Drug interactions
Imipramine + Netupitant-palonosetron
Severity: Moderate
Imipramine and Netupitant-palonosetron: 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
Serotonin syndrome has been reported with 5-HT3 antagonists plus serotonergic antidepressants such as imipramine. Netupitant may also slightly raise imipramine levels via CYP3A4 inhibition. Both effects could increase toxicity.
What this interaction means in plain words
Imipramine and Netupitant-palonosetron 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; Netupitant-palonosetron belongs to Gastrointestinal Tract.
Why it happens
Additive serotonergic effects with a possible minor CYP3A4 contribution.
What to do
Monitor for serotonin syndrome and anticholinergic or cardiac effects. Withdraw the antiemetic if toxicity develops.
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 Netupitant-palonosetron
- Apomorphine + Netupitant-palonosetron Contraindicated
- Flibanserin + Netupitant-palonosetron Contraindicated
- Apalutamide + Netupitant-palonosetron Major
- Avapritinib + Netupitant-palonosetron Major
- Carbamazepine + Netupitant-palonosetron Major
- Cobimetinib + Netupitant-palonosetron Major
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 Netupitant-palonosetron?
MediHelp rates the interaction as moderate. Imipramine and Netupitant-palonosetron 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. Serotonin syndrome has been reported with 5-HT3 antagonists plus serotonergic antidepressants such as imipramine. Netupitant may also slightly raise imipramine levels via CYP3A4 inhibition. Both effects could increase toxicity.
How serious is the interaction between Imipramine and Netupitant-palonosetron?
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 serotonin syndrome and anticholinergic or cardiac effects. Withdraw the antiemetic if toxicity develops.
What other medicines interact with Netupitant-palonosetron?
MediHelp also lists interactions of Netupitant-palonosetron with, for example, Apomorphine, Flibanserin, Apalutamide. The full list is on the Netupitant-palonosetron page.
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