Drug interactions
Imipramine + Venlafaxine
Severity: Major
Imipramine and Venlafaxine: 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 increase serotonin and norepinephrine activity, raising the risk of serotonin syndrome, hypertension and tachycardia. Venlafaxine is a weak CYP2D6 inhibitor and may modestly raise imipramine levels, and tricyclic cardiac effects add to concerns.
What this interaction means in plain words
Imipramine and Venlafaxine 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; Venlafaxine belongs to Central Nervous System.
Why it happens
Additive serotonin and norepinephrine reuptake inhibition with weak CYP2D6 inhibition.
What to do
Avoid if possible; if combined, use low doses and monitor blood pressure, ECG and signs of serotonin 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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Imipramine and Venlafaxine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
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 Venlafaxine
- Isocarboxazid + Venlafaxine Contraindicated
- Methylene blue + Venlafaxine Contraindicated
- Phenelzine + Venlafaxine Contraindicated
- Procarbazine + Venlafaxine Contraindicated
- Rasagiline + Venlafaxine Contraindicated
- Safinamide + Venlafaxine Contraindicated
Frequently asked questions
Can I take Imipramine with Venlafaxine?
MediHelp rates the interaction as major. Imipramine and Venlafaxine 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 increase serotonin and norepinephrine activity, raising the risk of serotonin syndrome, hypertension and tachycardia. Venlafaxine is a weak CYP2D6 inhibitor and may modestly raise imipramine levels, and tricyclic cardiac effects add to concerns.
How serious is the interaction between Imipramine and Venlafaxine?
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 if possible; if combined, use low doses and monitor blood pressure, ECG and signs of serotonin 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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
