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3-(5,6-dihydrobenzo[b][1]benzazepin-11-yl)-N,N-dimethylpropan-1-amine
Imipramine的抗憂鬱機轉未知,可能主要是抑制神經對正腎上腺素(NA)和serotonin(5-HT)的再吸收,但不包括對中樞神經系統的刺激作用。
用法及給藥方式因人而異,且須依並人情況作調整。原則上,儘可能用最低有效劑量,且要小心地增加劑量,特別是老年人或清少年的治療,使用Imipramine治療期間,須嚴密監測病人,以確定此藥的療效及病人耐受性。
住院患者:
初劑量為每日100mg,分次服用;必要時可逐漸增至每日200mg。二週後若無明顯改善則增至每日250-300mg。
門診患者:
初劑量為每日75mg,可增至每日150mg,每日劑量不得超過200mg,維持劑量為每日50-150mg。
青少年及老人:
初劑量每日30-40mg,每日不可超過100mg。
兒童夜尿:
6歲以上兒童之初劑量為每日25mg,睡前1小時服用,一週內若無明顯療效則一下列劑量投與: 12歲以下:每晚服用50mg。 12歲以上:每晚服用75mg。服用75mg以上之劑量並不會提高療效。對於入睡不久即尿床的小孩要在晚餐前給與部份劑量。每日劑量不可超過2.5mg/kg。
本藥對於6歲以下夜尿症兒童之有效性及安全性尚未確立。
Absorption
Tmax is 2 to 4 h. Steady state is reached in 2 to 5 days.
Distribution
More than 90% is protein bound. Lipid soluble.
Metabolism
Significant first pass effect. Metabolism occurs in liver. Active metabolite is desipramine.
Elimination
The t½ is 11 to 25 h.
Peak
2 to 4 weeks.
Carbamazepine
Carbamazepine levels may increase; imipramine levels may decrease.
Cimetidine, fluoxetine
May cause increased imipramine blood levels and effects.
Clonidine
May result in hypertensive crisis.
CNS depressants
Depressant effects may be additive.
Dicumarol
Anticoagulant actions may increase.
Guanethidine
Hypotensive action may be inhibited.
MAO inhibitors
May cause hyperpyretic crises, severe convulsions, and death when given with imipramine.
Sympathomimetics
Pressor response may be decreased by indirect-acting sympathomimetics and increased by direct-acting ones.
2. 心肌梗塞危急者。
3. 已知對本藥及Dibenzazepine類三環抗憂鬱劑過敏者。
a. 有心血管功能不全的病人、房室阻斷、心律不整、鬱血性心臟衰竭、心肌梗塞、中風及心跳過速。
b. 有狹角性青光眼的病人。
c. 因尿液流動受阻而排尿異常的病人。(如有攝護腺疾病的病人)
d. 低抽搐閥值的病人。
e. 有嚴重肝臟或腎臟疾病的病人。



