Drug interactions
Erythromycin stearate + Imipramine
Severity: Major
Erythromycin stearate and Imipramine: 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
Erythromycin can raise imipramine concentrations and both drugs prolong the QT interval. This increases the risk of tricyclic toxicity and torsades de pointes.
What this interaction means in plain words
Erythromycin stearate 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
Erythromycin inhibits CYP3A4, reducing imipramine metabolism, and the two drugs have additive QT prolongation.
What to do
Use a non-macrolide antibiotic with less QT and CYP interaction. If unavoidable, monitor ECG and for tricyclic toxicity, adjusting the imipramine dose.
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 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 Erythromycin stearate with Imipramine?
MediHelp rates the interaction as major. Erythromycin stearate 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. Erythromycin can raise imipramine concentrations and both drugs prolong the QT interval. This increases the risk of tricyclic toxicity and torsades de pointes.
How serious is the interaction between Erythromycin stearate 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: Use a non-macrolide antibiotic with less QT and CYP interaction. If unavoidable, monitor ECG and for tricyclic toxicity, adjusting the imipramine dose.
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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