Drug interactions
Imipramine + Pyridostigmine
Severity: Moderate
Imipramine and Pyridostigmine: 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's anticholinergic effects oppose pyridostigmine and may reduce its benefit in myasthenia gravis. Anticholinergic effects such as constipation and urinary retention may also worsen.
What this interaction means in plain words
Imipramine and Pyridostigmine 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; Pyridostigmine belongs to Central Nervous System.
Why it happens
Pharmacodynamic antagonism between muscarinic blockade and cholinesterase inhibition.
What to do
Monitor muscle strength and anticholinergic symptoms, and adjust pyridostigmine dose by response. Prefer a less anticholinergic antidepressant if 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 Pyridostigmine
Frequently asked questions
Can I take Imipramine with Pyridostigmine?
MediHelp rates the interaction as moderate. Imipramine and Pyridostigmine 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's anticholinergic effects oppose pyridostigmine and may reduce its benefit in myasthenia gravis. Anticholinergic effects such as constipation and urinary retention may also worsen.
How serious is the interaction between Imipramine and Pyridostigmine?
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 muscle strength and anticholinergic symptoms, and adjust pyridostigmine dose by response. Prefer a less anticholinergic antidepressant if 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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