Drug interactions
Mifepristone + Trimipramine
Severity: Major
Mifepristone and Trimipramine: major interaction.
Last updated Sources: UK SmPC
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
Mifepristone, especially at the higher doses used for Cushing syndrome, can prolong the QT interval and inhibits CYP3A4 and CYP2D6. Trimipramine also prolongs QT and its levels may rise, increasing the risk of arrhythmia including torsades de pointes.
What this interaction means in plain words
Mifepristone 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.
Mifepristone belongs to Endocrine; Trimipramine belongs to Central Nervous System.
Why it happens
Additive QT prolongation combined with mifepristone inhibition of CYP-mediated trimipramine metabolism.
What to do
Prefer an alternative antidepressant where possible. If combined, obtain a baseline and follow-up ECG, correct potassium and magnesium, and consider reducing the trimipramine dose.
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 Mifepristone and Trimipramine, 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 7 days on the web. No card needed.
References
Other interactions of Trimipramine
- Disopyramide + Trimipramine Contraindicated
- Dofetilide + Trimipramine Contraindicated
- Ibutilide + Trimipramine Contraindicated
- Isocarboxazid + Trimipramine Contraindicated
- Pentamidine + Trimipramine Contraindicated
- Phenelzine + Trimipramine Contraindicated
Other interactions of Mifepristone
- Apixaban + Mifepristone Contraindicated
- Argatroban + Mifepristone Contraindicated
- Cisapride + Mifepristone Contraindicated
- Cortisone + Mifepristone Contraindicated
- Cyclosporin + Mifepristone Contraindicated
- Dabigatran etexilate + Mifepristone Contraindicated
Frequently asked questions
Can I take Mifepristone with Trimipramine?
MediHelp rates the interaction as major. Mifepristone 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. Mifepristone, especially at the higher doses used for Cushing syndrome, can prolong the QT interval and inhibits CYP3A4 and CYP2D6. Trimipramine also prolongs QT and its levels may rise, increasing the risk of arrhythmia including torsades de pointes.
How serious is the interaction between Mifepristone 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: Prefer an alternative antidepressant where possible. If combined, obtain a baseline and follow-up ECG, correct potassium and magnesium, and consider reducing the trimipramine dose.
What other medicines interact with Trimipramine?
MediHelp also lists interactions of Trimipramine with, for example, Disopyramide, Dofetilide, Ibutilide. The full list is on the Trimipramine 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.
