imipramine
Brand names: Tofranil
Imipramine (Tofranil) is a medicine used to treat depression and bedwetting in children. It helps improve mood and reduce bedwetting episodes.
Drug Pricing (NADAC)
Generic Price
$0.07/unit
Generic Available
Yes (8 manufacturers)
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
This medicine can help relieve the symptoms of depression.
Common side effects
Dry mouth, Blurred vision, Constipation
Key warnings
Antidepressants may increase the risk of suicidal thoughts and behavior in children, teenagers, and young adults.
How It Works
Imipramine is a tricyclic antidepressant. It works by increasing the levels of certain natural chemicals in the brain that help regulate mood. For bedwetting, it's thought to affect bladder control.
How to Take It
Take this medicine as your doctor tells you. For depression, adults usually start with a low dose that is slowly increased. Elderly patients and teenagers usually need lower doses. For bedwetting, children usually take it 1 hour before bedtime.
Pregnancy & Breastfeeding
Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. This medicine may not be safe for you or your baby. Talk to your doctor about the risks and benefits.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is close to your next dose, skip the missed dose and continue with your regular schedule.
Storage
Store at room temperature, away from heat and moisture.
Side Effects (from patient reports)
Based on 306 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 537 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.
Total Reports
537
Death-Related Reports
30
Hospitalization Reports
198
Top Indication
Product Used For Unknown Indication
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | OFF LABEL USE | 37 |
| 2 | DIZZINESS | 35 |
| 3 | DRUG INEFFECTIVE | 35 |
| 4 | FATIGUE | 30 |
| 5 | HYPERTENSION | 29 |
| 6 | ANXIETY | 28 |
| 7 | DEPRESSION | 28 |
| 8 | DYSPNOEA | 28 |
| 9 | HALLUCINATION, AUDITORY | 28 |
| 10 | PSYCHOTIC DISORDER | 28 |
| 11 | HEADACHE | 27 |
| 12 | DRUG INTERACTION | 25 |
| 13 | NAUSEA | 25 |
| 14 | PARANOIA | 25 |
| 15 | ARTHRALGIA | 24 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
Antidepressants may increase the risk of suicidal thoughts and behavior in children, teenagers, and young adults. Your doctor will monitor you closely for worsening depression, suicidal thoughts, or unusual changes in behavior. Families and caregivers should also watch for these changes.
Known Drug Interactions
Avoid the use of preparations, such as decongestants and local anesthetics, that contain any sympathomimetic amine (e.g., epinephrine, norepinephrine), since it has been reported that tricyclic antidepressants can potentiate the effects of catecholamines.
Mechanism: Imipramine can make the effects of epinephrine much stronger, which could cause a dangerous physical reaction.
What to do: Avoid using medicines or local numbing agents that contain epinephrine while you are taking imipramine.
Avoid the use of preparations, such as decongestants and local anesthetics, that contain any sympathomimetic amine (e.g., epinephrine, norepinephrine), since it has been reported that tricyclic antidepressants can potentiate the effects of catecholamines.
Mechanism: Imipramine can make the effects of norepinephrine much stronger, which could lead to serious side effects.
What to do: Avoid using medicines that contain norepinephrine while you are taking imipramine.
7 DRUG INTERACTIONS CNS depressants, including alcohol: Possible adverse additive CNS- depressant effects ( 5.1 , 7.1 ) Opioids: Concomitant use may increase risk of respiratory depression ( 5.7 , 7.1 ) Imipramine: Decreased alertness observed ( 7.1 ) Chlorpromazine: Impaired alertness and psychomotor performance observed ( 7.1 ) CYP3A4 inducers (rifampin or St. Limit dosage and duration of concomitant use of Zolpidem Tartrate Tablets and opioids [ see Dosage and Administration ( 2.3 ), Warnings and Precautions ( 5.7 )] Imipramine, Chlorpromazine Imipramine in combination with Zolpidem prod...
Mechanism: Both drugs slow down the central nervous system, which can lead to a combined effect that makes you feel much less alert.
What to do: Be very careful when performing tasks that require focus and talk to your doctor about the risks of taking these together.
While all the selective serotonin reuptake inhibitors (SSRIs), e.g., fluoxetine, sertraline, and paroxetine, inhibit P450 2D6, they may vary in the extent of inhibition.
Mechanism: Sertraline interferes with how your liver processes imipramine, which can lead to higher levels of imipramine in your blood.
What to do: Your doctor may need to lower your imipramine dose and monitor you closely.
While all the selective serotonin reuptake inhibitors (SSRIs), e.g., fluoxetine, sertraline, and paroxetine, inhibit P450 2D6, they may vary in the extent of inhibition.
Mechanism: Paroxetine blocks the enzyme that breaks down imipramine, which can cause imipramine to build up to high levels in your body.
What to do: Your doctor may need to adjust your dose of imipramine and watch for signs of toxicity.
Common Questions
How long does it take for this medicine to work?
Can I stop taking this medicine suddenly?
What should I avoid while taking this medicine?
Will this medicine cure my depression?
Can this medicine cause weight gain?
Can this medicine affect my heart?
Is it safe to take other medicines with this?
What if the bedwetting comes back after stopping the medicine?
Can this medicine cause seizures?
What should I do if I have side effects?
What are the common side effects of imipramine?
Does imipramine interact with other medications?
What drug class is imipramine?
Is imipramine safe during pregnancy?
Related Medications in Tricyclic Antidepressant (TCA)
Other drugs grouped near imipramine — same-class peers and common alternatives.
acamprosate
Campral
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alprazolam
Xanax
Alprazolam (Xanax) is a medication that can help you with anxiety and panic disorders.
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amitriptyline
Elavil
Amitriptyline is a medicine used to treat depression.
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amphetamine/dextroamphetamine
Adderall, Adderall XR
Adderall XR is a stimulant medicine.
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aripiprazole
Abilify
Aripiprazole (Abilify) is a medicine used to treat certain mental disorders and mood problems.
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Medication Guides
Understanding Drug Interactions
How CYP450 enzymes, inhibitors, and inducers affect your medications
Generic vs Brand Name Drugs
FDA requirements, cost savings, and when the difference matters
Narrow Therapeutic Index Drugs
Why some drugs demand precise dosing and monitoring
Common Drug Interactions
Dangerous medication combinations and how to protect yourself
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What the FDA Data Shows for imipramine
The FDA label for imipramine (sold under brand names such as Tofranil) classifies it as a prescription-only medication in the Tricyclic Antidepressant (TCA) class. This medicine can help relieve the symptoms of depression. Official labeling lists 8 commonly reported side effects, including Dry mouth, Blurred vision, Constipation.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 306 voluntary reports. The database also lists 20 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS shows a generic unit cost of $0.07.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: September 18, 2025
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages