Drug interactions
Imipramine + Olanzapine / samidorphan
Severity: Moderate
Imipramine and Olanzapine / samidorphan: 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
Both imipramine and olanzapine can cause drowsiness and orthostatic hypotension, so combined use may increase dizziness, sedation and fall risk. Both drugs also have anticholinergic activity, which can add to constipation, urinary retention and confusion, particularly in older adults.
What this interaction means in plain words
Imipramine and Olanzapine / samidorphan 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
Additive pharmacodynamic effects: CNS depression, alpha-1 adrenergic blockade and antimuscarinic activity.
What to do
Monitor blood pressure, sedation and anticholinergic symptoms, especially after initiation or dose increases. Start low and titrate slowly in elderly patients, and counsel on rising slowly.
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 Olanzapine / samidorphan?
MediHelp rates the interaction as moderate. Imipramine and Olanzapine / samidorphan 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. Both imipramine and olanzapine can cause drowsiness and orthostatic hypotension, so combined use may increase dizziness, sedation and fall risk. Both drugs also have anticholinergic activity, which can add to constipation, urinary retention and confusion, particularly in older adults.
How serious is the interaction between Imipramine and Olanzapine / samidorphan?
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 blood pressure, sedation and anticholinergic symptoms, especially after initiation or dose increases. Start low and titrate slowly in elderly patients, and counsel on rising slowly.
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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