Patient/caregiver was educated on how to take Tofranil as follows:
- Take this medication as ordered by your physician. Take the medication dose for the duration prescribed without fail.
- Observe compliance with the timing of dose intake, by having the medication dose at the same time every day. This helps to avoid forgetting the intake of medication and maintain therapeutic levels of the antidepressant medication in the blood.
- Maintain strict compliance with regards to dosage and frequency, to derive the benefit of the medication. Do not change the dose on this medication without consulting your doctor.
- This medication can induce some nausea and vomiting, when taken on empty stomach. Taking the medication with a glass of water and some food or snack can help avoid these unpleasant gastrointestinal symptoms. Tofranil can also induce extreme dry mouth and constipation. Sucking on a sugar free hard candy can help with symptomatic relief of dry mouth. Proper hydration measures and compliance with daily fluid intake recommendations can help with relief from constipation. If you experience any further bothersome constipation, report it to your physician for a recommendation on laxative/stool softener use.
- Tofranil can induce some dizziness and make one drowsy. Starting the medication at a low dose and gradually increasing the dose, to help optimal control of your symptoms, can contribute to reducing the risk for drowsiness and dizziness due to the medication. If the dizziness becomes bothersome, report it to your physician and other health care personnel, for any change in plan of care to be considered. Stay away from activities, such as, driving and operating heavy machinery, until you are used to the side effects caused by Tofranil.
- Do not take Tofranil with alcohol or opioid pain medications, such as, hydrocodone and codeine, as these products can add to the dizziness and confusion caused by Tofranil. A number of OTC cough medications, antihistamines, and antianxiety medications, can potentiate the confusion caused by Tofranil and so, must be avoided taking along with Tofranil.
- Tofranil can interact with a number of other medications and can precipitate serious reactions. If you are being newly started on Tofranil, discuss with your physician regarding all other medications you are currently taking and their safety with Tofranil. Also, if you have been taking Tofranil for long, discuss with your physician regarding your history of Tofranil intake, when you are being started on any new medication.
- Take the regular tablet as a whole, using a glass of water. If you encounter difficulty swallowing the whole tablet, you may cut the tablet and swallow it in pieces with a glass of water. You may also crush the tablet and sprinkle the powder on a spoonful of soft jelly or applesauce, to facilitate an easy swallow.
- Take the Tofranil capsule as a whole, using a glass of water. If you encounter difficulty swallowing the whole capsule, you may open the capsule and sprinkle the powder on a spoonful of soft jelly or applesauce, to facilitate an easy swallow.
- Tofranil takes some time to fairly balance the chemicals in the brain, before any improvement in mood and behavior are noted. It could take about 3 – 6 weeks to see this change in mood. So, do not discontinue taking the medication without consulting your physician, as you failed to see the improvement with depressive symptoms immediately after taking the medication.
- Tofranil only helps with managing the depressive symptoms, by affecting the fine balance between the chemical neurotransmitters in the brain and is not a permanent cure. So, continue taking Tofranil, even if your mood feels better. Discontinuing the medication abruptly can result in disruption of this chemical balance in the brain, resulting in onset of severe withdrawal and depressive symptoms. Individuals can present with listlessness, lack of energy, exacerbation of depressive symptoms, anxiety, sleep disturbances, appetite changes, hallucinations, and mania. Discontinuation on Tofranil use must be slow and gradual, using tapering doses, and only on your physician recommendation.
- As the balance between the chemicals in the brain has to be finely regulated to help relieve the anxiety and depressive symptoms and experience feelings of well-being, the dose of Tofranil also needs to be finely regulated, in order to accomplish this goal. Your physician could change the dose of Tofranil, based on the response and side-effects developed. Maintain compliance with follow-up physician appointments and be accommodative to the plan of dose changes, until you show an optimum response.
- Your physician could change the dose of Tofranil, based on the response obtained and side-effects developed. Notify your doctor of any continuing or worsening symptoms of depression, aggression, abnormal thought processes, sleep disturbances, and neuropathy, so that, your dosage on the medication could be appropriately Maintain compliance with follow-up physician appointments and be accommodative to the plan of dose changes, until you show an optimum response.
- Periodical labs could be ordered to evaluate the blood levels of potassium and magnesium ions and to evaluate cardiac function with Tofranil use. Observe compliance with any labs and cardiac function tests ordered.
- If you miss a dose, try taking it at the earliest notice of noncompliance. If it is time for the next dose, skip the missed dose and take the dose scheduled. Do not take an extra dose to try making up for the missed dose. Notify your doctor and other health care personnel regarding your dose noncompliance.
