Drug interactions
Hydroxyzine + Trimipramine
Severity: Major
Hydroxyzine and Trimipramine: 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
Both drugs cause sedation and anticholinergic effects, and both can prolong the QT interval. Together they increase the risk of oversedation, confusion and ventricular arrhythmias such as torsades de pointes.
What this interaction means in plain words
Hydroxyzine and Trimipramine 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.
Hydroxyzine belongs to Respiratory; Trimipramine belongs to Central Nervous System.
Why it happens
Additive QT prolongation, H1 antagonism and antimuscarinic effects.
What to do
Avoid the combination when possible, particularly in older patients or those with QT risk factors. If necessary, use the lowest hydroxyzine dose, check an ECG and electrolytes, and monitor sedation.
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 Trimipramine
- Disopyramide + Trimipramine Contraindicated
- Dofetilide + Trimipramine Contraindicated
- Ibutilide + Trimipramine Contraindicated
- Isocarboxazid + Trimipramine Contraindicated
- Pentamidine + Trimipramine Contraindicated
- Phenelzine + Trimipramine Contraindicated
Other interactions of Hydroxyzine
- Droperidol + Hydroxyzine Contraindicated
- Hydroxyzine + Pimozide Contraindicated
- Hydroxyzine + Thioridazine Contraindicated
- Hydroxyzine + Vandetanib Contraindicated
- Alfentanil + Hydroxyzine Major
- Amiodarone + Hydroxyzine Major
Frequently asked questions
Can I take Hydroxyzine with Trimipramine?
MediHelp rates the interaction as major. Hydroxyzine and Trimipramine 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 cause sedation and anticholinergic effects, and both can prolong the QT interval. Together they increase the risk of oversedation, confusion and ventricular arrhythmias such as torsades de pointes.
How serious is the interaction between Hydroxyzine and Trimipramine?
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 the combination when possible, particularly in older patients or those with QT risk factors. If necessary, use the lowest hydroxyzine dose, check an ECG and electrolytes, and monitor sedation.
What other medicines interact with Trimipramine?
MediHelp also lists interactions of Trimipramine with, for example, Disopyramide, Dofetilide, Ibutilide. The full list is on the Trimipramine page.
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