Clinical data
Trade names Lomont, Emdalen, Gamanil
AHFS/Drugs.com International Drug Names
Routes of
ATC code N06AA07 (WHO)
Legal status
Legal status
  • UK: POM (Prescription only)
Pharmacokinetic data
Bioavailability 7%[1]
Protein binding 99%[2]
Metabolism Hepatic (via P450 cytochromes)
Biological half-life 1.7-2.5 hours (dose-dependent; parent drug); 12-24 hours (active metabolites)
Excretion Urine (mostly as metabolites)
CAS Number 23047-25-8 N
PubChem (CID) 3947
ChemSpider 3810 YesY
KEGG D08140 YesY
ChEBI CHEBI:47782 YesY
ECHA InfoCard 100.041.254
Chemical and physical data
Formula C26H27ClN2O
Molar mass 418.958 g/mol
3D model (Jmol) Interactive image
 NYesY (what is this?)  (verify)

Lofepramine (brand name: Lomont (UK) Emdalen (ZA), Gamanil (IE, UK (discontinued)) & Tymelyt (discontinued)) is a third generation[3] tricyclic antidepressant which was introduced in 1983 for the treatment of depressive disorders.[4] Lofepramine is less sedating than, for instance, amitriptyline, and is safer in overdose than older tricyclics.[2]


In the United Kingdom, Lofepramine is licensed for the treatment of depression which is its primary use in medicine.[2][5]

Side effects[6]

Other side effects

Delusions, nightmares, facial oedema, general feeling of being unwell, bleeding from skin, inflammation of mucous membranes, loss of taste, psychiatric problems such as self-harm, pins and needles, sweating, dizziness. Can cause behavioural disturbance in the young. May produce weight gain or cause changes in the levels of blood sugar. Some patients report muscular discomfort, particularly in the shoulders.


Lofepramine is known to interact with


Mechanism of action

Lofepramine is a strong inhibitor of norepinephrine reuptake (Ki=5.4 nM) and a moderate inhibitor of serotonin reuptake (Ki=70 nM).[10] It is a weak-intermediate level antagonist of the muscarinic acetylcholine receptors (Ki values of 67 nM, 330 nM, 130 nM, 340 nM, 460 nM for M1, M2, M3, M4 & M5 respectively).[10]

The measured affinity [Kd (nM)] of Lofepramine at different receptor or transporter binding sites are listed below:

Compound SERT NET M1
Lofepramine 70 5.4 67


It is partially converted to its active metabolite desipramine in vivo.[4] However, it is unlikely this property plays a substantial role in its overall effects as lofepramine exhibits lower toxicity and anticholinergic side effects relative to desipramine while retaining equivalent antidepressant efficacy.[4]

This has assertion however has been contradicted in many papers and texts (Seminars in General Adult Psychiatry - Page 84), that claim the bioavailability of lofepramines metabolite, desipramine, is ultimately higher than that of the parent compound.


To be used with caution for epileptic patients or those with glaucoma or psychosis. Lofepramine should not be given to people who have suffered liver failure or heart disease. Not advisable for use in pregnant women.


In the United Kingdom, lofepramine is marketed (as the hydrochloride salt) in the form of 70 mg tablets [9] and 70mg/5ml oral suspension.[11]


Lofepramine synthesis: E. Eriksoo et al., GB 1177525 ; eidem, U.S. Patent 3,637,660 (1970, 1972 both to Leo AB).


  1. Lancaster, SG; Gonzalez, JP (February 1989). "Lofepramine: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in depressive illness". Drugs. 37 (2): 123–140. doi:10.2165/00003495-198937020-00003. PMID 2649353.
  2. 1 2 3 "Lofepramine 70mg tablets - Summary of Product Characteristics (SPC)". electronic Medicines Compendium. Merck Serono. 18 November 2010. Retrieved 21 November 2013.
  3. "SAFC Commercial Life Science Products & Services | Sigma-Aldrich". Safcglobal.com. 2015-05-12. Retrieved 2016-02-24.
  4. 1 2 3 Leonard BE (October 1987). "A comparison of the pharmacological properties of the novel tricyclic antidepressant lofepramine with its major metabolite, desipramine: a review". International Clinical Psychopharmacology. 2 (4): 281–97. doi:10.1097/00004850-198710000-00001. PMID 2891742.
  5. Joint Formulary Committee (2013). British National Formulary (BNF) (65 ed.). London, UK: Pharmaceutical Press. ISBN 978-0-85711-084-8.
  6. https://www.medicinescomplete.com/mc/bnf/current/PHP2352-tricyclic-and-related-antidepressant-drugs.htm#PHP2353. Missing or empty |title= (help)
  7. https://www.medicinescomplete.com/mc/bnf/current/bnf_int252-antidepressants-tricyclic-related.htm. Missing or empty |title= (help)
  8. "Tricyclic and related antidepressant drugs / Contraindications".
  9. 1 2 "Lofepramine 70mg Tablets".
  10. 1 2 Roth, BL; Driscol, J (12 January 2011). "PDSP Ki Database". Psychoactive Drug Screening Program (PDSP). University of North Carolina at Chapel Hill and the United States National Institute of Mental Health. Retrieved 21 November 2013.
  11. Lofepramine Rosemont, SPC from the eMC
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