Drug interactions
Imipramine + Rifampin
Severity: Moderate
Imipramine and Rifampin: 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
Rifampin is a potent inducer of hepatic enzymes and can lower concentrations of imipramine and desipramine, which may reduce antidepressant efficacy. The effect develops over days to weeks and reverses after rifampin is stopped.
What this interaction means in plain words
Imipramine and Rifampin 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
Induction of CYP enzymes (including CYP3A4, 2C19, 1A2) increases imipramine clearance.
What to do
Monitor clinical response and consider tricyclic level monitoring with imipramine dose increase if needed. Reduce the dose again when rifampin is discontinued.
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 Rifampin?
MediHelp rates the interaction as moderate. Imipramine and Rifampin 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. Rifampin is a potent inducer of hepatic enzymes and can lower concentrations of imipramine and desipramine, which may reduce antidepressant efficacy. The effect develops over days to weeks and reverses after rifampin is stopped.
How serious is the interaction between Imipramine and Rifampin?
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 clinical response and consider tricyclic level monitoring with imipramine dose increase if needed. Reduce the dose again when rifampin is discontinued.
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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