Drug interactions
Imipramine + Trimipramine
Severity: Major
Imipramine and Trimipramine: 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
Both are tricyclic antidepressants, so combined use duplicates therapy with additive QT prolongation, conduction delay, anticholinergic effects, sedation, hypotension and seizure risk. Competition for CYP2D6 and CYP2C19 may raise levels of each.
What this interaction means in plain words
Imipramine and Trimipramine 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; Trimipramine belongs to Central Nervous System.
Why it happens
Duplicate tricyclic pharmacology with additive cardiac, anticholinergic and serotonergic effects and shared metabolism.
What to do
Avoid using two tricyclics together; when switching, taper one drug and monitor ECG and for toxicity.
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 Trimipramine
- Disopyramide + Trimipramine Contraindicated
- Dofetilide + Trimipramine Contraindicated
- Ibutilide + Trimipramine Contraindicated
- Isocarboxazid + Trimipramine Contraindicated
- Pentamidine + Trimipramine Contraindicated
- Phenelzine + Trimipramine Contraindicated
Frequently asked questions
Can I take Imipramine with Trimipramine?
MediHelp rates the interaction as major. Imipramine and Trimipramine 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. Both are tricyclic antidepressants, so combined use duplicates therapy with additive QT prolongation, conduction delay, anticholinergic effects, sedation, hypotension and seizure risk. Competition for CYP2D6 and CYP2C19 may raise levels of each.
How serious is the interaction between Imipramine and Trimipramine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid using two tricyclics together; when switching, taper one drug and monitor ECG and for toxicity.
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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