This medication description is not meant for treatment prescription without the intervention of a specialist.

Common Uses

Anafranil is a tricyclic antidepressant. It is applied in treatment of: depression with lack of energy or mild agitation, obsessive-compulsive disorder, panic attacks with or without agoraphobia, narcolepsy, premature ejaculation, chronic pain with or without organic disease, particular headache of the tension type, enuresis (involuntary nightly urinating in sleep) in children and adolescents.

How to Take

Initial doses are usually 25 mg 2 or 3 times daily or 75 mg once daily in slow released form. The dose may be increased in regular intervals (the usual dose per day is 100 to 225 mg). Doses up to 300 mg may be used, but these are associated with an increased risk of seizures. This medication may be taken with food to prevent stomach upset. It may take 2 to 3 weeks before you notice the effect of Anafranil. Continue to use Anafranil even if you feel well. Do not miss any doses.

Warning and Precautions

Do not take this medicine if: you are taking antihistamines, cisapride, droperidol, a ketolide (eg, telithromycin), a macrolide (eg, erythromycin), mibefradil, or pimozide; you are recovering from a heart attack.

If you suddenly stop taking Anafranil, you may have withdrawal symptoms which may include dizziness, headache, irritability, nausea, tiredness, trouble sleeping, and vomiting.

Do not become overheated in hot weather or while you are being active; heatstroke may occur.

Anafranil may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Anafranil. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.

Children, teenagers, and young adults who take Anafranil may be at increased risk for suicidal thoughts or actions. Contact your doctor at once if new, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.

Tell your doctor or dentist that you take Anafranil before you receive any medical or dental care, emergency care, or surgery.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. If you take 1 dose daily at bedtime, do not take the missed dose the next morning.

Overdose

If overdose is suspected, contact your local poison control center or emergency room immediately.

Storage

Store Anafranil at room temperature, in a tightly sealed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Anafranil out of the reach of children and away from pets.

Possible Side Effects

Anafranil may have a broad range of side effects:

CNS: fatigue, dizziness, lightheadedness, headaches, confusion, agitation, insomnia, nightmares, increased anxiety, seizures; rarely: hypomania or induction of schizophrenia (immediate termination of therapy required).

Anticholinergic side effects in different grades of severity are quite common: dry mouth, constipation; rarely ileus (paralysis of the large intestine, life-threatening), difficulties in urinating, sweating, precipitation of glaucoma (may lead to permanent eye-damage or even blindness, if untreated). The incidence of dental caries may be increased due to dry mouth.

Antiadrenergic side effects occur very frequently due to strong central and peripheral blockage of alpha receptors: hypotension, postural collapse (when patient is rising too fast from lying or sitting position to standing), arrhythmias. Preexisting heart insufficiency can be worsened.

Most of these side-effects are dose related and/or tolerance will develop with continued use.

Allergic/toxic: skin reactions and photosensitivity with increased frequency of sunburns are seen in a few percentage of cases. Rarely liver damage of the cholostatic type, hepatitis, and leukopenia or other forms of blood dyskrasia are seen, also severe acute allergy including difficulties in breathing, skin reaction, chest pain etc.

Other side effects may include heartburn, weight gain, but also nausea and bruxism - teeth-grinding while asleep.

The drug often causes sexual problems in men (e.g. impotence, ejaculation difficulties). In about 5% of patients, it can instead cause inadvertent orgasms when yawning.

More Information

The information given above is a summary. Your pharmacist can provide more information about Anafranil. Do not share this medicine with others for whom it was not prescribed. Do not use this medicine for other health conditions. If using this medicine for an extended period of time, obtain refills before your supply runs out.