Imipramine
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TCA, Antidepressant
Imipramine
Tofranil
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Effects
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Interactions
Pharmacogenomic + mechanism interactions
Pharmacogenomic guideline recommendationsCPIC and Dutch Pharmacogenetics Working Group clinical guidelines
CPIC rec 8094333 [Strong]: Initiate therapy with recommended starting dose. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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CPIC rec 8094333 [Strong]: Initiate therapy with recommended starting dose. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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CPIC rec 8094305 [Optional]: Avoid imipramine use. If a imipramine is warranted, consider a 50% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040] FDA labeling (Precautions)
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CPIC rec 8094305 [Optional]: Avoid imipramine use. If a imipramine is warranted, consider a 50% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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CPIC rec 8094315 [Optional]: Avoid imipramine use; If imipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040] FDA labeling (Precautions)
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CPIC rec 8094328 [Optional]: Avoid imipramine use. If a imipramine is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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CPIC rec 8094351 [Optional]: Avoid imipramine use; If imipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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CPIC rec 8094352 [Optional]: Avoid imipramine use; If imipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040] FDA labeling (Precautions)
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CPIC rec 8094356 [Optional]: Avoid imipramine use. If imipramine is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040] FDA labeling (Precautions)
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CPIC rec 8094374 [Optional]: Avoid imipramine use; If imipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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CPIC rec 8094397 [Optional]: Avoid imipramine use; If imipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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CPIC rec 8094443 [Optional]: Avoid imipramine use. If a imipramine is warranted, consider a 50% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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CPIC rec 8094466 [Optional]: Avoid imipramine use; If imipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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CPIC rec 8094375 [Optional]: Consider alternative drug not metabolized by CYP2C19; If imipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040] FDA labeling (Precautions)
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CPIC rec 8094375 [Optional]: Consider alternative drug not metabolized by CYP2C19; If imipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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CPIC rec 8094379 [Optional]: Consider alternative drug not metabolized by CYP2C19; If imipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040] FDA labeling (Precautions)
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CPIC rec 8094398 [Optional]: Consider alternative drug not metabolized by CYP2C19; If imipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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CPIC rec 8094306 [Optional]: Consider a 25% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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Outcome (-100 worst, +100 best)
CPIC rec 8094306 [Optional]: Consider a 25% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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CPIC rec 8094452 [Optional]: Initiate therapy with recommended starting dose. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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Patient experience
Fluoxetine via Category:Antidepressants exp n/a/5 outcome n/a (n=1) exp 1.0/5 outcome +33.0 (n=1)
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- checking this mechanism here
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Summary
Classes
TCA, Antidepressant
Common uses
Pharmacy
Pharmacology
Purported mechanism
Serotonin and norepinephrine reuptake inhibitor