Tricyclic antidepressant
Lofepramine
Brand names: Gamanil, Lomont
Adult dose
Dose: 70mg BD–TDS (max 210mg/day)
Route: PO
Frequency: BD-TDS
Clinical pearls
- Better-tolerated TCA — useful where TCA needed but anticholinergic load undesirable
Contraindications
- Recent MI
- Arrhythmia
- Mania
- Severe hepatic impairment
- Concurrent MAOI
Side effects
- Less anticholinergic than older TCAs
- Less sedating
- Less cardiotoxic in overdose than amitriptyline
- Hepatotoxicity (rare)
Interactions
- MAOIs (avoid)
- SSRIs
- QT-prolonging drugs
Monitoring
- LFTs
- BP
Reference: BNF; NICE NG222; Maudsley; https://bnf.nice.org.uk/drugs/lofepramine/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Drugs
Pathways
- Acute Behavioural Disturbance / Rapid Tranquillisation · RCEM 2022; RCPsych 2022; NICE NG10
- Self-Harm Presentation · NICE NG225 (2022)
- Capacity Assessment (Mental Capacity Act) · MCA 2005; Code of Practice
- Acute Psychosis Management · NICE CG178 2014
- Depression Management · NICE CG90 2022
- Lithium Therapy Monitoring · NICE CG185 / BNF