Drug interactions
Imipramine + Lithium
Severity: Moderate
Imipramine and Lithium: 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
Combining lithium with a tricyclic antidepressant can raise the risk of serotonergic toxicity, tremor and neurotoxicity, and both drugs can prolong the QT interval or alter cardiac conduction. The combination is used in practice for resistant depression but needs surveillance.
What this interaction means in plain words
Imipramine and Lithium 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.
Imipramine belongs to Central Nervous System; Lithium belongs to Central Nervous System.
Why it happens
Additive serotonergic enhancement and additive effects on cardiac repolarization and CNS function.
What to do
Monitor for tremor, confusion, hyperreflexia and other signs of serotonin toxicity, and obtain an ECG at baseline and after dose changes in patients with cardiac risk factors. Check serum lithium levels periodically and keep electrolytes normal.
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 Imipramine
- Dronedarone + Imipramine Contraindicated
- Imipramine + Isocarboxazid Contraindicated
- Imipramine + Phenelzine Contraindicated
- Imipramine + Pimozide Contraindicated
- Imipramine + Rasagiline Contraindicated
- Imipramine + Safinamide Contraindicated
Other interactions of Lithium
- Lithium + Thioridazine Contraindicated
- Lithium + Vandetanib Contraindicated
- Aceclofenac + Lithium Major
- Acemetacin + Lithium Major
- Amisulpride + Lithium Major
- Amlodipine-benazepril + Lithium Major
Frequently asked questions
Can I take Imipramine with Lithium?
MediHelp rates the interaction as moderate. Imipramine and Lithium 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. Combining lithium with a tricyclic antidepressant can raise the risk of serotonergic toxicity, tremor and neurotoxicity, and both drugs can prolong the QT interval or alter cardiac conduction. The combination is used in practice for resistant depression but needs surveillance.
How serious is the interaction between Imipramine and Lithium?
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 tremor, confusion, hyperreflexia and other signs of serotonin toxicity, and obtain an ECG at baseline and after dose changes in patients with cardiac risk factors. Check serum lithium levels periodically and keep electrolytes normal.
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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