Drug interactions
Butalbital + Imipramine
Severity: Moderate
Butalbital 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
Butalbital is a barbiturate that may induce enzymes metabolizing imipramine and lower its levels, with a possible loss of antidepressant effect. Both agents cause sedation, so drowsiness and psychomotor impairment may be increased.
What this interaction means in plain words
Butalbital 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.
Why it happens
Barbiturate induction of CYP1A2, CYP2C19 and CYP3A4 increases imipramine clearance, along with additive CNS depression.
What to do
Monitor for reduced antidepressant efficacy, particularly with regular butalbital use, and adjust the imipramine dose according to response. Counsel on additive sedation and avoid alcohol.
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
Frequently asked questions
Can I take Butalbital with Imipramine?
MediHelp rates the interaction as moderate. Butalbital 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. Butalbital is a barbiturate that may induce enzymes metabolizing imipramine and lower its levels, with a possible loss of antidepressant effect. Both agents cause sedation, so drowsiness and psychomotor impairment may be increased.
How serious is the interaction between Butalbital 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 reduced antidepressant efficacy, particularly with regular butalbital use, and adjust the imipramine dose according to response. Counsel on additive sedation and avoid alcohol.
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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