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Read all ofthis leaflet carefully before you start taking this medicine because it contains important information for you.

•    Keep this leaflet. You may need to read it again.

•    If you have any further questions, please ask your doctor or pharmacist or nurse.

•    This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.

•    If you get any side effects, talk to your doctor, or pharmacist or nurse. This includes any possible side effects not listed in this leaflet. See section 4.

What is in this leaflet:

1.    WhatlmipramineTabletsareand what they are used for

2.    What you need to know before you take Imipramine Tablets

3.    How to take Imipramine Tablets

4.    Possible side effects

5.    How to store Imipramine Tablets

6.    Contents of the pack and other information

1.    WHAT IMIPRAMINE TABLETS ARE AND WHAT THEY ARE USED FOR

Imipramine belongs to a class of antidepressant drugs known as the tricyclics. Imipramine is used to treat depression. It can also be used to treat bed-wetting in children.

2.    WHAT YOU NEED TO KNOW BEFORE YOU TAKE IMIPRAMINE TABLETS

Do not take Imipramine Tablets

•    If you have previously suffered an allergic reaction to a medicine containing Imipramine orother antidepressant medicines.

•    If you think you are allergic to any of the other ingredients.

•    If you are recovering from a heart attack or have suffered from heart problems including abnormal heart rhythm (abnormal heart beat).

•    If you have had severe liver disease.

•    If you are or have recently taken (within 14 days) any other medicines for depression, particularly monoamine oxidase inhibitors (MAOIs). See: Other medicines and Imipramine Tablets

•    If you suffer from any mental illness such as manic-depression or obsessions.

•    If the patient is a child under 6 years old.

•    If you suffer from glaucoma (increased eye pressure).

•    If you have difficulty passing water.

•    If you have had a heart attack within the past three months.

•    If you suffer with porphyria (a genetic disorder of the red blood cells haemoglobin causing skin blisters, abdominal pain and brain/nervous system disorders).

Warnings and precautions Thoughts ofsuicide and worsening of your depression or anxiety disorder

If you are depressed and/or have anxiety disorders you can sometimes have thoughts ofharming or killing yourself. These may be increased when starting antidepressants, since these medicines all take time to work, usually about two weeks but sometimes longer.

You may be more likely to think like this:

•    If you have previously had thoughts about killing or harming yourself.

•    If you are a young adult. Information from clinical trials has shown an increased risk of suicidal behaviour in adults aged less than 25 years with psychiatric conditions who were treated with an antidepressant.

If you have thoughts of harming or killing yourself at any time, contact your doctor or go to a hospital straight away.

You may find it helpful to tell a relative or close friend that you are depressed or have an anxiety disorder and ask them to read this leaflet. You might ask them to tell you if they think your depression or anxiety is getting worse or if they are worried about changes in your behaviour.

Talk to your doctor or pharmacist or nurse before taking Imipramine Tablets:

•    If you have a history of epilepsy or suffered recently from convulsions (fits).

•    If you are taking medicines to treat a thyroid disorder

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•    If you have a tumour of the adrenal gland (e.g phaeochromocytoma or neuroblastoma)

•    If you suffer from constipation.

•    If you have low blood pressure or problems with yourcirculation.

•    If you are due to undergo surgery or receive anaesthetics (even at the dentist) or have electroconvulsive therapy (ECT).

•    If you wear contact lens as Imipramine may decrease tear production in eyes.

•    If you have had severe kidney problems.

•    If you are elderly as the doctor may need to do more check ups.

•    As these tablets may cause a dry mouth and increase tooth decay, therefore ensure regular dental checkups.

During the treatment with Imipramine, your doctor may wish to carry out a number of tests (heart, blood and liver tests). This is quite usual and nothing to be concerned about.

Other medicines and Imipramine Tablets:

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. In particular:

•    Monoamine oxidase inhibitors (MAOIs) and other medicines use to treat depression e.g clozopine, pimozide.

•    Medicines used to lower blood pressure e.g guanethidine, debrisoquine, bethanidine, methyldopa , clonidine ordiuretics ("watertablets").

•    Barbiturates used to depress the central nervous system by acting as a sedative (e.g Phenobarbital).

•    Bronchodilators which are used to help your breathing.

•    Thyroid hormone therapy.

•    Medicines used to treat Parkinson's disease e.g Apomorphine, Levodopa, entacapone orselegiline.

•    Disulfiram used to treat alcoholism.

•    Cimetidine used to treat stomach ulcers.

•    Sympathomimetic medicines such as adrenaline, ephedrine, isoprenaline, noradreanline, phenylphrine and phenylpropanolamine. These may be present in many medicines for colds and nasal stuffiness. Tell your pharmacist that you are taking Imipramine before buying these products.

•    Medicines used for heart disease e.g Quinidine.

•    Medicines used to thin the blood (anticoagulants e.g warfarin).

•    Oral contraceptives or oestrogens used for hormone replacement.

•    Methylphenidate, a drug used in the treatment of childhood behavioural disorders.

•    Beta blockers, used to treat angina, heart failure and high blood pressure.

•    Apraclonidine and brimonidine (to treat glaucoma).

•    Ritonavir (to treat HIV).

•    Medicines to treat some heart conditions such as diltiazem and verapamil.

•    Nitrates used to treat angina.

•    Appetite suppressants.

•    Painkillers such as nefopam, tramadol, codeine, dihydrocodeine.

•    Baclofen (a muscle relaxant).

Taking Imipramine Tablets with food, drink and alcohol:

Imipramine should not be taken with alcohol as it will increase the sedative effects of this medicine and therefore should be avoided. It is not necessary to take these tablets with food. These tablets are taken with a glass ofwater.

Pregnancy and Breastfeeding:

Imipramine Tablets should not be taken during pregnancy or if breast-feeding.

If Imipramine tablets are taken in the last 3 months the baby may be born with breathing difficulties, lethargy, colic, irritability, changes in blood pressure, tremors, spasm. Imipramine tablets should be withdrawn at least 7 weeks before the expected delivery date.

Driving and using machines:

If you feel dizzy or drowsy when you start taking this medicine do not operate machinery until these effects were off.

Imipramine Tablets contain lactose

If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.