Dosage ; Adults: Initially up to 75mg for outpatients.
For hospitalized patients the dose is increased stepwise to 150mg-200mg. Maintenance dose: 150-200mg daily.
| Brand Name | Manufacturer Name | Distributor | Drug Strength | Packaging | Formulation | Formulation Strength | Price |
|---|---|---|---|---|---|---|---|
| Tofranil | Novartis Consumers | Harley's Limited | 25mg | 50 | Tablet | per tablet | KES 933.00 |
| Imipramine | Metro | 25mg | 28s | Tablet | Per tablet | KES 300.00 |
| Mode Of Action | The mechanism of action of amitriptylinne is not fully known but may be due to its increasing the synaptic concentration of norepinephrine and/or serotonin in the central nervous system (CNS). These neurotransmitters are thought to be increased through inhibition of their reuptake by the presynaptic neuronal membrane. |
|---|---|
| Drug Indication | Depressive illness; useful in depression associated with anxiety and sleep disturbances; chronic neurogenic pain; and bulimia nervosa; temporary treatment of nocturnal enuresis in children 6 years of age or older. |
| Precautions | Blood monitoring; history of epilepsy; pregnancy and lactation; history of mania; close angle glaucoma; concurrent electroconvulsive therapy; anaesthesia; elderly; hepatic impairment; psychosis; withdraw gradually. |
| Contra-Indications | Severe hepatic disorders; acute recovery phase following myocardial infarction; hypersensitivity to tricyclic drugs; MAOIs. |
| Side Effects | Antimuscarinic actions namely: drowsiness; urinary retention; dry mouth; constipation; blurred vision; sweating; hypotensive effect, which may lead to dizziness and syncope. Arrhythmias and heart block; convulsions; haematological and hepatic reactions |
| Dosage | Adults: Initially up to 75mg for outpatients. For hospitalized patients the dose is increased stepwise to 150mg-200mg. Maintenance dose: 150-200mg daily. |
| Special Information | It has high anticholinergic and sedative effects and moderate to high orthostatic hypotensive effects. |
| Pregnancy Category | Category C |
| Pregnancy Category Description | Drugs which, owing to their pharmacological effects, or may be suspected of causing detrimental effects on human foetus or neonates without causing malfunctions. These effects may be reversible |
| Drug Category | DRUGS ACTING ON CNS |
| Drug Sub-Category | Antidepressants, anxiolytics
Dosing: Adult Depression: Outpatients: Initial: 75 mg/day; may increase gradually to 150 mg/day. May be given in divided doses or as a single bedtime dose; maximum: 200 mg/day Inpatients: Initial: 100-150 mg/day; may increase gradually to 200 mg/day; if no response after 2 weeks, may further increase to 250-300 mg/day. May be given in divided doses or as a single bedtime dose; maximum: 300 mg/day. Note: Maximum antidepressant effect may not be seen for 2 or more weeks after initiation of therapy. Post-traumatic stress disorder (PTSD) (unlabeled use): Oral: 75-200 mg/day Dosing: Pediatric Depression: Oral: Children (unlabeled use): 1.5 mg/kg/day with dosage increments of 1 mg/kg every 3-4 days to a maximum dose of 5 mg/kg/day in 1-4 divided doses; monitor carefully especially with doses ≥3.5 mg/kg/day. Adolescents: Initial: 30-40 mg/day; increase gradually; maximum: 100 mg/day in single or divided doses. Enuresis: Oral: Children ≥6 years: Initial: 25 mg at bedtime, if inadequate response still seen after 1 week of therapy, increase by 25 mg/day; dose should not exceed 2.5 mg/kg/day or 50 mg at bedtime if 6-12 years of age or 75 mg at bedtime if ≥12 years of age. Adjunct in the treatment of cancer pain (unlabeled use): Oral: Children: Initial: 0.2-0.4 mg/kg at bedtime; dose may be increased by 50% every 2-3 days up to 1-3 mg/kg/dose at bedtime. Dosing: Geriatric Depression: Initial: 25-50 mg at bedtime; may increase every 3 days for inpatients and weekly for outpatients if tolerated to a recommended maximum of 100 mg/day |