Drug interactions
Diamorphine + Imipramine
Severity: Major
Diamorphine 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
Diamorphine (heroin) combined with imipramine adds opioid respiratory depression to tricyclic sedation. Patients may experience profound drowsiness, hypotension and slowed breathing, and tricyclics may also potentiate opioid effects.
What this interaction means in plain words
Diamorphine 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.
Why it happens
Additive CNS and respiratory depression, with possible tricyclic potentiation of opioid effect.
What to do
Start with reduced doses and monitor sedation and respiratory rate closely. Avoid other CNS depressants and alcohol.
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 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 Diamorphine with Imipramine?
MediHelp rates the interaction as major. Diamorphine 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. Diamorphine (heroin) combined with imipramine adds opioid respiratory depression to tricyclic sedation. Patients may experience profound drowsiness, hypotension and slowed breathing, and tricyclics may also potentiate opioid effects.
How serious is the interaction between Diamorphine 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 with reduced doses and monitor sedation and respiratory rate closely. Avoid other CNS depressants and 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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