Tofranil

If you are switching from Prozac, wait at least 5 weeks after your last dose of Prozac before starting Tofranil.

Special information if you are pregnant or breastfeeding

The effects of Tofranil during pregnancy have not been adequately studied. Pregnant women should use Tofranil only when the potential benefits clearly outweigh the potential risks. If you are pregnant or plan to become pregnant, inform your doctor immediately. Tofranil may appear in breast milk and could affect a nursing infant. If this medication is essential to your health, your doctor may advise you to stop breastfeeding until your treatment is finished.

Recommended dosage

ADULTS

The usual starting dose is 75 milligrams a day. The doctor may increase this to 150 milligrams a day. The maximum daily dose is 200 milligrams. People who need to take 75 milligrams or more a day may use Tofranil-PM capsules instead of the regular tablets.

CHILDREN

Tofranil is not to be used in children to treat any condition but bedwetting, and its use will be limited to short-term therapy. Safety and effectiveness in children under the age of 6 have not been established. Tofranil-PM should not be used in children for any reason.

Total daily dosages for children should not exceed 2.5 milligrams for each 2.2 pounds of the child's weight.

Doses usually begin at 25 milligrams per day. This amount should be taken an hour before bedtime. If needed, this dose may be increased after 1 week to 50 milligrams (ages 6 through 11) or 75 milligrams (ages 12 and up), taken in one dose at bedtime or divided into 2 doses, 1 taken at mid-afternoon and 1 at bedtime.

OLDER ADULTS AND ADOLESCENTS

People in these two age groups should start with 25 to 50 milligrams per day of Tofranil tablets, since Tofranil-PM capsules are not available in these dosage strengths. The dose may be increased as necessary, but effective dosages usually do not exceed 100 milligrams a day.

Overdosage

Any medication taken in excess can have serious consequences. An overdose of Tofranil can cause death. It has been reported that children are more sensitive than adults to overdoses of Tofranil. If you suspect an overdose, seek medical help immediately.

• Symptoms of Tofranil overdose may include:
  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