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
Palonosetron is a 5-HT3 antagonist, and serotonin syndrome has been reported when such agents are used with serotonergic drugs. Netupitant also inhibits CYP3A4, which could raise imipramine exposure.
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.
Why it happens
Possible additive serotonergic effects, plus netupitant inhibition of CYP3A4 reducing imipramine clearance.
What to do
Monitor for signs of serotonin syndrome and tricyclic toxicity such as anticholinergic effects and QT prolongation. Consider an imipramine dose reduction if toxicity emerges.
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
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. Palonosetron is a 5-HT3 antagonist, and serotonin syndrome has been reported when such agents are used with serotonergic drugs. Netupitant also inhibits CYP3A4, which could raise imipramine exposure.
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 signs of serotonin syndrome and tricyclic toxicity such as anticholinergic effects and QT prolongation. Consider an imipramine dose reduction if toxicity emerges.
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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