Formulary
Lofepramine: Indications, Dosing, Side Effects and Interactions
Lofepramine clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Lofepramine: Indications, Dosing, Side Effects and Interactions
Lofepramine clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Depressive illness**
- **Adult** (By Mouth): 140-210 mg daily in divided doses.
- **Elderly** (By Mouth): May respond to lower doses.
Cautions
Cardiovascular disease; chronic constipation; diabetes; epilepsy; history of bipolar disorder; history of psychosis; hyperthyroidism (risk of arrhythmias); increased intra-ocular pressure; patients with a significant risk of suicide; phaeochromocytoma (risk of arrhythmias); prostatic hypertrophy; susceptibility to angle-closure glaucoma; urinary retention Cautions, further information Treatment should be stopped if the patient enters a manic phase. M Elderly patients are particularly susceptible to many of the side-effects of tricyclic antidepressants; low initial doses should be used, with close monitoring, particularly for psychiatric and cardiac side-effects M .
Contraindications
Acute porphyrias ; arrhythmias; during the manic phase of bipolar disorder; heart block; immediate recovery period after myocardial infarction
Side effects
Frequency not known Accommodation disorder; agitation; agranulocytosis; arrhythmias; bone marrow disorders; cardiac conduction disorder; confusion; constipation; coordination abnormal; dizziness; drowsiness; dry mouth; eosinophilia; face oedema; galactorrhoea; glaucoma; granulocytopenia; gynaecomastia; hallucination; headache; heart failure aggravated; hepatic disorders; hyperhidrosis (on discontinuation); hyponatraemia; hypotension; increased risk of fracture; leucopenia; malaise; mood altered; mucositis; nausea; paraesthesia; paranoid delusions; photosensitivity reaction; psychosis; respiratory depression; seizure; sexual dysfunction; SIADH; skin haemorrhage; skin reactions; sleep disorder; suicidal behaviours; taste altered; testicular disorders; thrombocytopenia; tinnitus; tremor; urinary disorders; vomiting; withdrawal syndrome Side-effects, further information The risk of side-effects is reduced by titrating slowly to the minimum effective dose (every 2-3 days). Consider using a lower starting dose in elderly patients. Overdose Tricyclic and related antidepressants cause dry mouth, coma of varying degree, hypotension, hypothermia, hyperreflexia, extensor plantar responses, convulsions, respiratory failure, cardiac conduction defects, and arrhythmias. Dilated pupils and urinary retention also occur. Lofepramine is associated with the lowest risk of fatality in overdosage, in comparison with other tricyclic antidepressant drugs. For details on the management of poisoning see Tricyclic and related antidepressants under Emergency treatment of poisoning .
Pregnancy
Neonatal withdrawal symptoms and respiratory depression reported if used during third trimester.
Breast feeding
The amount secreted into breast milk is too small to be harmful.
Hepatic impairment
Manufacturer advises caution in mild to moderate impairment; avoid in severe impairment.
Renal impairment
Use with caution in mild to moderate impairment; avoid in severe impairment. M
Medicinal forms
Solution,Tablet,Suspension
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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