Drug interactions
Imipramine + Neostigmine
Severity: Moderate
Imipramine and Neostigmine: 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
Imipramine has anticholinergic activity that opposes the effect of neostigmine, which may reduce its benefit in myasthenia gravis or reversal of neuromuscular blockade. Tricyclic anticholinergic effects such as ileus and urinary retention may also counter neostigmine's intended effect.
What this interaction means in plain words
Imipramine and Neostigmine 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; Neostigmine belongs to Central Nervous System.
Why it happens
Pharmacodynamic antagonism between muscarinic blockade and cholinesterase inhibition.
What to do
Monitor clinical response, such as muscle strength or bowel and bladder function, and adjust neostigmine dose if needed. Consider a less anticholinergic antidepressant when feasible.
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 Neostigmine
Frequently asked questions
Can I take Imipramine with Neostigmine?
MediHelp rates the interaction as moderate. Imipramine and Neostigmine 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 has anticholinergic activity that opposes the effect of neostigmine, which may reduce its benefit in myasthenia gravis or reversal of neuromuscular blockade. Tricyclic anticholinergic effects such as ileus and urinary retention may also counter neostigmine's intended effect.
How serious is the interaction between Imipramine and Neostigmine?
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 clinical response, such as muscle strength or bowel and bladder function, and adjust neostigmine dose if needed. Consider a less anticholinergic antidepressant when feasible.
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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