Drug interactions
Cocaine + Imipramine
Severity: Major
Cocaine 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
Cocaine blocks reuptake of monoamines including serotonin and norepinephrine, as does imipramine, and the combination can potentiate sympathomimetic effects. Topical cocaine has limited absorption but systemic use risks hypertension, arrhythmia and serotonin toxicity.
What this interaction means in plain words
Cocaine 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.
Cocaine belongs to Central Nervous System; Imipramine belongs to Central Nervous System.
Why it happens
Additive monoamine reuptake inhibition increases adrenergic and serotonergic activity.
What to do
Avoid cocaine in patients taking tricyclics; if topical use is essential, use the minimum dose and monitor blood pressure and ECG.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Cocaine and Imipramine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
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 Cocaine
- Cocaine + Isocarboxazid Contraindicated
- Cocaine + Phenelzine Contraindicated
- Cocaine + Procarbazine Contraindicated
- Amitriptyline + Cocaine Major
- Bisoprolol + Cocaine Major
- Citalopram + Cocaine Major
Frequently asked questions
Can I take Cocaine with Imipramine?
MediHelp rates the interaction as major. Cocaine 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. Cocaine blocks reuptake of monoamines including serotonin and norepinephrine, as does imipramine, and the combination can potentiate sympathomimetic effects. Topical cocaine has limited absorption but systemic use risks hypertension, arrhythmia and serotonin toxicity.
How serious is the interaction between Cocaine 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: Avoid cocaine in patients taking tricyclics; if topical use is essential, use the minimum dose and monitor blood pressure and ECG.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
