Imipramine (international nonproprietary name - imipramine) belongs to a large class now demanded drugs designed to combat depressive states, in other words - antidepressants.
Melipraminum available in three different dosage forms:
- Tablets, film-coated with an active substance (in its role appears imipramine hydrochloride) 25 mg per tablet. The package - 50 tablets;
- Drops. The content of the active substance and the amount of pellets in the package is the same as for tablets;
- Solution for parenteral administration at a dosage of 12 5 mg / mL in the package - 10 ampoules of 2 ml.
All of the above dosage forms are manufactured oldest Hungarian pharmaceutical factory "Aegis", which is already more than half a century, supplying its products to the Russian pharmacy shelves.
Analogues of imipramine in the full sense of the word (and this implies in terms of the identity of the active substance - imipramine) in the Russian market today, no. Imipramine refers to a group of non-selective inhibitors of reverse neuronal uptake of norepinephrine and serotonin. This group of drugs, in turn, are widely represented in local pharmacies. For analogs imipramine include:
- Anafranil (active ingredient - clomipramine), Switzerland;
- Klofranil (clomipramine), India;
- Amitriptyline (amitriptyline), Russia, Latvia (amitriptyline-Grindeks), Czech Republic (amitriptyline-Zentiva), Denmark (amitriptyline, Nycomed), Canada (Apo-Amitriptyline);
- Lyudiomil (maprotiline), Switzerland.
But the other antidepressants, of which, according to official international classification, there are 4 classes, can hardly be classified as imipramine analogs, as they have more or less different from a mechanism of action.
Melipraminum prevents reverse neuronal capture monoamine neurotransmitters transmission (norepinephrine and serotonin), thereby creating their increased concentration in the synapses of neurons in the central nervous system. Because of this, the drug has a stimulating effect and prevents the development of depression. Melipraminum removes brake barriers that reduce the motor activity, uplifting. But we should not expect instant action of the drug: the basis of reviews of imipramine, an antidepressant effect is lasting for 2-3 weeks of use of the drug.
Imipramine also has antidiuretic (which can be used in the treatment of enuresis), antiarrhythmic and analgesic.
According to the instructions to imipramine and reviews about him this drug is used in the following cases:
- Depressive of different origin and severity;
- Bedwetting in the absence of organic lesions of the central nervous system. Important: The drug should not be used in children under 6 years;
- Prophylaxis of migraine headaches.
Guide to imipramine in injectable form contains two indications:
- Panic disorder (occurrence at intervals several times a year (in severe cases - daily) unmotivated panic attacks);
- obsessive-compulsive disorders (obsessive occurrence of unreasonable ideas of force majeure).
Regulations on the use of imipramine
Adults begin treatment with a single oral (pills) 1-3- times a day. The maximum permitted daily dose - 8 tablets. To achieve sustainable antidepressant effect dose is reduced to two tablets a day.
Elderly and young people are usually assigned lower doses of the drug: poltabletki once a day. The maximum dose - 75 mg (three tablets / pills), divided into three stages. After the occurrence and retention of the therapeutic effect of the drug is taken in a maintenance dose that is 25 mg per day.
Babies for the treatment of bedwetting drug administered according to body weight (a complete table is given in the instructions for imipramine). The duration of treatment of enuresis - not less than 3 months.
With regard to the injection form of imipramine, the injections are made strictly intramuscularly. Application forms of formulation Ampouled justified at the beginning of treatment, when necessary to achieve a high concentration of active substance in the blood. The initial dose of -25 mg three times a day with a maximum - 100 mg per day. Subsequently, using tablets or dragees.
Reviews of imipramine caused the inclusion in the instructions following contraindications:
- idiosyncrasy of drug-induced hypersensitivity to it;
- the waiting period of the child and breastfeeding;
- the liver and kidneys;
- cardiac insufficiency, acute phase of coronary heart disease (heart attack);
- antidepressants, monoamine oxidase inhibitors belonging to the group (MAO);
- Children up to age 6 years.
In a review of imipramine cited the following adverse effects of this drug:
- blurred consciousness;
- involuntary trembling of body parts;
- numbness, "goose bumps" on the skin;
- somnological disorders (insomnia);
- palpitations or cardiac arrhythmias;
- urinary retention, constipation;
- decreased sex drive up to the impotence;
- body weight gain;
- increased sweating.
As mentioned above, Melipraminum not be used in conjunction with MAO inhibitors. If you need to change the antidepressant, the interval between courses of treatment with these two groups should be at least 2-weeks.
Strongly recommended to combine the drug with the drinking.
Sudden discontinuation of imipramine fraught with withdrawal syndrome, manifested by headache, nausea, mood swings, impaired heart rate and muscle tone. Therefore, we recommend gradually reduce the dosage of the drug to complete its cancellation.
Treatment of elderly patients imipramine binding makes a series of control tests: ECG, blood pressure and heart rate, blood tests and analysis on liver enzymes.
In order not to provoke insomnia (see. "Side effects"), Melipraminum for depression is usually recommended to take in the morning.
While on the course of treatment imipramine should not be sharply up from a sitting or lying down. Another limitation - a ban on driving vehicles and Occupation potentially hazardous activities that require attention.
Implementation of imipramine and analogs of pharmacies is strictly by prescription in the prescribed form. And if in relation to other, more innocuous drugs, pharmacists sometimes go to meet the buyer, in this case relaxations wait hardly worth it.
Instructions for storage Melipraminum
Melipraminum should be stored at 15-25 ° C. Shelf life is set within 3 years from the date of issue.