Generic name: Imipramine hydrochloride.

Other brand names: Janimine, SK-Pramine, Tofranil-PM, Typramine.

Tofranil is a tricyclic antidepressant. It is thought to relieve depression by increasing the concentration of the chemicals necessary for nerve transmission to the brain.

Quick Facts About Tofranil


Used to treat depression.

Tofranil Dosage

May take with or without food. Follow doctor’s instructions for stopping Tofranil. Do not stop medication if there is no immediate effect, can take 4 to 6 weeks to see improvement.

  • Usual adult dose: 75 milligrams per day, up to 150 and to a maximum of 200 milligrams per day. Seniors and adolescents — 30 to 40 milligrams per day, up to a maximum of 100 milligrams per day.
  • Usual child dose: is only used for bedwetting as a short term therapy. Dose is no more than 2.5 milligrams per each 2.2 pounds of body weight, and usually begins at 25 milligrams per day. Give dose to child 1 hour before bedtime. After 1 week, doctor may increase dose to 50 milligrams per day (children 6-11 years) or 75 milligrams per day (children ages 12 and up), taken in 1 dose at bedtime or divided into 2 doses, taken at mid-afternoon and bedtime.
  • Missed dose: if taking 1 dose per day at bedtime — do not take dose in the morning and contact your doctor. If taking more than 1 dose per day — take as soon as possible, unless almost time for next dose. In that case, do not take missed dose; go back to regular schedule. Do not double doses.

Tofranil Side Effects

Overdose symptoms:

agitation, bluish skin, coma, convulsions, difficulty breathing, dilated pupils, drowsiness, heart failure, high fever, involuntary writhing or jerky movements, irregular or rapid heartbeat, lack of coordination, low blood pressure, overactive reflexes, restlessness, rigid muscles, shock, stupor, sweating, vomiting. if you suspect an overdose, immediately seek medical attention.

More common side effects: abdominal cramps, agitation, anxiety, blackening of tongue, bleeding sore, blood disorders, blurred vision, breast development in males, confusion, congestive heart failure, constipation or diarrhea, cough, delusions, dilated pupils, disorientation, dizziness, drowsiness, dry mouth, episodes of elation or irritability, excessive or spontaneous milk flow, fatigue, fever, flushing, frequent urination or difficulty or delay in urinating, hair loss, hallucinations, headache, heart attack, heart failure, high blood pressure, high or low blood sugar, high pressure of fluid in eyes, hives, impotence, increased or decreased sex drive, inflammation of the mouth, insomnia, intestinal blockage, irregular heartbeat, lack of coordination, light-headedness, loss of appetite, nausea, nightmares, numbness in hands and feet, odd taste in mouth, palpitations, purple or reddish-brown skin spots, rapid heartbeat, resdessness, ringing in the ears, seizures, sensitivity to light, skin itching and rash, sore throat, stomach upset, stroke, sweating, swelling due to fluid retention (especially face and tongue), swelling of breasts, swelling of testicles, swollen glands, tendency to fall, tingling or pins and needles, tremors, visual problems, vomiting, weakness, weight gain or loss, yellowed skin and eyes. Most common side effect in children treated for bedwetting; nervousness, sleep disorders, stomach and intestinal problems, tiredness. Other side effects in children: anxiety, collapse, constipation, convulsions, emotional instability, fainting.

No known less common or rare Tofranil side effects.


Fatal reactions have occurred when Tofranil is taken with MAO inhibitors such as Nardil and Parnate. Do not take Tofranil for 2 weeks after taking a MAO inhibitor.

Inform your doctor before combining Tofranil with:

albuterol (Proventil or Ventolin); anticholinergics such as Cogentin; antihypertensives such as Wytensin; barbiturates such as Nembutal and Seconal; carbamazepine (Tegretol); central nervous system depressants such as Xanax and Valium; cimetidine (Tagamet); clonidine (Catapres); decongestants such as Sudafed; epinephrine (EpiPen); fluoxetine (Prozac); guanethidine (Ismelin); methylphenidate (Ritalin); norepinephrine; phenytoin (Dilantin); thyroid medications. May experience extreme drowsiness if taking Tofranil with narcotic painkillers such as Percocet or sleeping medications such as Valium.

Extreme drowsiness or other serious side effects may occur if using alcohol with Tofranil. 

Special Cautions

If pregnant or planning to become pregnant, inform your doctor immediately. May appear in breast milk; could affect a nursing infant.

Seniors are prescribed lower doses.

Children are at higher risk for overdose due to increased sensitivity. Follow doctor’s instructions carefully for children. Not generally prescribed for children under 6 years.

  • May impair your ability to drive a car or operate machinery. Do not take part in any activity that requires alertness.
  • Avoid use if recovering from a heart attack.
  • Use with caution if you have or ever had: narrow-angle glaucoma; difficulty urinating; heart liver, kidney, or thyroid disease; seizures; or if taking thyroid medication.
  • Inform your doctor if a sore throat or fever develops when taking Tofranil.
  • May cause sensitivity to sunlight.
  • Doctor will discontinue Tofranil if you are having elective surgery.

Note: provides accurate and independent information prescription pills, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. If you have questions about  dosage, or Tofranil side effects, please contact your healthcare provider