Drug interactions
Imipramine + Midodrine
Severity: Moderate
Imipramine and Midodrine: 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
Midodrine is an alpha-1 agonist and imipramine can potentiate pressor responses by blocking norepinephrine reuptake, so blood pressure may rise excessively. Reflex bradycardia and supine hypertension may be amplified.
What this interaction means in plain words
Imipramine and Midodrine 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; Midodrine belongs to Miscellaneous.
Why it happens
Additive adrenergic stimulation, with tricyclic reuptake blockade enhancing alpha-agonist pressor effects.
What to do
Monitor supine and standing blood pressure and heart rate, and reduce the midodrine dose if hypertension occurs.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Imipramine and Midodrine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
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 Midodrine
- Isocarboxazid + Midodrine Contraindicated
- Midodrine + Phenelzine Contraindicated
- Midodrine + Tranylcypromine Contraindicated
- Dextroamphetamine + Midodrine Major
- Dihydroergotamine intranasal + Midodrine Major
- Dihydroergotamine + Midodrine Major
Frequently asked questions
Can I take Imipramine with Midodrine?
MediHelp rates the interaction as moderate. Imipramine and Midodrine 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. Midodrine is an alpha-1 agonist and imipramine can potentiate pressor responses by blocking norepinephrine reuptake, so blood pressure may rise excessively. Reflex bradycardia and supine hypertension may be amplified.
How serious is the interaction between Imipramine and Midodrine?
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 supine and standing blood pressure and heart rate, and reduce the midodrine dose if hypertension occurs.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
