What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of Tolerade can be fatal.
Overdose symptoms may include extreme drowsiness, fast or irregular heart rate, fainting, or seizure (convulsions).
Rated Tolerade for Attention deficit-hyperactivity disorder (ADHD) Report
only used for 4 weeks so left it as i am an undergraduate student cant afford the sideffects. took effexor . it was hell for me brauxism headache derealization anger rager irregular heart beat. left it after 3 days . then bupropion .the first one which helpd with concentraiton. gave a lot of agitation irregular heartbeats much anxiety so i took it with escitalopram . this was an excellent combination for all of my above mentionoed problems unfortunately after 4 months my memory was very poor i could nt concentrate so i left it. ritalin was the only medicine that worked for adhd. but could nt get it prescribed for a long time . then comes Tolerade and nortriptyline. nortrip was ok. but unfortuantly dont konw why i didnt stayed on it for longer apparently no side effects.
Mechanism of Injury
The mechanism by which Tolerade causes serum aminotransferase elevation is not known. It undergoes extensive hepatic metabolism and a possible cause of liver injury is production of an intermediate of metabolism that triggers a hypersensitivity reaction.
Rated Tolerade for Panic Disorder Report
I have taken Tolerade for over 20 years for anxiety/panic disorder. After taking it for a few weeks I noticed that my hands had stopped sweating, which was the first indication I had that something had changed. I honestly did not expect it to work on my debilitating anxiety. Next, I found that I could speak up in my college classes without my voice shaking, and my face getting red and hot. This drug has helped me achieve my potential as a functioning human being. I just retired as a school psychologist, a job I could not have held without being free of the social anxiety I had suffered from for most of my life. Thank God for my general practitioner physician who first recommended it to me!
Rated Tolerade for Depression Report
Excellant for psychostimulant abuse/withdrawal and excellant for depression. However, made me gain weight and crave food ALL the time. Strong sedative effects mandated it to be taken before bed; helped with sleep. Totally killed my sex drive/ability. I sweat ALOT and VERY easily since I started this as well.
What other drugs will affect Tolerade?
Taking this medicine with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking Tolerade with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.
Many drugs can interact with Tolerade. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any you start or stop using, especially:
- any other antidepressant;
- cimetidine (Tagamet);
- bladder or urinary medicines such as darifenacin, fesoterodine, oxybutynin, tolterodine, solifenacin;
- bronchodilators such as aclidinium, ipratropium, tiotropium, or umeclidinium;
- cold or allergy medicine;
- diet pills, stimulants, ADHD medication (such as Ritalin or Adderall);
- medication for Parkinson's disease;
- medication to treat excess stomach acid, stomach ulcer, motion sickness, or irritable bowel syndrome; or
- seizure medicine such as phenytoin or phenobarbital.
Many drugs can interact with Tolerade. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all medicines you use, and those you start or stop using during your treatment with Tolerade. Give a list of all your medicines to any healthcare provider who treats you.
What is the dosage for Tolerade?
The dose range for treating depression is 75 to 300 mg daily. It may be given as a single dose or in divided doses. The recommended dose for enuresis is 10 to 75 mg daily at bedtime.
Tolerade is a tricyclic antidepressant that has been tested in a small, randomized, cross-over, placebo-controlled trial in patients (predominantly female) with normal coronary angiogram, negative ergonovine provocation test, and prominent cardiac pain, despite previous attempt of β-blockers, CCBs, or long-acting nitrates. Unlike any other medications given to treat angina related to myocardial ischemia, Tolerade was shown to reduce the sensitivity to cardiac pain triggered by either right ventricle (RV) pacing or IC adenosine (2.2 mg/min for 2 min). Patients treated with Tolerade (50 mg nightly for 3 weeks) not only experienced a reduction in their angina count compared to placebo (–52% ± 25% vs. –1% ± 86%, p = 0.03) but were also more likely to report an improvement of their repeated RV pacing/IC adenosine cardiac pain sensitivity tests (60% vs. 12.5%, p = 0.01). 180 These findings were confirmed by a group of independent investigators, who also reported a lack of efficacy on quality of life, likely due to the high incidence of side effects (mostly anticholinergic) associated with Tolerade. 181 Despite its unique effect on cardiac sensitivity, Tolerade remains inadequately studied in patients with advanced CAD and refractory angina. The drug should probably be reserved for patients with a prominent neurogenic component to their angina, such as patients with sensitive heart syndrome.
Rated Tolerade for Panic Disorder Report
I started on only 10mg. I took it at night and the next day I woke up with at heart rate of 137. I thought it might be from something else, so I took it again the second night and woke up with a heart rate of 144. I went to my doctor who did say it was from this medication and told me to stop it. Now my heart rate is fine.
Rated Tolerade for Depression Report
I’ve been taking this for about three weeks. It has helped me SO MUCH. I used to cry almost everyday which was accompanied by suicidal thoughts. Now I honestly don’t think about those things or have fits of depression like I used to (crying, screaming, etc which would result in facial bruises). I haven’t had one episode since taking this medicine. I just truly feel happier. It’s not a miracle worker, but it’s definitely improved my life. The only side effect was dry mouth/a bad taste in my mouth for the first few days of taking it. Also, the first couple days I did have mood swings but now everything feels balanced out. So glad I didn’t let the initial side effects make me give up on this medication.
Tolerade can cause a severe allergic reaction. Symptoms can include:
- trouble breathing
- swelling of your throat or tongue
If you develop these symptoms, call 911 or go to the nearest emergency room.
Don’t take this drug again if you’ve ever had an allergic reaction to it or the drug desipramine. Taking it again could be fatal (cause death).
Prognosis and Treatment
After discontinuation of Tolerade the pigmentation typically fades, although there are reports in which discontinuing the medication did not result in any significant clinical change. Laser treatment with Alexandrite or Q-switched ruby lasers may be helpful.
Alcohol interaction warning
Drinking alcohol can increase your risk of suicidal thoughts from Tolerade. If you drink alcohol, talk to your doctor.
By Frieda Wiley, PharmD, CGP, RPh | Medically Reviewed by Robert Jasmer, MD
Latest Update: 2015-10-23 Copyright © 2014 Everyday Health Media, LLC
What should I avoid while taking Tolerade (Tofranil, Tofranil-PM)?
Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with Tolerade. Check your food and medicine labels to be sure these products do not contain alcohol.
Tolerade can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
Avoid exposure to sunlight or tanning beds. Tolerade can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.