Drug interactions
Imipramine + Verapamil
Severity: Moderate
Imipramine and Verapamil: 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
Verapamil may increase imipramine concentrations through inhibition of its CYP-mediated metabolism. This can raise the risk of anticholinergic effects, sedation, orthostatic hypotension and cardiac conduction abnormalities. Both drugs can also affect cardiac conduction.
What this interaction means in plain words
Imipramine and Verapamil 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; Verapamil belongs to Cardiovascular.
Why it happens
Verapamil inhibits CYP3A4 (and possibly CYP1A2) metabolism of imipramine, raising its levels.
What to do
Monitor ECG, blood pressure and TCA adverse effects, and consider tricyclic serum levels. Lower the imipramine dose if toxicity appears.
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 Verapamil
- Dofetilide + Verapamil Contraindicated
- Flibanserin + Verapamil Contraindicated
- Lomitapide + Verapamil Contraindicated
- Lonafarnib + Verapamil Contraindicated
- Pimozide + Verapamil Contraindicated
- Acebutolol + Verapamil Major
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 Verapamil?
MediHelp rates the interaction as moderate. Imipramine and Verapamil 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. Verapamil may increase imipramine concentrations through inhibition of its CYP-mediated metabolism. This can raise the risk of anticholinergic effects, sedation, orthostatic hypotension and cardiac conduction abnormalities. Both drugs can also affect cardiac conduction.
How serious is the interaction between Imipramine and Verapamil?
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 ECG, blood pressure and TCA adverse effects, and consider tricyclic serum levels. Lower the imipramine dose if toxicity appears.
What other medicines interact with Verapamil?
MediHelp also lists interactions of Verapamil with, for example, Dofetilide, Flibanserin, Lomitapide. The full list is on the Verapamil page.
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