Drug interactions
Epinephrine racemic + Imipramine
Severity: Major
Epinephrine racemic 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 can markedly potentiate the pressor and arrhythmogenic effects of epinephrine, causing severe hypertension and tachyarrhythmias. The effect is most notable with systemic doses or with epinephrine in local anesthetics.
What this interaction means in plain words
Epinephrine racemic 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
Imipramine blocks neuronal reuptake of catecholamines, increasing adrenergic receptor stimulation.
What to do
Avoid systemic epinephrine unless essential and use the lowest effective dose. Limit epinephrine in local anesthetic, and monitor ECG and blood pressure.
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 Epinephrine racemic with Imipramine?
MediHelp rates the interaction as major. Epinephrine racemic 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 can markedly potentiate the pressor and arrhythmogenic effects of epinephrine, causing severe hypertension and tachyarrhythmias. The effect is most notable with systemic doses or with epinephrine in local anesthetics.
How serious is the interaction between Epinephrine racemic 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 unless essential and use the lowest effective dose. Limit epinephrine in local anesthetic, and monitor ECG and blood pressure.
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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