Clinical decision-support only. For use by licensed dental professionals. Not a substitute for professional judgment or a complete drug reference. Always verify with primary sources.
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Medication

Imipramine

Antidepressant (tricyclic)

Brand names: Tofranil

Oral health effects

  • Xerostomia (dry mouth)

    Marked anticholinergic xerostomia.

    Clinical management: Hydration, sugar-free gum/xylitol, salivary substitutes, high-fluoride products; reinforce caries prevention.

  • Dizziness on standing (orthostatic hypotension)

    Tricyclics block alpha-1 receptors; the label lists orthostatic hypotension among cardiovascular reactions.

    Clinical management: Raise the chair slowly at the end of the appointment and have the patient sit upright for a minute or two before standing; steady them as they get up. Ask about dizziness on standing, especially after dose changes or in older patients.

Sources

  1. A Guide to Medications Inducing Salivary Gland Dysfunction, Xerostomia, and Subjective Sialorrhea: A Systematic Review Sponsored by the World Workshop on Oral Medicine VI. Wolff A, Joshi RK, Ekström J, et al. Drugs in R&D, 2017.
  2. Imipramine prescribing information (FDA label) REMEDYREPACK INC. / DailyMed, 2026.