Drug interactions
Atazanavir + Imipramine
Severity: Moderate
Atazanavir 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
Atazanavir can raise imipramine plasma concentrations, increasing the risk of anticholinergic effects, sedation, orthostatic hypotension and cardiac conduction disturbances. Atazanavir itself can prolong the PR interval, which adds to the cardiac concern.
What this interaction means in plain words
Atazanavir 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.
Atazanavir belongs to Anti Virals; Imipramine belongs to Central Nervous System.
Why it happens
Atazanavir inhibits CYP3A4 (and may affect other pathways), reducing the metabolism of imipramine.
What to do
Start imipramine at a low dose and titrate to clinical response, monitoring for TCA toxicity. Consider an ECG and a serum TCA level if symptoms or conduction abnormalities appear.
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 Imipramine
- Dronedarone + Imipramine Contraindicated
- Imipramine + Isocarboxazid Contraindicated
- Imipramine + Phenelzine Contraindicated
- Imipramine + Pimozide Contraindicated
- Imipramine + Rasagiline Contraindicated
- Imipramine + Safinamide Contraindicated
Other interactions of Atazanavir
- Alfuzosin + Atazanavir Contraindicated
- Atazanavir + Avanafil Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Atazanavir + Eletriptan Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Atazanavir + Ergotamine Contraindicated
Frequently asked questions
Can I take Atazanavir with Imipramine?
MediHelp rates the interaction as moderate. Atazanavir 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. Atazanavir can raise imipramine plasma concentrations, increasing the risk of anticholinergic effects, sedation, orthostatic hypotension and cardiac conduction disturbances. Atazanavir itself can prolong the PR interval, which adds to the cardiac concern.
How serious is the interaction between Atazanavir 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: Start imipramine at a low dose and titrate to clinical response, monitoring for TCA toxicity. Consider an ECG and a serum TCA level if symptoms or conduction abnormalities appear.
What other medicines interact with Imipramine?
MediHelp also lists interactions of Imipramine with, for example, Dronedarone, Isocarboxazid, Phenelzine. The full list is on the Imipramine page.
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