Drug interactions
Trimipramine + Voriconazole
Severity: Major
Trimipramine and Voriconazole: 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 drugs can prolong the QT interval, and voriconazole may also raise tricyclic levels through enzyme inhibition. The result is an increased risk of arrhythmia including torsades de pointes, along with anticholinergic and sedative effects.
What this interaction means in plain words
Trimipramine and Voriconazole 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.
Trimipramine belongs to Central Nervous System; Voriconazole belongs to Anti Fungals.
Why it happens
Additive QT prolongation plus voriconazole inhibition of CYP2C19/CYP3A4 metabolism of trimipramine.
What to do
Obtain a baseline ECG, correct potassium and magnesium, and monitor QTc during co-therapy. Consider reducing the trimipramine dose or choosing an alternative.
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 Voriconazole
- Avanafil + Voriconazole Contraindicated
- Butabarbital + Voriconazole Contraindicated
- Carbamazepine + Voriconazole Contraindicated
- Conivaptan + Voriconazole Contraindicated
- Dihydroergotamine intranasal + Voriconazole Contraindicated
- Dihydroergotamine + Voriconazole 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 Trimipramine with Voriconazole?
MediHelp rates the interaction as major. Trimipramine and Voriconazole 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 drugs can prolong the QT interval, and voriconazole may also raise tricyclic levels through enzyme inhibition. The result is an increased risk of arrhythmia including torsades de pointes, along with anticholinergic and sedative effects.
How serious is the interaction between Trimipramine and Voriconazole?
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, correct potassium and magnesium, and monitor QTc during co-therapy. Consider reducing the trimipramine dose or choosing an alternative.
What other medicines interact with Voriconazole?
MediHelp also lists interactions of Voriconazole with, for example, Avanafil, Butabarbital, Carbamazepine. The full list is on the Voriconazole page.
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