Drug interactions
Epinephrine + Imipramine
Severity: Major
Epinephrine 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
Tricyclics block neuronal noradrenaline uptake and can markedly enhance the pressor and arrhythmic effects of injected epinephrine. Systemic doses may cause severe hypertension and tachyarrhythmia, while small local anaesthetic doses carry less risk.
What this interaction means in plain words
Epinephrine 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.
Epinephrine belongs to Endocrine; Imipramine belongs to Central Nervous System.
Why it happens
Blocked neuronal catecholamine reuptake by imipramine potentiates adrenergic receptor stimulation.
What to do
Avoid systemic epinephrine where possible and use the lowest effective dose with ECG and blood pressure monitoring. Limit epinephrine volume in local anaesthetic infiltration.
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
Other interactions of Epinephrine
- Epinephrine + Isocarboxazid Contraindicated
- Epinephrine + Phenelzine Contraindicated
- Epinephrine + Tranylcypromine Contraindicated
- Acebutolol + Epinephrine Major
- Amitriptyline + Epinephrine Major
- Amoxapine + Epinephrine Major
Frequently asked questions
Can I take Epinephrine with Imipramine?
MediHelp rates the interaction as major. Epinephrine 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. Tricyclics block neuronal noradrenaline uptake and can markedly enhance the pressor and arrhythmic effects of injected epinephrine. Systemic doses may cause severe hypertension and tachyarrhythmia, while small local anaesthetic doses carry less risk.
How serious is the interaction between Epinephrine 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 systemic epinephrine where possible and use the lowest effective dose with ECG and blood pressure monitoring. Limit epinephrine volume in local anaesthetic infiltration.
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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