Imipramine HCl 25mg/tab

2. ImipramineHCl 25mg/tab • 適應症: 憂鬱病、夜尿 • Onset (depression): 4-8weeks • Metabolism: Hepatic, primarily via CYP2D6 to desipramine (active) and other metabolites; significant first-pass effect • Analgesic for certain chronic and neuropathic pain (including diabetic neuropathy)

3. Depression • Nocturnal enuresis (6歲以上) • Binging(暴食) • Diabetic neuropathy • Panic disorder: Oral: Initial: 10 mg once daily; increase gradually to a usual dose of 75-300 mg daily. • Urinary incontinence: 75-150mg/day

4. Nocturnal enuresis • Children ≥6 years and Adolescents: Oral: Initial: 25 mg 1 hour before bedtime, if inadequate response still seen after 1 week of therapy, increase by 25 mg daily; 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

5. Depression - Outpatients: Initial: 75 mg daily; may increase gradually to 150 mg daily. May be given in divided doses or as a single bedtime dose; Maintenance 50-150 mg daily; maximum: 200 mg daily - Inpatients: Initial: 100-150 mg daily; may increase gradually to 200 mg daily; if no response after 2 weeks, may further increase to 250-300 mg daily. May be given in divided doses or as a single bedtime dose; maximum: 300 mg daily. • Diabetic neuropathy - Standard doses of 100 milligrams/day of imipramine may not be high enough to produce therapeutic benefit in some patients with diabetic neuropathy. In one study, the therapeutic dose range was 125 milligrams/day to 350 milligrams/day. The maximum therapeutic effect in neuropathy is reached within a week. Dosage titration should be started with a dose corresponding to a plasma level of 100 to 200 nmol/L for imipramine plus desipramine • Neuropathic pain (unlabeled use): - Initial: 50 mg once daily or in divided doses twice daily; increase gradually up to 150 mg daily or to a dosage sufficient to achieve an imipramine plus desipramine plasma concentration of 113-170 ng/mL (SI: 400-600 nmol/L)

6. 包含amitriptyline、imipramine、desipramine和 nortriptyline。這類型藥物藉由抑制中樞神經內的 norepinephrine和 serotonin回收，阻斷痛覺訊號由周邊組織傳回中樞，機轉與SNRIs類藥物類似。正在服用單胺氧化酶抑制劑（MAOI） 或是 MAOI停用不足二星期者，避免使用此類藥物，以免發生血清素症候群（激動、精神紊亂、幻覺及亢進等）。近期曾發生心肌梗塞者，不可使用本類藥品，過去曾有心臟傳導障礙或心律不整及心衰竭者則須小心使用。TCAs 常見副作用包括口乾、嗜睡，因此，初使用者，建議於睡前服用，直至適應藥品之前，應盡量避免從事須集中注意力的工作。相較於年輕人，年長者有較高副作用發生機率，故不建議老年人使用。另外，TCAs 可能會造成尿液滯留問題，因此，同時有前列腺肥大者、青光眼和姿勢性低血者應避免使用。這類藥物可能會影響精神狀況，因此，服藥期間需注意是否有自殺等意念。