Drug interactions
Bupropion + Imipramine
Severity: Major
Bupropion and Imipramine: major interaction.
Last updated Sources: US FDA label
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
Bupropion inhibits CYP2D6 and can raise tricyclic antidepressant concentrations such as imipramine and its metabolite desipramine. Both drugs lower the seizure threshold, so the combination increases the risk of seizures and tricyclic toxicity including anticholinergic and cardiac effects.
What this interaction means in plain words
Bupropion and Imipramine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Bupropion belongs to Central Nervous System; Imipramine belongs to Central Nervous System.
Why it happens
CYP2D6 inhibition by bupropion raises tricyclic levels, plus additive lowering of seizure threshold.
What to do
Start imipramine at a low dose and titrate cautiously, using tricyclic plasma levels and ECG where appropriate. Keep bupropion at the lowest effective dose and avoid in patients with seizure risk factors.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Bupropion
- Bupropion + Isocarboxazid Contraindicated
- Bupropion + Linezolid Contraindicated
- Bupropion + Phenelzine Contraindicated
- Bupropion + Rasagiline Contraindicated
- Bupropion + Selegiline Contraindicated
- Bupropion + Selegiline transdermal Contraindicated
Other interactions of Imipramine
- Dronedarone + Imipramine Contraindicated
- Imipramine + Isocarboxazid Contraindicated
- Imipramine + Phenelzine Contraindicated
- Imipramine + Pimozide Contraindicated
- Imipramine + Rasagiline Contraindicated
- Imipramine + Safinamide Contraindicated
Frequently asked questions
Can I take Bupropion with Imipramine?
MediHelp rates the interaction as major. Bupropion and Imipramine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Bupropion inhibits CYP2D6 and can raise tricyclic antidepressant concentrations such as imipramine and its metabolite desipramine. Both drugs lower the seizure threshold, so the combination increases the risk of seizures and tricyclic toxicity including anticholinergic and cardiac effects.
How serious is the interaction between Bupropion and Imipramine?
MediHelp rates it major, 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 cautiously, using tricyclic plasma levels and ECG where appropriate. Keep bupropion at the lowest effective dose and avoid in patients with seizure risk factors.
What other medicines interact with Bupropion?
MediHelp also lists interactions of Bupropion with, for example, Isocarboxazid, Linezolid, Phenelzine. The full list is on the Bupropion page.
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