Peringatan Keamanan

The anticholinergic actvity of imipramine can produce dry mucous membranes, blurred vision, increased intraocular pressure, hyperthermia, constipation, adynamic ileus, urinary retention, delayed micturition, and dilation of the urinary tract L1360.

Central nervous system and neuromuscular effects include drowsiness, lethargy, fatigue, agitation, excitement, nightmares, restlessness, insomnia, confusion, disturbed concentration, disorientation, delusions, and hallucinations.

Effects on the GI tract include anorexia, nausea and vomiting, diarrhea, abdominal cramps, increases in pancreatic enzymes, epigastric distress, stomatitis, peculiar taste, and black tongue.

Rarely agranulocytosis, thrombocytopenia, eosinophilia, leukopenia, and purpura have occured.

Infants whose mothers were receiving tricyclic antidepressants prior to delivery have experienced cardiac problems, irritability, respiratory distress, muscle spasms, seizures, and urinary retention.

Serotonin syndrome can occur when used in conjunction with other pro-serotonergic drugs.

### LD50 Values
Rat
- Oral 250 mg/kg
- Intraperitoneal 79mg/kg
- Subcutaneous 250 mg/kg
- Intravenous 15.9 mg/kg

Mouse
- Oral 188 mg/kg
- Intraperitoneal 51.6 mg/kg
- Subcutaneous 195 ?g/kg
- Intravenous 21 mg/kg

Human range of toxicity is considered to include single dosages greater than 5 mg/kg.

Imipramine

DB00458

small molecule approved

Deskripsi

Imipramine, the prototypical tricyclic antidepressant (TCA), is a dibenzazepine-derivative TCA. TCAs are structurally similar to phenothiazines. They contain a tricyclic ring system with an alkyl amine substituent on the central ring. In non-depressed individuals, imipramine does not affect mood or arousal, but may cause sedation. In depressed individuals, imipramine exerts a positive effect on mood. TCAs are potent inhibitors of serotonin and norepinephrine reuptake. Tertiary amine TCAs, such as imipramine and amitriptyline, are more potent inhibitors of serotonin reuptake than secondary amine TCAs, such as nortriptyline and desipramine. TCAs also block histamine H1 receptors, α1-adrenergic receptors and muscarinic receptors, which accounts for their sedative, hypotensive and anticholinergic effects (e.g. blurred vision, dry mouth, constipation, urinary retention), respectively A6584. Imipramine has less sedative and anticholinergic effects than the tertiary amine TCAs, amitriptyline and clomipramine. Imipramine may be used to treat depression and nocturnal enuresis in children FDA Label. Unlabeled indications include chronic and neuropathic pain (including diabetic neuropathy), panic disorder, attention-deficit/hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD) L1349,L1348,A31900,L1351,L1352,L1353,A31904.

Struktur Molekul 2D

Berat 280.4073
Wujud solid

Peta Jejaring Molekuler
Legenda: ObatTargetGenEnzim(Panah → menunjukkan arah efek / relasi)TransporterCarrier

Profil Farmakokinetik

Waktu Paruh (Half-Life) Imipramine has a mean half life of 12 h. Its active metabolite, desipramine has a mean half life of 22.5 h [A31907].
Volume Distribusi Imipramine has a high apparent volume of distribution of 10-20 L/kg [A31907]. The drug is known to accumulate in the brain at concentrations 30-40 times that in systemic circulation.
Klirens (Clearance) Imipramine has a mean clearance of 1 L/h/kg. Its active metabolite, desipramine has a mean clearance of 1.8 L/h/kg [A31907].

Absorpsi

Rapidly and well absorbed (>95%) after oral administration A31907. The primary site of absorption is the small intestine as the basic amine groups are ionized in the acidic environment of the stomach, preventing movement across tissues. Bioavailability ranges from 29-77% due to high inter-individual variability. Peak plasma concentration is usually attained 2-6 hours following oral administration. Absorption is unaffected by food.

Metabolisme

Imipramine is nearly exclusively metabolized by the liver A31907. Imipramine is converted to desipramine by CYP1A2, CYP3A4, CYP2C19. Both imipramine and desipramine are hydroxylated by CYP2D6 A31915. Desipramine is an active metabolite. Minor metabolic pathways include dealkylation to form an imidodibenzyl product as well as demethylation of desipramine to didemethylimipramine and subsequent hydroxylation A31907. Less than 5% of orally administered imipramine is excreted unchanged.

Rute Eliminasi

Imipramine is primarily excreted in the urine with less than 5% present as the parent compound A31907

Farmakogenomik

9 Varian
CYP2D6 (rs3892097)

Patients with this genotype have reduced metabolism of imipramine.

CYP2D6 (rs35742686)

The presence of this polymorphism in CYP2D6 is associated with poor metabolism of imipramine.

CYP2D6 (rs3892097)

The presence of this polymorphism in CYP2D6 is associated with poor metabolism of imipramine.

CYP2D6 (None)

The presence of this polymorphism in CYP2D6 is associated with poor metabolism of imipramine.

CYP2D6 (rs5030655)

The presence of this polymorphism in CYP2D6 is associated with poor metabolism of imipramine.

CYP2C19 (rs4244285)

The presence of this polymorphism in CYP2C19 is associated with poor metabolism of imipramine.

CYP2C19 (rs4986893)

The presence of this polymorphism in CYP2C19 is associated with reduced or poor metabolism of imipramine.

CYP2D6 (rs1135824)

The presence of this polymorphism in CYP2D6 is associated with poor metabolism of imipramine.

CYP2D6 (rs28371733)

The presence of this polymorphism in CYP2D6 is associated with poor metabolism of imipramine.

Interaksi Makanan

5 Data
  • 1. Avoid alcohol.
  • 2. Avoid St. John's Wort.
  • 3. Do not take with bran and high fiber foods.
  • 4. Limit caffeine intake.
  • 5. Take with food.

Interaksi Obat

2428 Data
Ivabradine Ivabradine may increase the QTc-prolonging activities of Imipramine.
Duloxetine The risk or severity of orthostatic hypotension and syncope can be increased when Imipramine is combined with Duloxetine.
Levodopa The risk or severity of hypotension and orthostatic hypotension can be increased when Imipramine is combined with Levodopa.
Risperidone Imipramine may increase the hypotensive activities of Risperidone.
Cilostazol The serum concentration of Cilostazol can be increased when it is combined with Imipramine.
Deferasirox The serum concentration of Imipramine can be increased when it is combined with Deferasirox.
Flibanserin The serum concentration of Flibanserin can be increased when it is combined with Imipramine.
Peginterferon alfa-2b The serum concentration of Imipramine can be increased when it is combined with Peginterferon alfa-2b.
Leflunomide The serum concentration of Imipramine can be decreased when it is combined with Leflunomide.
Teriflunomide The serum concentration of Imipramine can be decreased when it is combined with Teriflunomide.
Valsartan Imipramine may decrease the antihypertensive activities of Valsartan.
Remikiren Imipramine may decrease the antihypertensive activities of Remikiren.
Guanadrel Imipramine may decrease the antihypertensive activities of Guanadrel.
Olmesartan Imipramine may decrease the antihypertensive activities of Olmesartan.
Minoxidil Imipramine may decrease the antihypertensive activities of Minoxidil.
Trandolapril Imipramine may decrease the antihypertensive activities of Trandolapril.
Benazepril Imipramine may decrease the antihypertensive activities of Benazepril.
Candoxatril Imipramine may decrease the antihypertensive activities of Candoxatril.
Nitroglycerin Imipramine may decrease the antihypertensive activities of Nitroglycerin.
Cryptenamine Imipramine may decrease the antihypertensive activities of Cryptenamine.
Eprosartan Imipramine may decrease the antihypertensive activities of Eprosartan.
Quinapril Imipramine may decrease the antihypertensive activities of Quinapril.
Omapatrilat Imipramine may decrease the antihypertensive activities of Omapatrilat.
Deserpidine Imipramine may decrease the antihypertensive activities of Deserpidine.
Rescinnamine Imipramine may decrease the antihypertensive activities of Rescinnamine.
Saprisartan Imipramine may decrease the antihypertensive activities of Saprisartan.
Spirapril Imipramine may decrease the antihypertensive activities of Spirapril.
Diethylnorspermine Imipramine may decrease the antihypertensive activities of Diethylnorspermine.
Temocapril Imipramine may decrease the antihypertensive activities of Temocapril.
Rauwolfia serpentina root Imipramine may decrease the antihypertensive activities of Rauwolfia serpentina root.
Angiotensin 1-7 Imipramine may decrease the antihypertensive activities of Angiotensin 1-7.
Imidapril Imipramine may decrease the antihypertensive activities of Imidapril.
BQ-123 Imipramine may decrease the antihypertensive activities of BQ-123.
Zofenopril Imipramine may decrease the antihypertensive activities of Zofenopril.
Guanoxan Imipramine may decrease the antihypertensive activities of Guanoxan.
Delapril Imipramine may decrease the antihypertensive activities of Delapril.
Vincamine Imipramine may decrease the antihypertensive activities of Vincamine.
Linsidomine Imipramine may decrease the antihypertensive activities of Linsidomine.
Guanoxabenz Imipramine may decrease the antihypertensive activities of Guanoxabenz.
Tolonidine Imipramine may decrease the antihypertensive activities of Tolonidine.
Endralazine Imipramine may decrease the antihypertensive activities of Endralazine.
Cadralazine Imipramine may decrease the antihypertensive activities of Cadralazine.
Bietaserpine Imipramine may decrease the antihypertensive activities of Bietaserpine.
Guanazodine Imipramine may decrease the antihypertensive activities of Guanazodine.
Methoserpidine Imipramine may decrease the antihypertensive activities of Methoserpidine.
Guanoclor Imipramine may decrease the antihypertensive activities of Guanoclor.
Tocopherylquinone Imipramine may decrease the antihypertensive activities of Tocopherylquinone.
Benazeprilat Imipramine may decrease the antihypertensive activities of Benazeprilat.
Fosinoprilat Imipramine may decrease the antihypertensive activities of Fosinoprilat.
Ramiprilat Imipramine may decrease the antihypertensive activities of Ramiprilat.
Perindoprilat Imipramine may decrease the antihypertensive activities of Perindoprilat.
Quinaprilat Imipramine may decrease the antihypertensive activities of Quinaprilat.
Pinacidil Imipramine may decrease the antihypertensive activities of Pinacidil.
Riociguat The serum concentration of Imipramine can be increased when it is combined with Riociguat.
Aliskiren Imipramine may decrease the antihypertensive activities of Aliskiren.
Bosentan Imipramine may decrease the antihypertensive activities of Bosentan.
Enalapril Imipramine may decrease the antihypertensive activities of Enalapril.
Candesartan cilexetil Imipramine may decrease the antihypertensive activities of Candesartan cilexetil.
Irbesartan Imipramine may decrease the antihypertensive activities of Irbesartan.
Captopril Imipramine may decrease the antihypertensive activities of Captopril.
Cilazapril Imipramine may decrease the antihypertensive activities of Cilazapril.
Candesartan Imipramine may decrease the antihypertensive activities of Candesartan.
Ramipril Imipramine may decrease the antihypertensive activities of Ramipril.
Perindopril Imipramine may decrease the antihypertensive activities of Perindopril.
Diazoxide Imipramine may decrease the antihypertensive activities of Diazoxide.
Buprenorphine Imipramine may increase the central nervous system depressant (CNS depressant) activities of Buprenorphine.
Doxylamine Doxylamine may increase the central nervous system depressant (CNS depressant) activities of Imipramine.
Dronabinol Dronabinol may increase the central nervous system depressant (CNS depressant) activities of Imipramine.
Droperidol Droperidol may increase the central nervous system depressant (CNS depressant) activities of Imipramine.
Hydrocodone Imipramine may increase the central nervous system depressant (CNS depressant) activities of Hydrocodone.
Magnesium sulfate The therapeutic efficacy of Imipramine can be increased when used in combination with Magnesium sulfate.
Methotrimeprazine Imipramine may increase the central nervous system depressant (CNS depressant) activities of Methotrimeprazine.
Metyrosine Imipramine may increase the sedative activities of Metyrosine.
Minocycline Minocycline may increase the central nervous system depressant (CNS depressant) activities of Imipramine.
Nabilone Nabilone may increase the central nervous system depressant (CNS depressant) activities of Imipramine.
Orphenadrine Imipramine may increase the central nervous system depressant (CNS depressant) activities of Orphenadrine.
Paraldehyde Imipramine may increase the central nervous system depressant (CNS depressant) activities of Paraldehyde.
Perampanel Perampanel may increase the central nervous system depressant (CNS depressant) activities of Imipramine.
Pramipexole Imipramine may increase the sedative activities of Pramipexole.
Rotigotine Imipramine may increase the sedative activities of Rotigotine.
Rufinamide The risk or severity of adverse effects can be increased when Rufinamide is combined with Imipramine.
Sodium oxybate Imipramine may increase the central nervous system depressant (CNS depressant) activities of Sodium oxybate.
Suvorexant Imipramine may increase the central nervous system depressant (CNS depressant) activities of Suvorexant.
Tapentadol Tapentadol may increase the central nervous system depressant (CNS depressant) activities of Imipramine.
Thalidomide Imipramine may increase the central nervous system depressant (CNS depressant) activities of Thalidomide.
Dabrafenib The serum concentration of Imipramine can be decreased when it is combined with Dabrafenib.
Clopidogrel The serum concentration of the active metabolites of Clopidogrel can be reduced when Clopidogrel is used in combination with Imipramine resulting in a loss in efficacy.
Brexpiprazole The metabolism of Brexpiprazole can be decreased when combined with Imipramine.
Eliglustat The metabolism of Imipramine can be decreased when combined with Eliglustat.
Aclidinium The risk or severity of adverse effects can be increased when Imipramine is combined with Aclidinium.
Mianserin Mianserin may increase the anticholinergic activities of Imipramine.
Mirabegron The risk or severity of urinary retention can be increased when Imipramine is combined with Mirabegron.
Potassium chloride The risk or severity of gastrointestinal ulceration can be increased when Imipramine is combined with Potassium chloride.
Pramlintide The risk or severity of reduced gastrointestinal motility can be increased when Pramlintide is combined with Imipramine.
Secretin porcine The therapeutic efficacy of Secretin porcine can be decreased when used in combination with Imipramine.
Tiotropium The risk or severity of adverse effects can be increased when Imipramine is combined with Tiotropium.
Topiramate The risk or severity of hyperthermia and oligohydrosis can be increased when Imipramine is combined with Topiramate.
Umeclidinium The risk or severity of adverse effects can be increased when Imipramine is combined with Umeclidinium.
Doxapram The risk or severity of hypertension can be increased when Imipramine is combined with Doxapram.
Phenmetrazine The risk or severity of hypertension can be increased when Imipramine is combined with Phenmetrazine.

Target Protein

Sodium-dependent noradrenaline transporter SLC6A2
Sodium-dependent serotonin transporter SLC6A4
5-hydroxytryptamine receptor 2A HTR2A
Histamine H1 receptor HRH1
Alpha-1A adrenergic receptor ADRA1A
Alpha-1D adrenergic receptor ADRA1D
Muscarinic acetylcholine receptor M1 CHRM1
Muscarinic acetylcholine receptor M2 CHRM2
Muscarinic acetylcholine receptor M3 CHRM3
Muscarinic acetylcholine receptor M4 CHRM4
Muscarinic acetylcholine receptor M5 CHRM5
A-type voltage-gated potassium channel KCND2 KCND2
A-type voltage-gated potassium channel KCND3 KCND3
5-hydroxytryptamine receptor 2C HTR2C
Alpha-1B adrenergic receptor ADRA1B
5-hydroxytryptamine receptor 7 HTR7
D(1) dopamine receptor DRD1
D(2) dopamine receptor DRD2
Voltage-gated inwardly rectifying potassium channel KCNH2 KCNH2
Sodium-dependent dopamine transporter SLC6A3
5-hydroxytryptamine receptor 1A HTR1A
5-hydroxytryptamine receptor 6 HTR6
Voltage-gated delayed rectifier potassium channel KCNH1 KCNH1
Alpha-1-acid glycoprotein 2 ORM2

Referensi & Sumber

Synthesis reference: U.S. Patent 2,554,736.
Artikel (PubMed)
  • PMID: 16925191
    Authors unspecified: Treatment of patients with eating disorders,third edition. American Psychiatric Association. Am J Psychiatry. 2006 Jul;163(7 Suppl):4-54.
  • PMID: 9846782
    Low PA, Dotson RM: Symptomatic treatment of painful neuropathy. JAMA. 1998 Dec 2;280(21):1863-4.
  • PMID: 2185906
    Sallee FR, Pollock BG: Clinical pharmacokinetics of imipramine and desipramine. Clin Pharmacokinet. 1990 May;18(5):346-64.
  • PMID: 16968950
    Gardiner SJ, Begg EJ: Pharmacogenetics, drug-metabolizing enzymes, and clinical practice. Pharmacol Rev. 2006 Sep;58(3):521-90. doi: 10.1124/pr.58.3.6.
  • PMID: 17471183
    Gillman PK: Tricyclic antidepressant pharmacology and therapeutic drug interactions updated. Br J Pharmacol. 2007 Jul;151(6):737-48. Epub 2007 Apr 30.
  • PMID: 17762509
    Schmidt HD, Duman RS: The role of neurotrophic factors in adult hippocampal neurogenesis, antidepressant treatments and animal models of depressive-like behavior. Behav Pharmacol. 2007 Sep;18(5-6):391-418. doi: 10.1097/FBP.0b013e3282ee2aa8.
  • PMID: 8852528
    Heninger GR, Delgado PL, Charney DS: The revised monoamine theory of depression: a modulatory role for monoamines, based on new findings from monoamine depletion experiments in humans. Pharmacopsychiatry. 1996 Jan;29(1):2-11. doi: 10.1055/s-2007-979535.
  • PMID: 3029045
    Wamsley JK, Byerley WF, McCabe RT, McConnell EJ, Dawson TM, Grosser BI: Receptor alterations associated with serotonergic agents: an autoradiographic analysis. J Clin Psychiatry. 1987 Mar;48 Suppl:19-25.
Menampilkan 8 dari 9 artikel.
Textbook
  • ISBN: 978-1-25-958473-2
    Brunton LL, Hilal-Dandan R, Knollmann BC. eds (2018). Goodman & Gilman's: The Pharmacological Basis of Therapeutics (13th ed.). McGraw-Hill Education.

Contoh Produk & Brand

Produk: 139 • International brands: 12
Produk
  • Apo-imipramine
    Tablet • 10 mg • Oral • Canada • Generic • Approved
  • Apo-imipramine
    Tablet • 25 mg • Oral • Canada • Generic • Approved
  • Apo-imipramine
    Tablet • 50 mg • Oral • Canada • Generic • Approved
  • Apo-imipramine
    Tablet • 75 mg • Oral • Canada • Generic • Approved
  • Imipramine
    Tablet • 75 mg • Oral • Canada • Approved
  • Imipramine
    Tablet • 25 mg • Oral • Canada • Approved
  • Imipramine
    Tablet • 50 mg • Oral • Canada • Approved
  • Imipramine
    Tablet • 10 mg • Oral • Canada • Approved
Menampilkan 8 dari 139 produk.
International Brands
  • Antidep — Torrent
  • Antideprin
  • Depsonil — Abbott
  • Depsonil-PM — Abbott
  • Elamin — Baroda
  • Fronil — Johnson
  • Imidol — Tanabe Mitsubishi Pharma
  • Imipramin Dak — Nycomed
  • Imiprex — Dumex
  • Irmin

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