Melipramine, pills 25mg 50pcs

Composition

Active ingredients:  

imipramine hydrochloride 25 mg;

glycerol 85%,

titanium dioxide (E 171),

macrogol 35 000,

dye (E 172) (iron oxide red),

gelatin,

magnesium stearate,

talc,

sucrose,

lactose monohydrate

Pharmacological action

Melipramine has an antidepressant effect.

Tricyclic antidepressant, a derivative of dibenzoazepine. Blocks the reverse neuronal uptake of monoamines in the brain; reduces motor lethargy, improves mood, helps normalize sleep, and has an unspoken psychostimulating effect. At the beginning of treatment, sedation may predominate, which is less pronounced than that of amitriptyline.

It has m-holinoblokiruyushchy, myotropic antispasmodic, antihistamine effect. Does not inhibit MAO.

The antidepressant effect develops gradually; the optimal therapeutic effect occurs 1-3 (up to 4) weeks after the start of therapy.

Indications

Depressive states of various etiologies: asthenodepressive syndrome, depression (endogenous, involutional, climacteric, reactive, alcoholic), depressive states in psychopathy and neuroses, panic disorders, functional enuresis in children.

Use during pregnancy and lactation

The drug is contraindicated for use during pregnancy and lactation.

Contraindications

Hypersensitivity, hepatic-renal failure, IHD, tachycardia, congestive heart failure, early post-infarction period, tendency to seizures, schizophrenia, epilepsy, glaucoma, prostate adenoma, bladder atony, pregnancy, children (up to 6 years).

Side effects

Nervous system and sensory disorders:  headache, dizziness, excessive sedation, paresthesia, tremor, convulsions, dysarthria, impaired coordination of movements, sleep disorders, agitation, hallucinations, accommodation disorders.

From the outside CVS and blood (hematopoiesis, hemostasis):  tachycardia, arrhythmia, orthostatic hypotension, leukocytosis or leukopenia, agranulocytosis.

From the digestive tract:  dry mouth, constipation, hepatitis.

From the genitourinary system:  urinary retention, gynecomastia, galactorrhea, decreased libido, impotence.

Other services:  weight gain, photosensitivity, hair loss, fever, hyperhidrosis.

Interaction

Concomitant use of Melipramine and MAO inhibitors significantly increases the risk of agitation, seizures, blood pressure fluctuations, hyperthermia, and coma. After stopping taking MAO inhibitors, it is necessary to take a break of 2-3 weeks before the appointment of Melipramine (and vice versa).

With the simultaneous use of Melipramine and m-holinoblockers, the anticholinergic effect of drugs is summed up.

With the simultaneous use of Melipramine and thyroid hormone preparations, the adrenergic effects increase, which can cause tachyarrhythmias and the development of angina attacks.

When Melipramine is co-administered with adrenomimetics (epinephrine, norepinephrine, mezaton), the risk of tachycardia, arrhythmia, and hypertension increases due to inhibition of catecholamine inactivation by Melipramine.

When Melipramine is co-administered with alpha-blockers and central alpha-adrenergic stimulators (clonidine, guanethidine, methyldopa), the antihypertensive effect of the latter decreases, which may be due to inhibition of their binding to presynaptic alpha-adrenergic receptors.

Imipramine reduces the anticonvulsant effect of phenytoin.

CNS depressants and ethanol increase the sedative effect of Melipramine, while benzodiazepine derivatives and phenothiazines enhance the sedative and anticholinergic effects of Melipramine.

Inhibitors of microsomal oxidation enzymes (cimetidine, methylphenidate, oral contraceptives) slow down the metabolism of imipramine and increase its half-life, and therefore increase the antidepressant effect and toxicity of the drug.

How to take, course of use and dosage

Adults are prescribed an initial dose of 25 mg 1-3 times a day (after meals); the dose can be increased to 150 mg / day, the maximum daily dose is 200 mg. After achieving the desired therapeutic effect, the dose can be reduced to a maintenance dose of 50-100 mg / day. For the elderly and young agesmelipramine is prescribed, starting with a dose of 12.5 mg 1 time a day in the evening, gradually increasing the daily dose to 75 mg (the drug is taken at 25 mg 3 times a day). The maintenance dose is usually equal to half the adult dose. In the treatment of nocturnal enuresis, children aged 6 to 8 years (body weight 20-25 kg) are prescribed the drug at a dose of 25 mg/day, from 9 to 12 years (body weight 25-35 kg) – 25-50 mg/day, older than 12 years – 50-75 mg/day. When treating children, it should be taken into account that the dose should not exceed 2.5 mg/kg of body weight of the child. The drug is best taken once after dinner. In cases where the child urinates in bed in the early evening, the daily dose can be prescribed in 2 doses: in the afternoon and after dinner. Treatment of enuresis should last no more than 3 months.

Overdose

Symptoms:  psychomotor agitation, dry mouth, mydriasis, tachycardia, urinary retention, confusion, difficulty breathing, convulsions, coma.

Treatment:  it is necessary to monitor the function of the cardiovascular and respiratory systems, conduct symptomatic therapy. For convulsions, diazepam, phenytoin, and phenobarbital are administered intravenously.

Imipramine does not undergo dialysis. Forced diuresis is also ineffective.

Special instructions

When prescribing Melipramine to patients with epilepsy, careful monitoring of the condition is necessary, since the drug can provoke an epileptic seizure in the first days of treatment.

When using the drug, it should be noted that the therapeutic effect occurs no earlier than 1-3 weeks after the start of treatment, the maintenance dose should be taken for at least 3 months. During the initial period of Melipramine therapy, it is necessary to constantly monitor patients with suicidal tendencies.

Withdrawal symptoms (nausea, headache, irritability, insomnia, arrhythmia, and extrapyramidal disorders) occur when the drug is suddenly discontinued.

Do not use electroshock therapy while using Melipramine.

In the case of bipolar depression, the drug can provoke the transition of the patient to the manic phase.

In the first days of using tricyclic antidepressants to treat a panic state, paradoxically increased psychomotor anxiety may occur. If this condition does not go away in 2 weeks, then it is advisable to prescribe benzodiazepine derivatives.

Melipramine should be used with caution in patients with a tendency to constipation.

Melipramine should be carefully prescribed for pheochromocytoma or acute porphyria due to the threat of exacerbation of diseases with the development of a crisis.

Caution should be exercised when prescribing the drug to elderly patients and children, as these groups of patients may develop serious side effects.

During treatment with Melipramine, it is recommended to systematically conduct a general blood test, assess liver function indicators, monitor ECG and blood pressure levels.

During treatment with Melipramine, you should not drink alcoholic beverages.

Influence on the ability to drive motor vehicles and manage mechanisms

During the use of Melipramine, it is forbidden to drive vehicles and perform other potentially dangerous work that requires increased concentration of attention and speed of psychomotor reactions.

Form of release

of dragees

Storage conditions

At a temperature of 15-25 °C.

Shelf life

3 years

Active ingredient

Imipramine

Conditions of release from pharmacies

By prescription

Dosage form

Tablets

Description

For adults and Children over 6 years of age

Indications

Manic-depressive psychosis, Phobias and panic attacks, Depression, Enuresis