Medicines

Imipramine for various conditions

This leaflet is for parents and carers about how to use this medicine in children. Our information may differ from that provided by the manufacturers, because their information usually relates to adults. Read this leaflet carefully. Keep it somewhere safe so that you can read it again.

Do not stop giving this medicine suddenly, as your child could get withdrawal symptoms.

Name of medicine

Imipramine (also called imipramine hydrochloride)

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.

Why is it important for my child to take imipramine?

This medicine will help to reduce your child’s symptoms and improve their mood and behaviour. If it is being used for bedwetting, 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?

Tablets

Tablets should be swallowed with a glass of water, milk or juice. Your child should not chew the tablets. You can crush the tablet and mix it with a small amount of soft food such as yogurt, honey or jam. Make sure your child swallows it all straight away.

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.

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.

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, do not give them another dose. Wait until the next normal dose.

If your child is sick again, seek advice from your family doctor, nurse, 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?

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.

It may be dangerous to give too much imipramine.

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 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 sipping 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.

  • They may be hungrier than usual (increased appetite). Encourage them to eat fruit and vegetables and low-calorie foods, rather than foods that contain a lot of calories (avoid crisps, cakes, biscuits and sweets), and to have plenty of exercise. Otherwise they may put on weight.

     

  • Your child may feel dizzy or light-headed when they stand up, or may faint. Encourage them to stand up slowly, and to sit or lie down if they feel dizzy or light-headed. If this happens often, contact your doctor to check your child’s blood pressure and blood sugar level, as it may be too low.

  • They may get headaches.

  • Your child’s eyesight may be blurred (fuzzy).

  • They may get constipated (have difficulty doing a poo). Make sure they eat food that contains fibre (e.g. bran, wholemeal bread, rice, pasta, fruit and vegetables) and that they drink plenty of fluid. If this is still a problem after 2 weeks, contact your doctor for advice.

     

  • Your child may feel sick or be sick (vomit) when they first start taking imipramine. Giving the medicine with some food may help. This effect should wear off after a few days as your child’s body gets used to the medicine. If it is still a problem after a week, contact your doctor for advice.

  • 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 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 and complementary medicines.

Is there anything else I need to know about this medicine?

If your child has ever had a problem with their heart or liver, 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 slowly to make sure 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 times 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.
  • 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 medicines you have at home have not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.

If you think someone else may have taken the medicine by accident, contact your doctor straight away.

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.
  • Some liquid medicine does not keep for long once opened. Write the date that you start it on the bottle and do not keep the medicine for longer than stated on the label.
  • 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 or pharmacist will be able to give you more information about imipramine and about other medicines used to treat your child’s condition.

England: NHS 111

Tel 111

www.nhs.uk

Scotland: NHS 24

Northern Ireland: NI Direct

Wales: NHS Direct

Tel 111 (free) or 0845 46 47 (2p per minute)

111.wales.nhs.uk/

ChildLine

ERIC: The Children's Bowel and Bladder Charity

Mind (mental health support)

0300 123 3393

www.mind.org.uk

Samaritans

Young Minds - parent helpine

Copyright disclaimer

Version [2]. © NPPG, RCPCH and WellChild, 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.