Drug interactions
Fluphenazine + Imipramine
Severity: Major
Fluphenazine 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
Both drugs can prolong the QT interval, so combined use increases the chance of torsades de pointes and other ventricular arrhythmias. Additive anticholinergic and sedative effects may also occur, and phenothiazines can inhibit CYP2D6 modestly, raising tricyclic levels.
What this interaction means in plain words
Fluphenazine 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.
Fluphenazine belongs to Central Nervous System; Imipramine belongs to Central Nervous System.
Why it happens
Additive QT prolongation and possible CYP2D6-mediated increase in imipramine exposure.
What to do
Obtain a baseline ECG and correct potassium and magnesium before combining; monitor QTc during therapy. Choose an alternative with less QT effect if the patient has cardiac risk factors.
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 Fluphenazine
- Arsenic trioxide + Fluphenazine Contraindicated
- Dofetilide + Fluphenazine Contraindicated
- Fluphenazine + Ibutilide Contraindicated
- Fluphenazine + Pimozide Contraindicated
- Adagrasib + Fluphenazine Major
- Alfentanil + Fluphenazine Major
Frequently asked questions
Can I take Fluphenazine with Imipramine?
MediHelp rates the interaction as major. Fluphenazine 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. Both drugs can prolong the QT interval, so combined use increases the chance of torsades de pointes and other ventricular arrhythmias. Additive anticholinergic and sedative effects may also occur, and phenothiazines can inhibit CYP2D6 modestly, raising tricyclic levels.
How serious is the interaction between Fluphenazine 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: Obtain a baseline ECG and correct potassium and magnesium before combining; monitor QTc during therapy. Choose an alternative with less QT effect if the patient has cardiac risk factors.
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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