Drug interactions
Imipramine + Ranolazine
Severity: Major
Imipramine and Ranolazine: 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
Imipramine can prolong QRS and QT intervals and ranolazine may raise tricyclic concentrations through weak CYP2D6 inhibition. The combination increases the risk of arrhythmia and anticholinergic toxicity.
What this interaction means in plain words
Imipramine and Ranolazine 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; Ranolazine belongs to Cardiovascular.
Why it happens
Additive QT prolongation plus CYP2D6 inhibition by ranolazine increasing imipramine exposure.
What to do
Obtain an ECG before and after combining, and reduce the imipramine dose or select an alternative antidepressant if the QTc or QRS lengthens. Correct electrolytes and consider imipramine levels.
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 Ranolazine
- Adagrasib + Ranolazine Contraindicated
- Amobarbital + Ranolazine Contraindicated
- Apalutamide + Ranolazine Contraindicated
- Butabarbital + Ranolazine Contraindicated
- Carbamazepine + Ranolazine Contraindicated
- Clarithromycin + Ranolazine Contraindicated
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 Ranolazine?
MediHelp rates the interaction as major. Imipramine and Ranolazine 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 can prolong QRS and QT intervals and ranolazine may raise tricyclic concentrations through weak CYP2D6 inhibition. The combination increases the risk of arrhythmia and anticholinergic toxicity.
How serious is the interaction between Imipramine and Ranolazine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain an ECG before and after combining, and reduce the imipramine dose or select an alternative antidepressant if the QTc or QRS lengthens. Correct electrolytes and consider imipramine levels.
What other medicines interact with Ranolazine?
MediHelp also lists interactions of Ranolazine with, for example, Adagrasib, Amobarbital, Apalutamide. The full list is on the Ranolazine page.
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