Applies to: HyperthyroidismMost tricyclic antidepressants should be administered with caution in hyperthyroid patients or those receiving thyroid medication as they may develop arrhythmias when these drugs are given.Moderate Potential Hazard, Moderate plausibility. Patients with tardive dyskinesia requiring therapy with TCAs should be monitored for exacerbation of the condition.Moderate Potential Hazard, Moderate plausibility. In some cases a gradual dose titration is recommended.Major Potential Hazard, Moderate plausibility. Should you be on a statin? There are very limited data concerning the use of TCAs in patients with renal and/or liver disease. In patients who may use alcohol excessively, it should be borne in mind that the potentiation may increase the danger inherent in any suicide attempt or overdosage.Moderate Potential Hazard, Moderate plausibility. Applies to: Glaucoma (Narrow Angle)Tricyclic antidepressants as other type of antidepressants have an effect on pupil size causing dilation. Consult your healthcare professional (e.g., doctor or pharmacist) for more in formation.These medications may interact and cause very harmful effects. Particularly doxepin hydrochloride capsules are contraindicated in patients with tendency to urinary retention.Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Sometimes, a statin is combined with another heart medication. There are 649 drug interactions with Tofranil (imipramine) Tofranil (imipramine) alcohol/food interactions. This is not a list of all drugs or health problems that interact with Tofranil (imipramine tablets). It may be prudent to refrain from dispensing large quantities of medication to these patients.Major Potential Hazard, Moderate plausibility. Applies to: Myocardial InfarctionThe use of most tricyclic antidepressants is contraindicated in patients that are going through the acute recovery period after a myocardial infarction.Major Potential Hazard, Moderate plausibility. These drugs should be used with caution in patients with hypoglycemia, hyperglycemia or diabetes. Therapy with TCAs should be administered cautiously in patients with significantly impaired renal or hepatic function. Applies to: SchizophreniaSome tricyclic antidepressants have shown to cause activation or exacerbation of psychosis in schizophrenic patients. Select one or more newsletters to continue. Applies to: Cardiovascular DiseaseTricyclic antidepressants should be used with extreme caution in patients with evidence of cardiovascular disease because of the possibility of fluctuations in the blood pressure, arrhythmias, conduction defects, tachycardia, myocardial infarction and stroke. Whether you need to be on a statin depends on your cholesterol levels and other risk factors for heart and blood vessel (cardiovascular) disease. Do not breast-feed while you take Tofranil (imipramine tablets). Consult your healthcare professional (e.g., doctor or pharmacist) for more in formation.These medications may cause some risk when taken together. Enhanced sympathetic activity can provoke hypertensive crises in patients with pheochromocytoma or other tumors of the adrenal medulla, such as some neuroblastomas. Patients should be monitored appropriately and observed closely for worsening of their symptoms, suicidality or changes in their behavior, especially during the first few months of treatment, and at times of dose changes. Close monitoring of cardiovascular status, including ECG changes, is recommended at all dosages. Many of the newer antidepressants, including bupropion and the selective serotonin reuptake inhibitors (SSRIs), are considerably less or minimally cardiotoxic and may be appropriate alternatives.Major Potential Hazard, Moderate plausibility. Physicians are encouraged to get additional dosing recommendations on the manufacturer's prescribing information.Moderate Potential Hazard, Low plausibility. Patients with preexisting bone marrow suppression or blood dyscrasias receiving TCAs should be monitored closely during therapy for further decreases in blood counts.Moderate Potential Hazard, Moderate plausibility. Although serious liver injury has only been reported rarely, therapy with these drugs should be administered cautiously in patients with preexisting liver disease and periodic monitoring of liver enzyme levels is recommended.Moderate Potential Hazard, Moderate plausibility. Applies to: Bone Marrow Depression/Low Blood CountsThe use of tricyclic and tetracyclic antidepressants (TCAs) has rarely been associated with bone marrow suppression. This also applies to patients who have family history of sudden death, cardiac dysrhythmias, or conduction disturbances. Patients with depressive symptoms should be adequately screened to determine if they are at risk for bipolar disorder prior to initiating treatment with a tricyclic antidepressant. These occurrences have also been reported rarely with the tetracyclic antidepressant, maprotiline. Applies to: Bipolar DisorderA major depressive episode can be the initial presentation of bipolar disorder. 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