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Tofranil vs. Cymbalta

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Imipramine (Tofranil) and duloxetine (Cymbalta) are both used to treat depression, but they belong to different classes of medications. Imipramine is a tricyclic antidepressant (TCA) that also helps with bedwetting in children, while duloxetine is a serotonin and norepinephrine reuptake inhibitor (SNRI) that treats anxiety, diabetic neuropathy, fibromyalgia, and long-term pain in addition to depression. Imipramine can cause side effects like sleepiness, dizziness, and dry mouth, and it may take 1 to 2 months to feel its full benefits. Duloxetine, on the other hand, can cause nausea, headache, and dry mouth, and it may take several weeks to feel its full effects. Both medications can lead to withdrawal symptoms if stopped abruptly, but duloxetine is also associated with a risk of liver damage and serotonin syndrome. However, imipramine can cause glaucoma. Both medications are available as low-cost generics.

Imipramine

 

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Duloxetine

(Cymbalta)

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Summary for Tofranil

Prescription only

Imipramine is a medication that's used to treat depression. It can also temporarily help with bedwetting in children at night. Imipramine belongs to a class of medications called tricyclic antidepressants (TCAs). There are two different forms of the medication: imipramine hydrochloride and imipramine pamoate. They used to be available under the brand name Tofranil but are now only sold as generic versions. The dosage generally depends on why you need imipramine, how severe your symptoms are, and your age. It's generally not a first-choice option because it can cause a lot of side effects, like sleepiness, dizziness, dry mouth, and changes in weight.

Indications for Tofranil

  • Depression
  • Bedwetting in children (imipramine hydrochloride only)

Pros and Cons for Tofranil

Pros

  • Available as a lower-cost generic
  • Can take with or without food
  • Dose can be adjusted by your provider based on how well the medication is working for you
  • For bedwetting, only needs to be taken right before bedtime

Cons

  • Can cause a lot of side effects, including blurry vision, dry mouth, and eye pain
  • Can cause withdrawal symptoms if you stop taking it too suddenly after long-term use
  • Has a risk for suicidal thoughts and behavior
  • Not a good option for people with a history of heart problems

Common Side Effects for Tofranil

In adults (with depression)

  • Dry mouth
  • Blurry vision
  • Nausea
  • Vomiting
  • Constipation
  • Sleepiness
  • Dizziness
  • Confusion
  • Anxiety
  • Restlessness

In children (with bedwetting problems)

  • Nervousness
  • Sleep problems
  • Tiredness
  • Stomach upset

Warnings for Tofranil

  • Worsening depression, suicidal thoughts, and unusual behavior
  • Not for use alone in bipolar disorder
  • Risk of heart problems, heart attack, or stroke
  • Glaucoma
  • Higher risk of falls
  • Seizures

Summary for Cymbalta

Prescription only

Duloxetine (Cymbalta) helps treat depression and anxiety. It can also help with some types of chronic pain, such as nerve pain from diabetes. Duloxetine (Cymbalta) is a type of antidepressant called an SNRI, or serotonin and norepinephrine reuptake inhibitor. Most people take it by mouth once a day, but some with depression might take it twice a day. Side effects include nausea, headache, and dry mouth. When it's time to stop taking the medication, the prescriber will slowly lower your dose to help prevent withdrawal symptoms.

Indications for Cymbalta

Pros and Cons for Cymbalta

Pros

  • Taken once a day for most people
  • Can take at any time of day
  • A first-choice option for depression
  • An option for some types of chronic pain, like nerve pain from diabetes

Cons

  • Can take several weeks before you feel its full effects
  • Might not be a good option for people who drink heavily or have liver or kidney problems
  • Can cause nausea or dry mouth
  • Can interact with many medications, including other antidepressants and certain pain relievers

Common Side Effects for Cymbalta

  • Nausea (23%)
  • Headache (14%)
  • Dry mouth (13%)
  • Drowsiness (10%)
  • Feeling tired (9%)
  • Trouble sleeping (9%)
  • Dizziness (9%)
  • Constipation (9%)
  • Diarrhea (9%)
  • Low appetite (7%)
  • A lot of sweating (6%)
  • Stomach pain (5%)

Warnings for Cymbalta

  • Suicidal thoughts or behavior
  • Liver damage
  • Changes in blood pressure and risk of falls
  • Serotonin syndrome
  • Higher risk of bleeding
  • Severe skin reaction
  • Withdrawal symptoms
  • Low sodium levels
  • Sexual problems
  • Not for use alone for bipolar disorder because of the risk of mania
  • Angle-closure glaucoma in certain people

Prices with our coupons for Tofranil vs. Cymbalta

Price Card Drug Icon
Imipramine Hydrochloride90 tablets / 50mg
$26.65$64.90
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Price Card Drug Icon
Duloxetine30 capsules / 60mg
$11.45$32.26
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