Drug interactions
Ranolazine + Trimipramine
Severity: Major
Ranolazine 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
Ranolazine and the tricyclic antidepressant trimipramine both prolong the QT interval, raising arrhythmia risk. Ranolazine also inhibits CYP2D6 and may increase trimipramine concentrations.
What this interaction means in plain words
Ranolazine 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.
Ranolazine belongs to Cardiovascular; Trimipramine belongs to Central Nervous System.
Why it happens
Additive QTc prolongation plus possible CYP2D6 inhibition by ranolazine increasing tricyclic exposure.
What to do
Obtain a baseline ECG and monitor QTc, and correct electrolyte abnormalities. Use the lowest effective trimipramine dose or choose a less QT-prolonging antidepressant.
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 Ranolazine
- Adagrasib + Ranolazine Contraindicated
- Amobarbital + Ranolazine Contraindicated
- Apalutamide + Ranolazine Contraindicated
- Butabarbital + Ranolazine Contraindicated
- Carbamazepine + Ranolazine Contraindicated
- Clarithromycin + Ranolazine 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 Ranolazine with Trimipramine?
MediHelp rates the interaction as major. Ranolazine 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. Ranolazine and the tricyclic antidepressant trimipramine both prolong the QT interval, raising arrhythmia risk. Ranolazine also inhibits CYP2D6 and may increase trimipramine concentrations.
How serious is the interaction between Ranolazine 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: Obtain a baseline ECG and monitor QTc, and correct electrolyte abnormalities. Use the lowest effective trimipramine dose or choose a less QT-prolonging antidepressant.
What other medicines interact with Ranolazine?
MediHelp also lists interactions of Ranolazine with, for example, Adagrasib, Amobarbital, Apalutamide. The full list is on the Ranolazine page.
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