Imipramina
Imipramine
Imipramine hydrochloride, Imipramine pamoate
También conocido como: Tofranil-PM · imipramini chloridum · imipramini hydrochloridum · imizine · Antidep · Celamine · Depramina · Depsonil · Elepsin · Ethipramine · Imiprex · Imiprin · Imp-Tab · Impril · Janimine · Melipramine · Mipralin · Novo-Pramine · Praminan · Primonil · Pryleugan · Sermonil · Surplix · Talpramin · Imipraminum
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Urethral incompetence | 5-15 mg (total dose) | PO | q12h | — | 🌎 NA |
| Urinary incontinence when other agents fail | 5-20 mg (total dose) | PO | q12h | — | 🌎 NA |
| Cataplexy | 0.5-1 mg/kg | PO | q8h | — | 🌎 NA |
| Adjunctive treatment of separation anxiety or other tricyclic antidepressant-responsive behavior disorders | 2.2-4.4 mg/kg | PO | once to twice daily | — | 🌎 NA |
| Adjunctive cancer pain treatment | 0.5-1 mg/kg | PO | q8h | — | 🌎 NA |
| Anxiety, inappropriate urination, narcolepsy | 1-2 mg/kg | PO | q12h | — | 🌍 EU |
| Anxiety, inappropriate urination, narcolepsy | 2-4 mg/kg | PO | q24h | — | 🌍 EU |
- Cataplexy: Titrate dose based on clinical effect
- Anxiety, inappropriate urination, narcolepsy: Alternatively, 2-4 mg/kg p.o. q24h
- Anxiety, inappropriate urination, narcolepsy: Alternatively, 1-2 mg/kg p.o. q12h
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Urethral incompetence | 2.5-5 mg (total dose) | PO | q12h | — | 🌎 NA |
| Adjunctive cancer pain treatment | 2.5-5 mg (total dose) | PO | q12h | — | 🌎 NA |
| Anxiety, inappropriate urination | 0.5-1 mg/kg | PO | q12-24h | — | 🌍 EU |
Caballos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Pharmacologic induced ejaculation | 2 mg/kg | IV | once | — | 🌎 NA |
| Narcolepsy/cataplexy | 0.55 mg/kg IV or 250-750 mg (total dose) orally | IV, PO | once | — | 🌎 NA |
- Pharmacologic induced ejaculation: If imipramine alone does not induce erection and ejaculation in 10-15 minutes, give xylazine 0.2-0.3 mg/kg IV. (Note: ARCI UCGFS Class 2 Drug)
- Narcolepsy/cataplexy: PO administration produces inconsistent results.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
La imipramina es un antidepresivo tricíclico (ATC) utilizado fuera de indicación (off-label) en medicina veterinaria. Aunque se reconoce principalmente por sus aplicaciones conductuales (como la ansiedad por separación), su perfil de receptor único la hace altamente versátil.
- En perros y gatos, se utiliza frecuentemente para la incontinencia urinaria (incompetencia uretral) y la cataplejía.
- En medicina equina, se emplea para el manejo de la narcolepsia y para inducir la eyaculación farmacológica.
Perla clínica: La imipramina es un ATC de amina terciaria que se metaboliza rápidamente en el hígado a su metabolito activo de amina secundaria, la desipramina. Esta doble acción amplía su espectro farmacológico, afectando tanto a las vías de la serotonina como de la norepinefrina.
Mecanismo de acción
Imipramine and its active metabolite, desipramine, exert their effects through a complex, multi-receptor pharmacologic profile:
- Monoamine Reuptake Inhibition: Blocks the presynaptic amine pump, preventing the reuptake of serotonin (5-HT) and norepinephrine (NE) → increases neurotransmitter concentrations in the synaptic cleft → modulates mood, arousal, and pain pathways.
- Anticholinergic Activity: Antagonizes muscarinic receptors centrally and peripherally. This mechanism is primarily responsible for its efficacy in treating urinary incontinence (facilitating urine storage by relaxing the detrusor muscle) and its common side effects (dry mouth, tachycardia).
- Alpha-Adrenergic Agonism/Antagonism: Exhibits complex interactions at alpha receptors, which may contribute to increasing internal urethral sphincter tone.
- Antihistaminic (H1) Activity: Contributes to its significant sedative properties.
Seguridad y advertencias
Contraindicaciones
- Prior sensitivity to any tricyclic antidepressant
- Concomitant use with monoamine oxidase inhibitors (MAOIs) within 14 days
- Glaucoma
- History of seizures
- Urinary retention
- Severe liver disease
- Hypersensitivity to tricyclic antidepressants
Efectos adversos
- Sedation
- Dry mouth
- Constipation
- Tachycardia
- Hyperexcitability
- Tremors
- Seizures (CNS stimulation)
- Bone marrow suppression
- Diarrhea
- Vomiting
- Diarrhoea
- Arrhythmias
- Hypotension
- Syncope
- Increased appetite
Precauciones
Use with extreme caution in patients with seizure disorders, as imipramine may lower the seizure threshold.
Pregnancy Warning: There are isolated reports of limb reduction abnormalities (teratogenic potential). Restrict use in pregnant animals to situations where benefits clearly outweigh the risks (FDA Category D in humans).
Nursing: Excreted into milk in low concentrations (milk:plasma ratio 0.4 to 1.5).
Interacciones farmacológicas
Additive anticholinergic effects; use cautiously
May inhibit tricyclic antidepressant metabolism and increase the risk of toxicity
Additive CNS depressant effects; use cautiously
Imipramine may decrease levodopa oral absorption
May decrease tricyclic levels
Increased risk for QTc interval prolongation and tricyclic adverse effects
May decrease tricyclic blood levels
Increased risk for serotonin syndrome
May increase the risk of cardiac effects (arrhythmias, hypertension, hyperpyrexia)
Concomitant use (within 14 days) is generally contraindicated due to risk of serotonin syndrome
May increase risk for cardiac arrhythmias
Increased risk for prolonged QT interval
Tricyclics may increase blood pressure
High risk of fatal serotonin syndrome
Altered metabolism via cytochrome P450 2D6 competition/inhibition
Increased risk of serotonin syndrome
Increased risk of serotonin syndrome (use only in exceptional cases with careful monitoring)
Monitorización
- Clinical efficacy
- Adverse effects
- ECG (Tricyclics can widen QRS complexes, prolong PR intervals, and invert or flatten T-waves)
- Blood Glucose (Tricyclics may increase or decrease blood glucose levels)
- Heart rate and rhythm (ECG) in susceptible patients
- Signs of serotonin syndrome (agitation, tremors, hyperthermia, tachycardia) if used with other serotonergic drugs
- Liver function tests (baseline and periodic)
Farmacocinética
Absorción
Rapidly absorbed from both the GI tract and parenteral injection sites. Peak levels occur within 1-2 hours after oral dosing.
Distribución
Enters the CNS and maternal milk in levels equal to that found in maternal serum.
Metabolismo
Metabolized in the liver to several metabolites, including the active metabolite desipramine.
Sobredosis
Overdosage with tricyclics can be life-threatening, leading to severe arrhythmias and cardiorespiratory collapse. Because the toxicities and therapies for treatment are complicated and controversial, it is highly recommended to contact a poison control center for further information in any potential overdose situation.
Productos disponibles
Formulaciones
- Tablets
- Capsules
- Injection (Note: The injectable product is no longer marketed in the USA)
- 10 mg oral tablet
- 25 mg oral tablet
Etiquetado para humanos
- Imipramine HCl Tablets: 10 mg, 25 mg & 50 mg (Tofranil, generic)
- Imipramine Pamoate Capsules: 75 mg, 100 mg, 125 mg & 150 mg (Tofranil-PM, generic)
- Tofranil 10 mg tablets
- Tofranil 25 mg tablets
- Imipramine 10 mg tablets
- Imipramine 25 mg tablets
Estado regulador
POM. Veterinary authorized products (e.g., clomipramine) are preferred under the cascade.
POM. Veterinary authorized products (e.g., clomipramine) are preferred under the cascade.
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Imipramine HCl tablets and pamoate capsules should be stored in tight, light-resistant containers, preferably at room temperature. The HCl injection should be stored at < 40°C; avoid freezing. Imipramine HCl will turn yellow to reddish on exposure. Slight discoloration will not affect potency, but marked changes in color are associated with a loss of potency.
Información para el cliente
- La paciencia es clave: Los cambios conductuales pueden tardar varias semanas en notarse. Continúe con la administración según lo prescrito y no suspenda el medicamento abruptamente sin consultar a su veterinario.
- La seguridad es lo primero: Este medicamento es altamente tóxico en caso de sobredosis tanto para animales como para humanos. Manténgalo en un envase a prueba de niños, guardado de forma segura fuera del alcance de mascotas y niños.
- Efectos secundarios: Puede notar que su mascota se muestra somnolienta, tiene la boca seca o presenta estreñimiento. Si su mascota parece excesivamente excitada, tiembla o sufre una convulsión, contacte a su veterinario de inmediato.
- Dosis omitidas: Si olvida una dosis, adminístrela cuando lo recuerde, pero nunca duplique la dosis.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.