Drug interactions
Donepezil + Trimipramine
Severity: Major
Donepezil and Trimipramine: major 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
Both drugs can prolong the QT interval, so the arrhythmia risk is higher together. The anticholinergic effect of trimipramine also opposes the therapeutic action of donepezil.
What this interaction means in plain words
Donepezil 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.
Donepezil belongs to Central Nervous System; Trimipramine belongs to Central Nervous System.
Why it happens
Additive QT prolongation, plus pharmacodynamic antagonism between anticholinergic and cholinesterase-inhibitor effects.
What to do
Prefer a non-anticholinergic antidepressant. If the combination is required, check the ECG and electrolytes and monitor for bradycardia, syncope and loss of cognitive benefit.
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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Other interactions of Trimipramine
- Disopyramide + Trimipramine Contraindicated
- Dofetilide + Trimipramine Contraindicated
- Ibutilide + Trimipramine Contraindicated
- Isocarboxazid + Trimipramine Contraindicated
- Pentamidine + Trimipramine Contraindicated
- Phenelzine + Trimipramine 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 Trimipramine?
MediHelp rates the interaction as major. Donepezil 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. Both drugs can prolong the QT interval, so the arrhythmia risk is higher together. The anticholinergic effect of trimipramine also opposes the therapeutic action of donepezil.
How serious is the interaction between Donepezil 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: Prefer a non-anticholinergic antidepressant. If the combination is required, check the ECG and electrolytes and monitor for bradycardia, syncope and loss of cognitive benefit.
What other medicines interact with Trimipramine?
MediHelp also lists interactions of Trimipramine with, for example, Disopyramide, Dofetilide, Ibutilide. The full list is on the Trimipramine page.
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