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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by 4WD on February 2, 2006, at 20:39:48
My pdoc prescribed Tofranil PM 25mg at night for me today (going up later). Well, at the pharmacy they told me that they don't make Tofranil PM in 25mg, only in 75, 100, and 150mg. Same with generic imipramine/imipramine pm.
The pharmacist said something about it being the same chemical but a different salt? Will it make any difference whether I take imipramine pm or just plain imipramine?
Also, is brand Tofranil superior to imipramine? Does it matter?
Thanks for any help.Marsha
Posted by Phillipa on February 2, 2006, at 20:43:08
In reply to imipramine pm vs plain imipramine -any diff? Ed?, posted by 4WD on February 2, 2006, at 20:39:48
Marsha they're changing the TCA's how strange. I wonder why with the"miracle SSRI, SSNRI's". Fondly, Phillipa
Posted by SLS on February 2, 2006, at 21:24:29
In reply to imipramine pm vs plain imipramine -any diff? Ed?, posted by 4WD on February 2, 2006, at 20:39:48
Generic imipramine is available in 10mg, 25mg, and 50mg tablets. There really should be no differences in the effectiveness of Tofranil versus generic. As can happen when switching from one forumlation to another, however, dosage adjustments might be necessary.
I generally use the generic imipramine.
- Scott
Posted by 4WD on February 2, 2006, at 22:08:20
In reply to Re: imipramine pm vs plain imipramine -any diff? Ed? » 4WD, posted by SLS on February 2, 2006, at 21:24:29
> Generic imipramine is available in 10mg, 25mg, and 50mg tablets. There really should be no differences in the effectiveness of Tofranil versus generic. As can happen when switching from one forumlation to another, however, dosage adjustments might be necessary.
>
> I generally use the generic imipramine.
>
>
> - Scott
Do you know the difference between imipramine PM and regular imipramine?
Posted by 4WD on February 2, 2006, at 22:37:30
In reply to imipramine pm vs plain imipramine -any diff? Ed?, posted by 4WD on February 2, 2006, at 20:39:48
Just looked in my PDR. Imipramine PM is imipramine pamoate. Regular imipramine is imipramine hydrochloride.
The PDR says 75mg of imipramine pamoate is equivalent to 75mg of impramine hydrochloride. So I still don't know what the difference is.
Posted by Phillipa on February 2, 2006, at 23:32:31
In reply to imipramine pamoate vs imipramine hydrochloride, posted by 4WD on February 2, 2006, at 22:37:30
Marsha sounds rather odd wonder if you could google it? Fondly, Phillipa
Posted by ed_uk on February 3, 2006, at 13:05:22
In reply to imipramine pm vs plain imipramine -any diff? Ed?, posted by 4WD on February 2, 2006, at 20:39:48
Hi Marsha
I would NOT recommend Tofranil PM (imipramine pamoate) because it is much more expensive than generic imipramine hydrochloride. In addition, the lowest strength of Tofranil PM is 75mg, which is probably too high a dose to initiate treatment with. I do not believe Tofranil PM has any advantages over plain generic imipramine hydrochloride.
>Well, at the pharmacy they told me that they don't make Tofranil PM in 25mg, only in 75, 100, and 150mg.
That's right. It also comes in 125mg capsules.
>Same with generic imipramine/imipramine pm.
Generic imipramine hydrochloride comes in 10mg, 25mg and 50mg tablets.
>The pharmacist said something about it being the same chemical but a different salt?
That's right. They're both imipramine (the same drug) but they are different salts.
>Will it make any difference whether I take imipramine pm or just plain imipramine?
It will make a difference to your wallet. In addition, you might suffer more side effects with Tofranil PM because you'd be forced to start at a high(ish) dose.
>Also, is brand Tofranil superior to imipramine?
No, I don't believe it is. It's a lot more expensive though!
I'd encourage your pdoc to prescribe generic imipramine tablets. You could ask for the 10mg tablets initially, but the 25mg tablets would also be acceptable.
Regards
Ed
Posted by ed_uk on February 3, 2006, at 13:08:50
In reply to Re: imipramine pm vs plain imipramine -any diff? Ed? » SLS, posted by 4WD on February 2, 2006, at 22:08:20
>Do you know the difference between imipramine PM and regular imipramine?
Not a lot! They are different salts of imipramine ie. the imipramine is 'bonded' to a different ion.
Ed
Posted by 4WD on February 3, 2006, at 16:06:10
In reply to Re: imipramine pamoate vs imipramine hydrochloride » 4WD, posted by Phillipa on February 2, 2006, at 23:32:31
> Marsha sounds rather odd wonder if you could google it? Fondly, Phillipa
Hi Phillipa,
I did. That's how I found out. I guess it doesn't matter much. We'll see. HOpe you are doing okay? Are you still seeing that new pdoc?
Marsha
Posted by 4WD on February 3, 2006, at 16:08:39
In reply to Re: imipramine pm vs plain imipramine -any diff? Ed? » 4WD, posted by ed_uk on February 3, 2006, at 13:08:50
> >Do you know the difference between imipramine PM and regular imipramine?
>
> Not a lot! They are different salts of imipramine ie. the imipramine is 'bonded' to a different ion.
>
> Ed
Thanks, Ed, for this and the above post. That's what I needed to know. I've called his office and asked them to call in just plain imipramine at 25mg.It's wonderful having a pharmacist on this board. If you ever need anything a librarian can be helpful with, you let me know.
Marsha
Posted by ed_uk on February 4, 2006, at 11:41:15
In reply to Re: imipramine pm vs plain imipramine -any diff? Ed? » ed_uk, posted by 4WD on February 3, 2006, at 16:08:39
Hi Marsha
>It's wonderful having a pharmacist on this board.
:)
I'm actually not a pharmacist, although I do work in a pharmacy.
Regards
Ed
Posted by ed_uk on February 4, 2006, at 11:49:10
In reply to Re: imipramine pm vs plain imipramine -any diff? Ed? » ed_uk, posted by 4WD on February 3, 2006, at 16:08:39
Hi Marsha
>I've called his office and asked them to call in just plain imipramine at 25mg.
Good idea. I'd recommend starting at a dose of 1/2 a tablet daily. Swallow it quickly because the powder from broken TCAs tends to 'numb' the mouth a bit!
I often hear of doctors in the US 'calling in' prescriptions. Does this mean than they don't write a prescription, they just call the pharmacy? In the UK all prescriptions have to be written.
Ed
Posted by zeugma on February 4, 2006, at 12:52:54
In reply to Re: imipramine pm vs plain imipramine -any diff? Ed? » 4WD, posted by ed_uk on February 4, 2006, at 11:49:10
I often hear of doctors in the US 'calling in' prescriptions. Does this mean than they don't write a prescription, they just call the pharmacy? In the UK all prescriptions have to be written>>
Hi Ed,
Doctors in the US can have the pharmacy call them for prescriptions except for scheduled drugs. I regret to say that for any kind of controlled drug... I'm going to get political, so I won't say any more (am very upset over this issue as for others). But I'll say that anything 'addicting' is regarded very askance here in America. 'Addiction' is probably the dirtiest word in the American vocabulary. And drugs deemed 'addictive' cannot be called in.
-z
Posted by ed_uk on February 4, 2006, at 13:23:09
In reply to Re: imipramine pm vs plain imipramine -any diff? Ed? » ed_uk, posted by zeugma on February 4, 2006, at 12:52:54
Hi Z
Controlled drugs seem to be prescribed a lot more in the US than in the UK, but legislation relating to controlled drugs seems to be a lot stricter in the US.
Ed
Posted by Phillipa on February 4, 2006, at 19:08:27
In reply to Re: imipramine pm vs plain imipramine -any diff? Ed? » zeugma, posted by ed_uk on February 4, 2006, at 13:23:09
RN's usually call in the meds for the doctors and they call in controlled meds too. Ritalin or one of those may be different though never called a stimulant in to the Rx. But have called benzos, sleeping pills, antipsychotic, antidepressants, etc. The docs use the Nurses to save time. Fondly, Phillipa
Posted by 4WD on February 4, 2006, at 22:09:54
In reply to Re: imipramine pm vs plain imipramine -any diff? Ed? » 4WD, posted by ed_uk on February 4, 2006, at 11:49:10
> Hi Marsha
>
> >I've called his office and asked them to call in just plain imipramine at 25mg.
>
> Good idea. I'd recommend starting at a dose of 1/2 a tablet daily. Swallow it quickly because the powder from broken TCAs tends to 'numb' the mouth a bit!
>
> I often hear of doctors in the US 'calling in' prescriptions. Does this mean than they don't write a prescription, they just call the pharmacy? In the UK all prescriptions have to be written.
>
> Ed
Yes, they call the pharmacy and tell them what the prescription is. Actually, it's usually the doctor's nurse or assistant who calls in the script. They can even call in hydrocodone. The more heavily scheduled drugs have to be a written script, though. There's a big business in phony called in scripts for hydrocodone, etc. People call the pharmacy, pretend to be a nurse, call in a script in a fake name and then go pick it up.I'm trying to balance the idea of starting at half a tablet to minimize side effects and going ahead and starting at 25mg to maximize quickness of response. Maybe I'll compromise and take half a pill the first 2 or 3 nights and see how it goes and then go up to a whole pill. I'm just scared of being off Effexor and the imipramine not having kicked in yet and falling back into suicidal depression in the meantime.
As far as your not being a pharmacist, you may as well be. You know more than most doctors and pharmacists I know. I guess maybe you have a "personal interest" in psych meds. :-)
Marsha
Posted by ed_uk on February 5, 2006, at 17:01:42
In reply to Re: imipramine pm vs plain imipramine -any diff? Ed?, posted by 4WD on February 4, 2006, at 22:09:54
Hi M
I don't think starting at 12.5mg will affect the speed of response. You can increase the dose as quickly as your body allows.
Ed
Posted by 4WD on February 5, 2006, at 18:47:20
In reply to Re: imipramine pm vs plain imipramine -any diff? Ed? » 4WD, posted by ed_uk on February 5, 2006, at 17:01:42
> Hi M
>
> I don't think starting at 12.5mg will affect the speed of response. You can increase the dose as quickly as your body allows.
>
> EdOh. I figured the more, the quicker. So maybe I should stay at 12.5 until side effects (if any) abate?
Marsha
Posted by ed_uk on February 6, 2006, at 12:42:16
In reply to Re: imipramine pm vs plain imipramine -any diff? Ed?, posted by 4WD on February 5, 2006, at 18:47:20
Hi M
>So maybe I should stay at 12.5 until side effects (if any) abate?
Yes, because you can increase (in small steps) as rapidly as side effects permit :) Stay on each dose for at least 2 days or so to see how they affect you.
Ed
This is the end of the thread.
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