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What is/are Anafranil tablets?

ANAFRANIL, a chemical cousin of tricyclic antidepressant medications such as Tofranil and Elavil, is used to treat people who suffer from obsessions and compulsions.

An obsession is a persistent, disturbing idea, image, or urge that keeps coming to mind despite the person's efforts to ignore or forget it--for example, a preoccupation with avoiding contamination.

A compulsion is an irrational action that the person knows is senseless but feels driven to repeat again and again - for example, hand-washing perhaps dozens or even scores of times throughout the day.

Sustained-release (SR), extended-release (ER, XR, or XL), time-release or timed-release, controlled-release (CR), or continuous-release (CR or Contin) pills are tablets or capsules formulated to dissolve slowly and release a drug over time. The advantages of sustained-release tablets or capsules are that they can often be taken less frequently than instant-release formulations of the same drug, and that they keep steadier levels of the drug in the bloodstream.

What should I tell my health care providers before I take this medicine?

They need to know if you have any of these conditions:

• seizure
• brain damage or alcoholism
• narrow-angle glaucoma
• kidney function is not normal
• tumor of the adrenal gland

How should I use this medicine?

Take Anafranil with meals, at first, to avoid stomach upset. After your regular dosage has been established, you can take 1 dose at bedtime to avoid sleepiness during the day. Always take it exactly as prescribed.

This medicine may cause dry mouth. Hard candy, chewing gum, or bits of ice may relieve this problem.

What if I miss a dose?

If you take 1 dose at bedtime, consult your doctor. Do not take the missed dose in the morning. If you take 2 or more doses a day, take the missed dose as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at the same time.

What may interact with this medicine?

• antipsychotic drugs such as Haldol and chlorpromazine
• barbiturates
• Cimetidine
• Digoxin
• drugs that ease spasms
• Flecainide
• Methylphenidate
• MAO inhibitors
• Phenytoin
• Propafenone
• Quinidine
• serotonin-boosting drugs
• thyroid medications
• tranquilizers
• Warfarin

Avoid alcoholic beverages while taking Anafranil.

What side effects may I notice from this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• seizures
• fatigue
• nausea

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• constipation
• dizziness
• dry mouth
• increased appetite
• nervousness
• sleepiness

This list may not describe all possible side effects.

What should I watch for while using this medicine?

This drug should be used with caution in children with depression. In clinical studies, antidepressants increased the risk of suicidal thinking and behavior in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of Anafranil or any other antidepressant in a child or adolescent must balance this risk with the clinical need. In children, Anafranil is only approved to treat obsessive-compulsive disorder.

Additionally, the progression of major depression is associated with a worsening of symptoms and/or the emergence of suicidal thinking or behavior in both adults and children, whether or not they are taking antidepressants. Individuals being treated with Anafranil and their caregivers should watch for any change in symptoms or any new symptoms that appear suddenly - especially agitation, anxiety, hostility, panic, restlessness, extreme hyperactivity, and suicidal thinking or behavior - and report them to the doctor immediately. Be especially observant at the beginning of treatment or whenever there is a change in dose.

Because Anafranil poses a possible risk of seizures, and because it may impair mental or physical ability to perform complicated tasks, your doctor will probably warn you to take special precautions if you need to drive a car, operate complicated machinery, or take part in activities such as swimming or climbing, in which suddenly losing consciousness could be dangerous.

Anafranil may cause your skin to become more sensitive to sunlight. Avoid prolonged exposure to sunlight.

Before having any kind of surgery involving the use of general anesthesia, tell your doctor or dentist that you are taking Anafranil. You may be advised to discontinue the drug temporarily.

When it is time to stop taking Anafranil, do not stop abruptly. Your doctor will have you taper off gradually to avoid withdrawal symptoms such as dizziness, fever, general feeling of illness, headache, high fever, irritability or worsening emotional or mental problems, nausea, sleep problems, vomiting.

Where should I keep this medicine?

Store at room temperature in a tightly closed container, away from moisture.