When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to imipramine or a similar medicine, or you had a recent heart attack.

How to Use This Medicine:
Capsule, Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you. It may take 2 to 3 weeks before you start to feel better.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine and an MAO inhibitor (MAOI) within 14 days of each other.
• Some foods and medicines can affect how imipramine works. Tell your doctor if you are using any of the following:
  
  • Buspirone, cimetidine, clonidine, epinephrine, fentanyl, guanethidine, lithium, methylphenidate, norepinephrine, St John's wort, tramadol, or tryptophan supplements
  • A triptan medicine to treat migraine headaches, medicine for heart rhythm problems (quinidine, flecainide, propafenone), medicine to lower blood pressure, medicine to treat seizures (phenobarbital, phenytoin), or a phenothiazine medicine (such as chlorpromazine, perphenazine, promethazine, prochlorperazine, thioridazine)
• Tell your doctor if you are also using other medicine to treat depression, such as fluoxetine, paroxetine, or sertraline. You may need to wait at least 5 weeks before you begin using imipramine.
• Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney or liver disease, glaucoma, heart or blood vessel disease, heart rhythm problems, trouble urinating, thyroid problems, or a history of schizophrenia or seizures.
• For some children, teenagers, and young adults, this medicine may increase mental or emotional problems. This may lead to thoughts of suicide and violence. Talk with your doctor right away if you have any thoughts or behavior changes that concern you. Tell your doctor if you or anyone in your family has a history of bipolar disorder or suicide attempts.
• This medicine may cause a serious reaction called serotonin syndrome, which can be life-threatening.
• This medicine may make you dizzy or drowsy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
• Tell any doctor or dentist who treats you that you are using this medicine. You may need to stop using this medicine several days before you have surgery or medical tests.
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• This medicine may make your skin more sensitive to sunlight. Wear sunscreen. Do not use sunlamps or tanning beds.
• This medicine may raise or lower your blood sugar level.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Agitation, irritability, sudden increase in energy, trouble sleeping
• Anxiety, restlessness, fever, sweating, muscle spasms, nausea, vomiting, diarrhea, seeing or hearing things that are not there
• Eye pain, vision changes, seeing halos around lights
• Fast, pounding, or uneven heartbeat
• Fever, sore throat, cough, chills
• Thoughts of hurting yourself or others, trouble sleeping, unusual behavior

If you notice these less serious side effects, talk with your doctor:

• Dry mouth, constipation
• Tiredness

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088