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Imipramine for various conditions
This leaflet is about the use of imipramine. It can be used in a variety of problems, including depression, bedwetting (which is also called nocturnal enuresis), hyperactivity and behavioural problems.
This leaflet has been written specifically for parents and carers about the use of this medicine in children. The information may differ from that provided by the manufacturer. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again.
Do not stop giving imipramine suddenly, as your child may get withdrawal symptoms.
Name of drug
Imipramine (also called imipramine hydrochloride)
Why is it important for my child to take this medicine?
This medicine will help to reduce your child’s symptoms and improve their mood and behaviour. If it is being used for bed-wetting, it should help your child to stay dry at night.
What is imipramine available as?
- Tablets: 10 mg, 25 mg; these contain lactose and sucrose
- Liquid medicine: 25 mg in 5 mL; contains sorbitol. If you have any concerns or questions, speak with your child's doctor or pharmacist.
When should I give imipramine?
Imipramine is given once each day, this is usually in the evening for bedwetting. Imipramine is usually given twice each day for mood or behavioural problems.
Give the medicine at about the same time each day so that this becomes part of your child’s daily routine, which will help you to remember.
How much should I give?
Your doctor will work out the amount of imipramine (the dose) that is right for your child. The dose will be shown on the medicine label.
When you first start giving imipramine to your child, you will probably give them a low dose, which may be increased bit by bit over a few days or weeks. This helps your child to get used to the medicine. Your doctor will explain what to do.
It is important that you follow your doctor’s instructions about how much to give.
How should I give imipramine?
This medicine works best when the stomach is empty, so try to give it to your child about an hour before they eat. However, if your child has an upset stomach, you can give it with a small amount of food.
Tablets should be swallowed whole with a glass of water, milk or juice. Your child should not chew the tablet.
You can crush the tablet and mix it with a small amount of soft food such as yogurt, honey or mashed potato. Make sure your child swallows it straight away, without chewing.
Liquid medicine: Measure out the right amount using a medicine spoon or oral syringe. You can get these from your pharmacist. Do not use a kitchen teaspoon as it will not give the right amount.
When should the medicine start working?
It may take some time for imipramine to work. It is important that you continue to give it regularly, even if you think it isn’t helping yet.
Your doctor will want to see your child when they have been taking the medicine for 4–6 weeks, to see if it is helping.
What if my child is sick (vomits)?
- If your child is sick less than 30 minutes after having a dose of imipramine, give them the same dose again.
- If your child is sick more than 30 minutes after having a dose of imipramine, you do not need to give them another dose. Wait until the next normal dose.
If your child is sick again, seek advice from your GP, pharmacist or hospital. They will decide what to do based on your child’s condition and the specific medicine involved.
What if I forget to give it?
If you forget to give imipramine you do not need to wake your child up to give the missed dose.
- For bedwetting: you can give the missed dose in the morning, as long as this is at least 6 hours before the evening dose is due. However, if this is likely to make your child sleepy, it may be better to forget the missed dose altogether and give the next evening dose as usual.
- For mood or behavioural problems: Wait until the next normal dose. If you have forgotten to give more than one dose, contact your doctor for advice.
Never give a double dose of imipramine.
What if I give too much?
It may be dangerous to give too much imipramine.
If you think you may have given your child too much imipramine, take your child to hospital straight away. Take the medicine container or packet with you, even if it is empty. This will be useful to the doctor. Have the packet with you if you telephone for advice.
Are there any possible side-effects?
We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects).
Side-effects that you must do something about
If your child has a seizure (fit), take them to hospital or telephone for an ambulance straight away, as they may have had too much imipramine.
If your child’s heart is racing, or they feel a fluttering feeling in the chest (palpitations), contact your doctor straight away, or take your child to hospital.
If your child develops shakes, contact your doctor straight away.
Other side-effects you need to know about
- Your child may have a dry mouth. Eating citrus fruits (e.g. oranges) and taking sips of water may help.
- Your child may feel drowsy or sleepy for a few hours after each dose. This is why imipramine is usually taken at bedtime.
- Your child may have more of an appetite than usual. Encourage them to eat fruit and vegetables and low-calorie foods, rather than foods that contain a lot of calories (cakes, biscuits, crisps) and to have plenty of physical activity. Otherwise they may put on weight.
- Your child may get headaches.
- Your child may feel light headed, dizzy or faint, especially if they stand up too quickly. They should stand up slowly, and should lie down for a short while if they feel faint.
Your child may get the following side-effects when they first start taking imipramine. These usually wear off as their body gets used to the medicine. If they are still a problem after a week of so, contact your doctor.
- Your child’s vision may be blurred (fuzzy).
- They may have constipation (difficulty doing a poo). Give your child food that contains fibre (wholemeal bread, bran, fruit and vegetables) and make sure they have plenty to drink.
- Your child may feel sick or be sick (vomit). It may help to give the tablets with some food.
- Your child may feel tense, nervous, distressed, restless, worried or on edge.
There may, sometimes, be other side-effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side-effects to a UK safety scheme at http://www.mhra.gov.uk/yellowcard.
Can other medicines be given at the same time as imipramine?
- You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.
- Imipramine should not be taken with some medicines that you get on prescription. It is important to tell your doctor and pharmacist about any other medicines your child is taking, before starting imipramine.
- Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal or complementary medicines.
Is there anything else I need to know about imipramine?
If your child has ever had a problem with their heart, tell your doctor before giving imipramine.
Do not suddenly stop giving imipramine to your child, as they may get withdrawal symptoms.
- If your doctor decides to stop imipramine, they will discuss this with you. You will usually reduce the dose bit by bit to make sure that your child doesn’t get withdrawal symptoms. Do not change the dose without talking to your doctor first.
General advice about medicines
- Try to give medicines at about the same time each day, to help you remember.
- Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.
If you think someone else may have taken the medicine by accident, contact your doctor straight away.
- Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.
- Make sure that the medicine you have at home has not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.
Where should I keep this medicine?
- Keep the medicine in a cupboard, away from heat and direct sunlight. It does not need to be kept in the fridge.
- Make sure that children cannot see or reach the medicine.
- Keep the medicine in the container it came in.
Who to contact for more information
Your child’s doctor, pharmacist or nurse will be able to give you more information about imipramine and about other medicines used to treat your child’s condition.
You can also get useful information from:
- England - NHS 111
- Scotland - NHS 24
- Wales/Galw lechyd Cymru - NHS Direct
0845 46 47
- Northern Ireland - NI Direct
0845 766 0163
- YoungMinds Parents helpline
0808 802 5544
- Samaritans Helpline
08457 90 90 90
- ChildLine Helpline
- ERIC (Education and Resources to Improve Childhood Continence)
0845 370 8008
Version 2, January 2014. © NPPG, RCPCH and WellChild 2010, all rights reserved. Review by: January 2017.
The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk
We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.