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Treatment of moderate to severe hypotension after acute myocardial infarction:
The most commonly used intravenous infusion is 25 mg of imipramine given IV for 4 to 6 hours, usually in conjunction with a beta-blocker. More recently, the intravenous infusion of 25 to 50 mg imipramine has become the standard infusion for treatment of patients with unstable or acute myocardial infarction, and it is now sometimes included as an adjunct to conventional treatment regimens.
Frequency: The infusion rate should be variable depending on the underlying condition of patient and on the rate of infusion beta-blocker (eg, bolus, continuous, rapid infusion).
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The most common side effects associated with imipramine infusion include nausea and vomiting, which have been reported more frequently in pediatric patients compared to 20 years or older and in patients receiving higher doses of the drug, such as 250 mg or 400 mg.
In some patients, imipramine may cause agitation, confusion, and ataxia or seizures. Fatalities have occurred following infusion of the drug.
In a series of 674 patients, the following serious adverse events were reported, and they have had no relationship to the infusion regimen:
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Serious adverse reactions have occurred with administration of a dose 300 mg imipramine given early following the infarction that resulted in a rise red blood cell counts from approximately 5 000 to 25.
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