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Drug interactions

Imipramine + Moxifloxacin

Severity: Major

Imipramine and Moxifloxacin: 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

Imipramine can prolong QRS and QT intervals, and moxifloxacin adds further QT prolongation. The combination increases the risk of ventricular arrhythmias including torsades de pointes, especially in overdose or in patients with cardiac disease.

What this interaction means in plain words

Imipramine and Moxifloxacin 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.

Imipramine belongs to Central Nervous System; Moxifloxacin belongs to Anti Bacterial.

Evidence level: Moderate

Why it happens

Additive effects on cardiac repolarization via IKr blockade, with tricyclic sodium channel blockade adding to conduction delay.

What to do

Avoid the combination where an alternative antibiotic exists. If it is used, obtain an ECG at baseline and during therapy and correct electrolyte abnormalities.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Imipramine with Moxifloxacin?

MediHelp rates the interaction as major. Imipramine and Moxifloxacin 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. Imipramine can prolong QRS and QT intervals, and moxifloxacin adds further QT prolongation. The combination increases the risk of ventricular arrhythmias including torsades de pointes, especially in overdose or in patients with cardiac disease.

How serious is the interaction between Imipramine and Moxifloxacin?

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 where an alternative antibiotic exists. If it is used, obtain an ECG at baseline and during therapy and correct electrolyte abnormalities.

What other medicines interact with Moxifloxacin?

MediHelp also lists interactions of Moxifloxacin with, for example, Amiodarone, Arsenic trioxide, Disopyramide. The full list is on the Moxifloxacin page.

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