Drug interactions
Imipramine + Perphenazine
Severity: Major
Imipramine and Perphenazine: 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
Perphenazine is a CYP2D6 substrate and inhibitor and can raise imipramine levels, and both drugs affect QT. The combination increases risk of arrhythmia, sedation and anticholinergic effects.
What this interaction means in plain words
Imipramine and Perphenazine 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; Perphenazine belongs to Central Nervous System.
Why it happens
CYP2D6 competition/inhibition and additive QT prolongation.
What to do
Monitor ECG and electrolytes, and consider tricyclic level monitoring with imipramine dose reduction if toxicity signs appear.
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?
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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 Perphenazine
- Ibutilide + Perphenazine Contraindicated
- Perphenazine + Pimozide Contraindicated
- Perphenazine + Thioridazine Contraindicated
- Adagrasib + Perphenazine Major
- Alfentanil + Perphenazine Major
- Amiodarone + Perphenazine Major
Frequently asked questions
Can I take Imipramine with Perphenazine?
MediHelp rates the interaction as major. Imipramine and Perphenazine 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. Perphenazine is a CYP2D6 substrate and inhibitor and can raise imipramine levels, and both drugs affect QT. The combination increases risk of arrhythmia, sedation and anticholinergic effects.
How serious is the interaction between Imipramine and Perphenazine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor ECG and electrolytes, and consider tricyclic level monitoring with imipramine dose reduction if toxicity signs appear.
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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