Drug interactions
Imipramine + Lofepramine
Severity: Major
Imipramine and Lofepramine: 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
Combining two tricyclic antidepressants duplicates therapy and increases anticholinergic, serotonergic, cardiac conduction and seizure-threshold effects. QT/QRS prolongation and arrhythmia risk are heightened, especially in overdose or with cardiac disease.
What this interaction means in plain words
Imipramine and Lofepramine 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
Additive pharmacodynamic effects on cardiac ion channels, monoamine reuptake and muscarinic receptors; lofepramine is also partly metabolised to desipramine.
What to do
Avoid concurrent use of two tricyclics and use a single agent. If a switch is needed, taper one before starting the other and obtain an ECG if cardiac risk factors exist.
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 Imipramine with Lofepramine?
MediHelp rates the interaction as major. Imipramine and Lofepramine 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. Combining two tricyclic antidepressants duplicates therapy and increases anticholinergic, serotonergic, cardiac conduction and seizure-threshold effects. QT/QRS prolongation and arrhythmia risk are heightened, especially in overdose or with cardiac disease.
How serious is the interaction between Imipramine and Lofepramine?
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 concurrent use of two tricyclics and use a single agent. If a switch is needed, taper one before starting the other and obtain an ECG if cardiac risk factors exist.
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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