Generic Name: Imipramine

  • What is Tofranil?

    Tofranil is a medication used to treat depression. It is also used to treat bed-wetting in children ≥6 years.

  • What is the most important information I should know about Tofranil?

    Tofranil may increase suicidal thoughts or actions in some children, teenagers, and young adults when it is first started.

    Do not take Tofranil if you are taking another antidepressant drug known as a monoamine oxidase inhibitor (MAOI) or if you have stopped taking an MAOI in the last 14 days. MAOI drugs include phenelzine, tranylcypromine, and isocarboxazid. Taking Tofranil within 2 weeks of an MAOI can result in serious, sometimes fatal, reactions, including high body temperature, coma, and seizures.

  • Who should not take Tofranil?

    Do not take Tofranil if you are recovering from a heart attack, if you are allergic or sensitive to it, or if you are using MAOI drugs or have used an MAOI in the last 14 days.

  • What should I tell my doctor before I take the first dose of Tofranil?

    Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Tofranil. Also, talk to your doctor about your complete medical history, especially if you have a history of heart disease, congestive heart failure, abnormal heart rhythm, have had a heart attack, stroke, rapid heartbeat, glaucoma (increased pressure in the eye), difficulty urinating, an enlarged prostate, overactive thyroid, seizures, schizophrenia, bipolar disorder, kidney or liver disease, diabetes, and if you will be undergoing surgery or electroconvulsive therapy (ECT).

  • What is the usual dosage?

    The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.


    Adults: The usual dose is 75 milligrams (mg) a day, but your doctor may increase this to 150 mg a day.

    Elderly and adolescents: The usual dose is 30-40 mg a day.


    Children ≥6 years: The starting dose is 25 mg a day taken 1 hour before bedtime. If needed, this dose may be increased after 1 week to 50 mg (ages 6-11 years) or 75 mg (ages ≥12 years).

  • How should I take Tofranil?

    Take Tofranil exactly as prescribed by your doctor. Do not stop taking Tofranil if you feel no immediate effect. It can take anywhere from 1-3 weeks before you feel better. An abrupt decrease in dose could result in general feelings of illness, headache, and nausea.

    Tofranil may be taken with or without food. It may be taken several times a day or in one daily dose at bedtime.

  • What should I avoid while taking Tofranil?

    Do not drive or operate machinery, or participate in any activities that require full alertness until you know how this medication affects you.

    Use alcohol cautiously since it may increase drowsiness and dizziness while you are taking Tofranil.

    Tofranil may increase your skin's sensitivity to sunlight which could cause rash, itching, redness, or sunburn. Avoid direct sunlight or wear protective clothing.

  • What are possible food and drug interactions associated with Tofranil?

    If Tofranil is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Tofranil with the following: albuterol, antidepressants, antipsychotic drugs, barbiturates such as phenobarbital, benztropine, blood pressure medications, carbamazepine, cimetidine, epinephrine, flecainide, guanethidine, methylphenidate, narcotic painkillers such as codeine and oxycodone, norepinephrine, phenytoin, propafenone, pseudoephedrine, quinidine, thyroid medications, and tranquilizers. If you are switching from fluoxetine (an antidepressant), wait at least 5 weeks after your last dose of fluoxetine before starting Tofranil.

  • What are the possible side effects of Tofranil?

    Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

    Side effects may include: breast development in males, breast enlargement in females, breast milk production, confusion, diarrhea, dry mouth, hallucinations, high blood pressure, hives, low blood pressure upon standing, nausea, numbness, tremors, vomiting

    Side effects in children being treated for bed-wetting include: anxiety, collapse, constipation, emotional instability, fainting, fatigue, nervousness, seizures, sleep disorders, stomach and intestinal problems

  • Can I receive Tofranil if I am pregnant or breastfeeding?

    The effects of Tofranil during pregnancy and breastfeeding are unknown. Tell your doctor immediately if you are pregnant, plan to become pregnant, or are breastfeeding.

  • What should I do if I miss a dose of Tofranil?

    If you miss a dose of Tofranil, take it as soon as you remember. However, if it is almost time for your next dose, skip the one you missed and return to your regular dosing schedule. Do not take two doses at once.

  • How should I store Tofranil?

    Store at room temperature.