Imipramine (Tofranil) tablets 25 mg: Supply issue
AFT Pharmaceuticals (the supplier) have advised PHARMAC that the stock of imipramine hydrochloride (Tofranil) 25 mg tablets is likely to go out of stock from the end of August 2020 until November 2020.
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About the medicine
Imipramine is an antidepressant medicine used for depression and other serious mental health conditions. About 500 patients in New Zealand are using imipramine hydrochloride 25 mg tablets.
Tofranil is the only brand of imipramine hydrochloride tablets currently approved by Medsafe. The supplier, AFT Pharmaceuticals, has been unable to source an alternative brand that is chemically equivalent.
There is no shortage of the 10 mg strength of imipramine tablets.
Information for people taking imipramine (Tofranil) 25 mg
If you are taking the 25 mg tablet of imipramine, you will need to contact your prescriber about alternatives.
There is no shortage of imipramine hydrochloride 10 mg tablets. If you are only using imipramine hydrochloride 10 mg tablets, you do not need to contact your prescriber.
We know that changes to your medicine can be disruptive. We’re working hard to keep this to a minimum. Thank you for your understanding.
Information for prescribers
Prescribers will need to:
- ensure no new patients are started on imipramine hydrochloride 25 mg and
- either transition patients currently on imipramine hydrochloride 25 mg to an alternative treatment while imipramine hydrochloride 25 mg is out of stock
- or consider using an appropriate number of imipramine hydrochloride 10 mg tablets (including alternate day different dosing) to maintain therapeutic benefits for your patient.
We have received advice from our Mental Health Subcommittee that using multiple 10 mg tablets to maintain the correct dose could be a temporary alternative.
The supplier, AFT, has informed PHARMAC that they have adequate supply of imipramine hydrochloride 10 mg tablets to manage an increase in demand if it were used by all patients who usually use the 25 mg during the out of stock situation.
Alternative funded medicines
If decide to change medication, please note that there are stock issues for some other antidepressants
- Clomipramine (short supply)
- Maprotiline (discontinuation)
- Oxazepam (discontinuation)
- Phenelzine (discontinuation)
BPACnz has published information on the role of medicines in the management of depression in primary care which may be useful.
Information for pharmacists
You will need to tell people using imipramine hydrochloride 25 mg tablets to contact their prescriber to get advice about an appropriate alternative treatment to use during the out of stock.
Normal supply of imipramine hydrochloride 25 mg tablets is expected to resume in November 2020.
Thank you for the work you do supporting your patients during stock issues and other changes.
Who to contact
If you are a prescriber or pharmacist with questions about this short supply issue:
- email PHARMAC firstname.lastname@example.org
- email AFT Pharmaceuticals email@example.com
- call AFT Pharmaceuticals on 0800 423 823
If you take imipramine hydrochloride (Tofranil) 25 mg tablets, contact your doctor, nurse, or pharmacist. PHARMAC cannot give clinical advice to individuals.