Drug interactions
Esomeprazole + Imipramine
Severity: Moderate
Esomeprazole 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
Esomeprazole inhibits CYP2C19, which contributes to the demethylation of imipramine to desipramine. Imipramine exposure may rise modestly, particularly in CYP2C19 intermediate or poor metabolizers, increasing anticholinergic, cardiac and sedative effects.
What this interaction means in plain words
Esomeprazole 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.
Esomeprazole belongs to Gastrointestinal Tract; Imipramine belongs to Central Nervous System.
Why it happens
Esomeprazole inhibits CYP2C19-mediated metabolism of imipramine.
What to do
Monitor for tricyclic adverse effects such as sedation, dry mouth, tachycardia and conduction changes, and consider imipramine plasma levels or an ECG if symptoms emerge. Reduce the imipramine dose if toxicity appears.
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 Esomeprazole
- Esomeprazole + Mavacamten Contraindicated
- Esomeprazole + Rilpivirine Contraindicated
- Acalabrutinib + Esomeprazole Major
- Atazanavir + Esomeprazole Major
- Citalopram + Esomeprazole Major
- Clopidogrel + Esomeprazole Major
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 Esomeprazole with Imipramine?
MediHelp rates the interaction as moderate. Esomeprazole 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. Esomeprazole inhibits CYP2C19, which contributes to the demethylation of imipramine to desipramine. Imipramine exposure may rise modestly, particularly in CYP2C19 intermediate or poor metabolizers, increasing anticholinergic, cardiac and sedative effects.
How serious is the interaction between Esomeprazole 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: Monitor for tricyclic adverse effects such as sedation, dry mouth, tachycardia and conduction changes, and consider imipramine plasma levels or an ECG if symptoms emerge. Reduce the imipramine dose if toxicity appears.
What other medicines interact with Esomeprazole?
MediHelp also lists interactions of Esomeprazole with, for example, Mavacamten, Rilpivirine, Acalabrutinib. The full list is on the Esomeprazole page.
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