Drug interactions
Donepezil + Imipramine
Severity: Moderate
Donepezil 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
Imipramine's anticholinergic activity opposes the cholinesterase inhibition of donepezil, which can reduce the benefit in dementia. Both drugs can also prolong the QT interval or cause bradycardia, adding arrhythmia risk.
What this interaction means in plain words
Donepezil 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.
Donepezil belongs to Central Nervous System; Imipramine belongs to Central Nervous System.
Why it happens
Pharmacodynamic antagonism of cholinergic effects plus additive QT prolongation.
What to do
Avoid tricyclics in patients with dementia where possible and choose a less anticholinergic antidepressant. If combined, monitor cognition, heart rate and ECG.
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
Other interactions of Donepezil
- Donepezil + Dronedarone Contraindicated
- Donepezil + Pimozide Contraindicated
- Donepezil + Thioridazine Contraindicated
- Donepezil + Vandetanib Contraindicated
- Amiodarone + Donepezil Major
- Amisulpride + Donepezil Major
Frequently asked questions
Can I take Donepezil with Imipramine?
MediHelp rates the interaction as moderate. Donepezil 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. Imipramine's anticholinergic activity opposes the cholinesterase inhibition of donepezil, which can reduce the benefit in dementia. Both drugs can also prolong the QT interval or cause bradycardia, adding arrhythmia risk.
How serious is the interaction between Donepezil 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: Avoid tricyclics in patients with dementia where possible and choose a less anticholinergic antidepressant. If combined, monitor cognition, heart rate 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.
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