Drug interactions
Alprazolam + Imipramine
Severity: Moderate
Alprazolam and Imipramine: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Taking both can cause additive sedation and impaired psychomotor performance. Alprazolam may also modestly raise imipramine levels, which can add to anticholinergic and cardiovascular effects.
What this interaction means in plain words
Alprazolam and Imipramine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Alprazolam belongs to Central Nervous System; Imipramine belongs to Central Nervous System.
Why it happens
Additive CNS depression, and possible reduced imipramine clearance through competition for hepatic metabolism.
What to do
Monitor for excessive sedation, dizziness and anticholinergic effects, and adjust the imipramine dose if toxicity appears. Counsel against driving until the response is known.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Alprazolam
- Alprazolam + Calcium / magnesium / potassium / sodium oxybates Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Alprazolam + Levoketoconazole Contraindicated
- Alprazolam + Sodium oxybate Contraindicated
- Alfentanil + Alprazolam Major
Frequently asked questions
Can I take Alprazolam with Imipramine?
MediHelp rates the interaction as moderate. Alprazolam and Imipramine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Taking both can cause additive sedation and impaired psychomotor performance. Alprazolam may also modestly raise imipramine levels, which can add to anticholinergic and cardiovascular effects.
How serious is the interaction between Alprazolam and Imipramine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for excessive sedation, dizziness and anticholinergic effects, and adjust the imipramine dose if toxicity appears. Counsel against driving until the response is known.
What other medicines interact with Alprazolam?
MediHelp also lists interactions of Alprazolam with, for example, Calcium / magnesium / potassium / sodium oxybates, Itraconazole, Ketoconazole. The full list is on the Alprazolam page.
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