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Tricyclic antidepressant

Lofepramine

Brand names: Gamanil, Lomont

Lofepramine is a tricyclic antidepressant used in the treatment of depression, generally regarded as having a more favourable side-effect and toxicity profile than older tricyclics.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It inhibits the reuptake of noradrenaline and serotonin and is metabolised partly to desipramine, increasing monoamine availability at synapses.

Prescribing in practice

  • Although less toxic in overdose than some older tricyclics, it can still cause antimuscarinic and cardiac effects and should be used with caution in cardiovascular disease.
  • It has been associated with abnormal liver function tests, so caution is advised in hepatic impairment.
  • Use with caution in the elderly and in those at risk of urinary retention or angle-closure glaucoma.

Monitoring

Monitor mood and suicidal ideation, antimuscarinic and cardiovascular effects, and liver function where clinically indicated.

Counselling the patient

  • Explain that antidepressant benefit may take several weeks to develop.
  • Do not stop the medicine suddenly because of withdrawal effects.
  • Report worsening mood, suicidal thoughts or difficulty passing urine.

Evidence & guidelines

Lofepramine is an established tricyclic antidepressant available in the UK and is recognised as relatively safer in overdose than older agents in current prescribing references.

Reference: NICE NG222; Maudsley; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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