.61 $0.92 $62.33 Add to cart
90 pills - 75 mg $84.99 $0.94 $28.98 Add to cart
60 pills - 75 mg $61.95 $1.03 $14.03 Add to cart
30 pills - 75 mg $37.99 $1.27 No Add to cart
Tofranil 50 mg
180 pills - 50 mg
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$160.21 $0.89 $55.61 Add to cart
90 pills - 50 mg $81.99 $0.91 $25.92 Add to cart
60 pills - 50 mg $59.65 $0.99 $12.29 Add to cart
30 pills - 50 mg $35.97 $1.20 No Add to cart
Tofranil 25 mg
360 pills - 25 mg
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$153.91 $0.43 $121.97 Add to cart
180 pills - 25 mg $85.97 $0.48 $51.97 Add to cart
120 pills - 25 mg $63.93 $0.53 $28.03 Add to cart
90 pills - 25 mg $51.55 $0.57 $17.42 Add to cart
60 pills - 25 mg $38.91 $0.65 $7.07 Add to cart
30 pills - 25 mg $22.99 $0.77 No Add to cart

Product description

Name

Tofranil (Imipramine)

Pharmacological action

Antidepressant (tricyclic antidepressant). It has antidepressant, antidiuretic (in nocturnal urinary incontinence), anxiolytic (antipanic) and some analgesic (of central genesis) effects.


It has strong peripheral and central anticholinergic effect due to high affinity to m-cholinoreceptors; strong sedative effect associated with affinity to H1-histamine receptors, and alpha-adrenoblocking effect. It has the properties of an antiarrhythmic drug of subgroup Ia; like quinidine, in therapeutic doses it slows ventricular conduction (in overdose it may cause severe intraventricular blockade).


The mechanism of antidepressant action is associated with an increase in the concentration of noradrenaline in synapses and/or serotonin in the CNS (reduction of their reverse absorption). Accumulation of these neurotransmitters occurs as a result of inhibition of their reuptake by the membranes of presynaptic neurons. With long-term use, it reduces the functional activity of beta-adreno- and serotonin receptors of the brain, normalizes adrenergic and serotonergic transmission, restores the balance of these systems that are disturbed in depressive states. In anxiety-depressive states it reduces anxiety, agitation and depressive manifestations.


The mechanism of anti-ulcer action is caused by the ability to block H2-histamine receptors in the parietal cells of the stomach, and to have sedative and m-cholin-blocking effects (in peptic ulcer disease of the stomach and duodenum it relieves pain and promotes faster healing of ulcers).


Efficacy in nocturnal urinary incontinence appears to be due to anticholinergic activity, leading to increased bladder distension capacity, direct beta-adrenergic stimulation, alpha-adrenergic agonist activity, accompanied by increased sphincter tone, and central serotonin capture blockade.


It has a central analgesic effect, which is thought to be due to changes in monoamine concentrations in the CNS, especially serotonin, and to effects on endogenous opioid systems.


The mechanism of action in bulimia nervosa is unclear (it may be similar to that in depression). The distinct effect of the drug in bulimia in patients both without and with depression is shown, and bulimia reduction can be observed without concomitant weakening of depression itself.


During general anesthesia, it decreases BP and body temperature. It does not inhibit MAO.


The mechanism of anxiolytic action is associated with decreased rate of locus ceruleus excitation through regulation of alpha2and beta-adrenergic receptor function and noradrenaline turnover.


The mechanism of analgesic action may be related to changes in the concentration of monoamines in the CNS, especially serotonin, and the effect on endogenous opioid systems.


It reduces motor retardation, improves mood, promotes normalization of sleep, digestion and other somatic functions, has some stimulating effect on the general tone of the organism. At the beginning of treatment, the sedative effect may predominate, which is less pronounced than in amitriptyline.


Antidepressant effect develops within 2-3 weeks after the start of use.


Contraindications

Hypersensitivity, usage together with MAO inhibitors and 2 weeks before the treatment, myocardial infarction (acute and subacute periods); acute intoxication with ethanol, hypnotics, narcotic analgesics, etc.; closed-angle glaucoma, severe intracardiac conduction disorders (pedicle leg block, AV block II stage). CNS depressant drugs; closed-angle glaucoma, severe intracardiac conduction disorders (Gis bundle branch block, AV blockade type II), lactation, children (under 6 years). Chronic alcoholism, bronchial asthma, bipolar disorders (manic-depressive psychosis), bone marrow inhibition, pregnancy (especially trimester I), cardiovascular diseases (angina pectoris, arrhythmia, heart block, CHF, myocardial infarction), pheochromocytoma and neuroblastoma (risk of hypertensive crisis), stroke, gastrointestinal motor dysfunction (risk of paralytic obstruction), hepatic and/or renal failure, thyrotoxicosis, prostatic hyperplasia (accompanied by urinary retention), schizophrenia (possible activation of psychosis), epilepsy, old age.

How to use: dosage and course of treatment.

Orally, during or immediately after meals (to reduce gastric mucosal irritation), individual selection of dosage is necessary; in adults, the initial dose is 25-50 mg 3-4 times daily, then the dose is increased daily by 25 mg and up to 200-250 mg/day, sometimes - up to 300 mg/day; treatment duration in mild forms of depression - 4-6 weeks. Thereafter, the dose is gradually reduced (by 25 mg every 2-3 days) and switch to maintenance therapy at a dose of 25 mg 1-4 times daily for another 4-6 weeks. In elderly people, the initial dose is 10 mg/day, with a gradual increase to 30-50 mg or more, until the optimal effect is obtained. To reduce the irritant effect on the gastric mucosa, it is recommended to take after meals. For maintenance therapy, a single overnight dose is often used, fractional intake is reserved for the elderly, adolescents and patients with cardiac diseases.


The highest doses for adults orally: single - 100 mg, daily - 200 mg (outpatient), 300 mg (inpatient) and 100 mg for the elderly.


In children, as an antidepressant, the initial dose is 10 mg; over 10 days, the dose is gradually increased: for children aged 6-8 years - to 20 mg, 8-14 years - to 20-25 mg, over 14 years - to 50 mg or more (up to a maximum of 100 mg), in 2 divided doses.


In nocturnal urinary incontinence at the beginning of treatment, the daily dose: for children aged 6-8 years - 25 mg, 9-12 years - 25-50 mg, over 12 years - 50-75 mg, once a day 1 hour before bedtime. In urinary incontinence manifested in the early night hours, the daily dose may be prescribed in 2 doses: one half of the dose is taken in the middle of the day and the other half before bedtime. If there is no effect after 1 week of treatment, higher doses are prescribed. A daily dose higher than 75 mg usually does not improve results.


The highest daily dose for children is 2.5 mg/kg.


In severe forms of depression, combined therapy may be used in hospital settings, i.m. and orally. As an antidepressant, up to 100 mg/day in divided doses. Higher doses for adults: single dose 50 mg, daily dose 300 mg. It is not recommended to use in children under 12 years of age.


Stopping treatment too early may lead to a recurrence of depression. Imipramine should be withdrawn gradually.