Drug interactions
Bupropion + Trimipramine
Severity: Major
Bupropion and Trimipramine: 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 can raise trimipramine concentrations through CYP2D6 inhibition. Both drugs lower the seizure threshold, so the combination increases seizure risk and tricyclic toxicity such as anticholinergic effects and arrhythmias.
What this interaction means in plain words
Bupropion and Trimipramine 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; Trimipramine belongs to Central Nervous System.
Why it happens
Bupropion inhibits CYP2D6, increasing tricyclic levels, and both drugs have additive seizure-threshold lowering effects.
What to do
Avoid the combination if possible; if used, start with low doses and titrate slowly. Reduce the trimipramine dose and monitor for seizures, ECG changes and anticholinergic toxicity.
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 Trimipramine
- Disopyramide + Trimipramine Contraindicated
- Dofetilide + Trimipramine Contraindicated
- Ibutilide + Trimipramine Contraindicated
- Isocarboxazid + Trimipramine Contraindicated
- Pentamidine + Trimipramine Contraindicated
- Phenelzine + Trimipramine Contraindicated
Frequently asked questions
Can I take Bupropion with Trimipramine?
MediHelp rates the interaction as major. Bupropion and Trimipramine 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 can raise trimipramine concentrations through CYP2D6 inhibition. Both drugs lower the seizure threshold, so the combination increases seizure risk and tricyclic toxicity such as anticholinergic effects and arrhythmias.
How serious is the interaction between Bupropion and Trimipramine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination if possible; if used, start with low doses and titrate slowly. Reduce the trimipramine dose and monitor for seizures, ECG changes and anticholinergic toxicity.
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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