enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.escitalopramSerious - Use Alternative (1)escitalopram and imipramine both increase serotonin levels. Avoid or Use Alternate Drug.esketamine intranasalMonitor Closely (1)esketamine intranasal, imipramine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.eslicarbazepine acetateMonitor Closely (1)eslicarbazepine acetate will increase the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.Minor (1)eslicarbazepine acetate will decrease the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.esomeprazoleMonitor Closely (1)esomeprazole will increase the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.estazolamMonitor Closely (1)estazolam and imipramine both increase sedation. Use Caution/Monitor.estradiolMinor (1)estradiol, imipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.estrogens conjugated syntheticMinor (1)estrogens conjugated synthetic, imipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.estrogens esterifiedMinor (1)estrogens esterified, imipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens may inhibit hepatic metabolism of tricyclic antidepressants. However, interactions are not common.estropipateMinor (1)estropipate, imipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.ethanolMonitor Closely (1)imipramine and ethanol both increase sedation. Use Caution/Monitor.Minor (1)ethanol decreases levels of imipramine by increasing metabolism. Minor/Significance Unknown. Interaction esp. seen in detoxified alcoholics.ethinylestradiolMinor (1)ethinylestradiol, imipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Oxidative metabolism of TCAs may be decreased by ethinyl estradiol. Increased antidepressant serum concentrations may occur. Potential for increased TCA adverse effects.etomidateMonitor Closely (1)etomidate and imipramine both increase sedation. Use Caution/Monitor.Minor (1)etomidate, imipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.etravirineMonitor Closely (1)etravirine will increase the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.Minor (1)etravirine will decrease the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.eucalyptusMinor (1)imipramine and eucalyptus both increase sedation. Minor/Significance Unknown.fedratinibMonitor Closely (2)fedratinib will increase the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP2C19 substrates as necessary. fedratinib will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP2D6 substrates as necessary.felbamateMonitor Closely (1)felbamate will increase the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.felodipineMonitor Closely (1)felodipine will increase the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.fenfluramineMonitor Closely (3)fenfluramine, imipramine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration with drugs that increase serotoninergic effects may increase the risk of serotonin syndrome. imipramine and fenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely. imipramine increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)imipramine, fenfluramine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.fesoterodineMonitor Closely (1)fesoterodine and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.fexinidazoleMonitor Closely (1)fexinidazole will increase the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)fexinidazole and imipramine both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.fezolinetantContraindicated (1)imipramine will increase the level or effect of fezolinetant by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated. Fezolinetant AUC and peak plasma concentration are increased if coadministered with drugs that are weak, moderate, or strong CYP1A2 inhibitorsfingolimodMonitor Closely (1)fingolimod and imipramine both increase QTc interval. Use Caution/Monitor.flavoxateMonitor Closely (1)flavoxate and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.flecainideMonitor Closely (1)imipramine and flecainide both increase QTc interval. Modify Therapy/Monitor Closely.fluconazoleMonitor Closely (1)fluconazole will increase the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.Serious - Use Alternative (2)imipramine and fluconazole both increase QTc interval. Avoid or Use Alternate Drug. fluconazole will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.fludrocortisoneMinor (1)fludrocortisone will decrease the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.fluoxetineMonitor Closely (1)imipramine and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (3)fluoxetine and imipramine both increase serotonin levels. Avoid or Use Alternate Drug. fluoxetine will increase the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. fluoxetine will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.fluphenazineMonitor Closely (1)fluphenazine and imipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)fluphenazine and imipramine both increase QTc interval. Avoid or Use Alternate Drug.Minor (2)imipramine, fluphenazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects. imipramine, fluphenazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.flurazepamMonitor Closely (1)flurazepam and imipramine both increase sedation. Use Caution/Monitor.fluvoxamineMonitor Closely (1)fluvoxamine will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)fluvoxamine and imipramine both increase serotonin levels. Avoid or Use Alternate Drug.formoterolMonitor Closely (1)imipramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (2)imipramine and formoterol both increase QTc interval. Avoid or Use Alternate Drug. imipramine, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.fosamprenavirMonitor Closely (1)fosamprenavir will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)fosamprenavir increases levels of imipramine by decreasing metabolism. Avoid or Use Alternate Drug.fosaprepitantMonitor Closely (1)fosaprepitant will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.foscarnetMonitor Closely (1)imipramine and foscarnet both increase QTc interval. Modify Therapy/Monitor Closely.fosphenytoinMonitor Closely (1)fosphenytoin will decrease the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.frovatriptanMonitor Closely (1)frovatriptan and imipramine both increase serotonin levels. Modify Therapy/Monitor Closely.gabapentinMonitor Closely (1)gabapentin, imipramine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.gabapentin enacarbilMonitor Closely (1)gabapentin enacarbil, imipramine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.galantamineMonitor Closely (1)galantamine increases and imipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.ganaxoloneMonitor Closely (1)imipramine and ganaxolone both increase sedation. Use Caution/Monitor.gemifloxacinMonitor Closely (1)gemifloxacin and imipramine both increase QTc interval. Use Caution/Monitor.gilteritinibMonitor Closely (1)gilteritinib and imipramine both increase QTc interval. Use Caution/Monitor.givosiranSerious - Use Alternative (1)givosiran will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP2D6 substrates with givosiran. If unavoidable, decrease the CYP2D6 substrate dosage in accordance with approved product labeling.glimepirideMinor (1)imipramine increases effects of glimepiride by pharmacodynamic synergism. Minor/Significance Unknown.glipizideMinor (1)imipramine increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.glyburideMinor (1)imipramine increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.glycopyrrolateMonitor Closely (2)glycopyrrolate and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. imipramine increases levels of glycopyrrolate by unknown mechanism. Use Caution/Monitor.glycopyrrolate inhaledMonitor Closely (2)glycopyrrolate inhaled and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. imipramine increases levels of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.glycopyrronium tosylate topicalMonitor Closely (1)glycopyrronium tosylate topical, imipramine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of glycopyrronium tosylate topical with other anticholinergic medications may result in additive anticholinergic adverse effects.granisetronMonitor Closely (1)granisetron and imipramine both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)granisetron, imipramine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.grapefruitMonitor Closely (1)grapefruit will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.griseofulvinMinor (1)griseofulvin will decrease the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.guanfacineSerious - Use Alternative (1)imipramine decreases effects of guanfacine by Other (see comment). Avoid or Use Alternate Drug. Comment: Inhibition of uptake by adrenergic neurons.haloperidolMonitor Closely (1)haloperidol and imipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)imipramine and haloperidol both increase QTc interval. Avoid or Use Alternate Drug. haloperidol will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.henbaneMonitor Closely (1)henbane and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.homatropineMonitor Closely (1)homatropine and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.huperzine AMonitor Closely (1)huperzine A increases and imipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.hydrocodoneMonitor Closely (1)hydrocodone, imipramine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.hydrocortisoneMinor (1)hydrocortisone will decrease the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.hydromorphoneMonitor Closely (1)hydromorphone and imipramine both increase sedation. Use Caution/Monitor.hydroxyprogesterone caproate (DSC)Minor (1)hydroxyprogesterone caproate (DSC), imipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.hydroxyzineMonitor Closely (2)hydroxyzine and imipramine both increase sedation. Use Caution/Monitor. hydroxyzine and imipramine both increase QTc interval. Use Caution/Monitor.hyoscyamineMonitor Closely (1)hyoscyamine and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.hyoscyamine sprayMonitor Closely (1)hyoscyamine spray and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.ibutilideContraindicated (1)imipramine and ibutilide both increase QTc interval. Contraindicated.iloperidoneMonitor Closely (2)imipramine and iloperidone both increase QTc interval. Modify Therapy/Monitor Closely. iloperidone and imipramine both increase sedation. Use Caution/Monitor.imatinibMonitor Closely (1)imatinib will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.indacaterol, inhaledMonitor Closely (1)indacaterol, inhaled, imipramine. QTc interval. Use Caution/Monitor. Indacaterol should be administered with extreme caution to patients treated with TCAs. Drugs that are known to prolong the QTc interval may have an increased the risk of ventricular arrhythmias.indapamideContraindicated (1)imipramine and indapamide both increase QTc interval. Contraindicated.indinavirMonitor Closely (1)indinavir will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.insulin aspartMinor (1)imipramine increases effects of insulin aspart by pharmacodynamic synergism. Minor/Significance Unknown.insulin detemirMinor (1)imipramine increases effects of insulin detemir by pharmacodynamic synergism. Minor/Significance Unknown.insulin glargineMinor (1)imipramine increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.insulin glulisineMinor (1)imipramine increases effects of insulin glulisine by pharmacodynamic synergism. Minor/Significance Unknown.insulin lisproMinor (1)imipramine increases effects of insulin lispro by pharmacodynamic synergism. Minor/Significance Unknown.insulin NPHMinor (1)imipramine increases effects of insulin NPH by pharmacodynamic synergism. Minor/Significance Unknown.insulin regular humanMinor (1)imipramine increases effects of insulin regular human by pharmacodynamic synergism. Minor/Significance Unknown.iobenguane I 123Contraindicated (1)imipramine decreases effects of iobenguane I 123 by pharmacodynamic antagonism. Contraindicated. If clinically appropriate, discontinue drugs that decrease uptake of NE for at least 5 half-lives; may cause false-negative imaging results.iobenguane I 131Serious - Use Alternative (1)imipramine will decrease the level or effect of iobenguane I 131 by Other (see comment). Avoid or Use Alternate Drug. Based on the mechanism of action of iobenguane, drugs that reduce catecholamine uptake or that deplete catecholamine stores may interfere with iobenguane uptake into cells, and thus, reduce iobenguane efficacy. Discontinue interfering drugs for at least 5 half-lives before administration of either the dosimetry or an iobenguane dose. Do not administer these drugs until at least 7 days after each iobenguane dose.ipratropiumMonitor Closely (1)ipratropium and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.isocarboxazidContraindicated (1)isocarboxazid and imipramine both increase serotonin levels. Contraindicated.isofluraneMonitor Closely (1)isoflurane and imipramine both increase QTc interval. Use Caution/Monitor.isoniazidMonitor Closely (3)isoniazid will increase the level or effect of imipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. imipramine and isoniazid both increase serotonin levels. Modify Therapy/Monitor Closely. isoniazid will increase the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.Minor (1)isoniazid will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.isoproterenolMonitor Closely (1)imipramine increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious