Imipramine + Diazepam Pharmacology
Imipramine + Diazepam
Imipramine
It is also useful in migraine prophylaxis. The monoamine uptake blocking property is related to migraine prophylactic activity. These are suited for patient with depression.
Distribution: It is widely distributed in the body in protein bound form.
Metabolism: Imipramine is metabolised in the liver to the active metabolite Desipramine.
Excretion: Drug is excreted mainly through urine.
2. Constipation
3. Difficulty in accommodation
4. Tachycardia
5. Difficulty in micturition
6. Impotence
7. Delayed ejaculation
8. Dizziness
9. Lethargy
10. Headache
11. Feeling of tiredness
12. Sedation
13. Tremor
14. Hyper-reflexia
15. Urticaria
16. Rash
17. Pruritis
18. Photosensitivity
19. Hypotension
20. Cardiomyopathy
21. Cholestatic jaundice
22. Edema
23. Agranulocytosis
24. Galactorrhoea
25. Gynaecomastia
26. Anorexia
2. Myocardial infarction
3. Patient on MAOI therapy
2. Hepatic impairment
3. Cardiac arrhythmia
4. Myocardial infarction
5. Tachycardia
6. Heart failure
7. Strokes
8. Angle closure glaucoma
9. History of urine retention
10. Increased intraocular pressure
11. Hyperthyroidism
12. Patient receiving thyroid medications
13. Patient at risk for suicide,
14. Slowly withdraw the drug with caution
15. Patient should be cautioned against driving vehicle, operating machine and activities requiring mental alertness or judgment
Below 6 years: Contraindicated
2. Nocturnal enuresis in children above 5 years
3. Migraine prophylaxis
Barbiturates: Serum level of imipramine decreased; additive respiratory depressant effect.
Clonidine: Hypertensive crisis.
Dicoumarol: Increase in anticoagulation effects.
Disulfiram: Acute organic brain syndrome.
Fluoxetine & Haloperidol: Potentiate action of imipramine.
Levodopa: Its bioavailability is reduced, hypertensive episodes.
MAOIs, Furazolidone: Seizures, sweating, coma, hyperexcitability, hyperthermia, tachycardia, mydriasis, confusion, DIC (Disseminated Intravascular Coagulation) and death.
Oral Contraceptives and Phenothiazines : Increase plasma levels of imipramine.
Smoking : Increases metabolic biotransformation.
Alcohol : Sedative effect of alcohol potentiated.
Maximum daily dose: 300 mg
Children :
Nocturnal enuresis in children above 5 years: 25 mg/ day to be taken 1 hour before bed time. If satisfactory response does not occur then gradually increases the dose up to 75 mg / day.
Maximum dose: 5 mg / kg / day
If the missed dose is taken only at night then skip the missed dose.
Diazepam
Antivertigo action: Although intravenous diazepam has been used to abort acute attacks of vertigo of peripheral origin, it can prolong compensation and recovery from vestibular lesions
2.Drowsiness
3.Lethargy
4.Hallucination
5.Nausea
6.Constipation
7.Amnesia
8.Dependence
9. Tremor
10.Confusion
11.Light headedness
12.Mood changes
13.Muscle cramp
14. Drug dependence
15.Respiratory depression
2.Acute narrow angle glaucoma.
2.Hepatic impairment
3.Open angle glaucoma
4.Depression
5.Pulmonary insufficiency
6.Epileptic patients
7.Driving vehicles, operating machines and other hazardous activities
NEONATES contraindicated:
2.Preanaesthetic medication
3.Insomnia
4.Treatment of Febrile seizure and Status epilepticus
5.Acute alcohol withdrawal syndrome,
6.Relief of muscle spasm
7.Tetanus
8.Eclampsia
9.General anaesthesia
10. Vertigo.
Aminophylline: Antagonizes the sedative effect.
Cimetidine, Oral contraceptives, Disulfiram, Fluoxetine, Isoniazid, Ketoconazole, Metoprolol, Propoxyphene, Propranalol, Valproic Acid: Elimination of diazepam decreased due to inhibition of hepatic metabolism leading to enhanced activity.
Digoxin, Imipiramine & Desipramine: Enhanced activity of these drugs.
Levodopa: Decrease in antiparkinsonism efficacy.
Ranitidine: Decreases GI absorption of Diazepam.
Rifampicin: Decreases efficacy.
Anxiety: 2 -10 mg 2 - 3 times a day; depending on the severity of the disease.
Muscle spasm: 2 -10 mg every 2 - 3 times a day; depending on the severity of the disease.
Acute alcohol withdrawal syndrome: Initial dose: 30 - 40 mg / day in 3 - 4 divided doses; if needed the dose can be reduced to 15 - 20 mg / day in divided doses.
Status epilepticus : 0.2 - 0.5 mg/ kg body weight as IV infusion followed by repeated doses.
PAM (((IM))): 5 - 10 mg before surgery
Children:
Anxiety: 3 - 10 mg / day in 3 - 4 divided dose. As needed dose can be increased gradually
Tetanus (((IM/IV infusion))): 1- 10 mg; repeated every 3 - 4 hour; dose is selected depending on the age and severity of the disease.
Status epilepticus :Above 7 years: 5 mg IV over 5 minutes; the dose may be repeated every 2 - 4 hour as needed; maximum dose: 10 mg
Status epilepticus 1 - 7 years: 2.5 mg IV over 5 minutes; the dose may be repeated every 2 - 4 hour as needed; maximum dose: 5mg
Home Delivery for Imipramine + Diazepam in Your City
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Imipramine + Diazepam is a generic medicine name and there are several brands available for it. Some of the brands for imipramine + diazepam might be better known than imipramine + diazepam itself. If the pharmacy that's willing to deliver medicines to your home doesn't have imipramine + diazepam in stock, you can ask for one of the branded alternatives for imipramine + diazepam.