- Use Alternative (1)imipramine, isoproterenol. 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.Minor (1)isoproterenol, imipramine. Mechanism: unknown. Minor/Significance Unknown. Risk of cardiac arrhythmias.itraconazoleSerious - Use Alternative (1)imipramine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.ketamineMonitor Closely (1)ketamine and imipramine both increase sedation. Use Caution/Monitor.Minor (1)ketamine, imipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.ketoconazoleMonitor Closely (1)ketoconazole will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)imipramine and ketoconazole both increase QTc interval. Avoid or Use Alternate Drug.ketotifen, ophthalmicMonitor Closely (1)imipramine and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.L-tryptophanMonitor Closely (1)imipramine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.lapatinibMonitor Closely (1)imipramine and lapatinib both increase QTc interval. Modify Therapy/Monitor Closely.lasmiditanMonitor Closely (2)lasmiditan, imipramine. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions. imipramine increases effects of lasmiditan by serotonin levels. Use Caution/Monitor. Coadministration may increase risk of serotonin syndrome.lemborexantMonitor Closely (1)lemborexant, imipramine. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.letermovirMonitor Closely (1)letermovir increases levels of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.levalbuterolMonitor Closely (1)imipramine increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)imipramine, levalbuterol. 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.levofloxacinMonitor Closely (1)imipramine and levofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.levoketoconazoleMonitor Closely (1)levoketoconazole will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)imipramine and levoketoconazole both increase QTc interval. Avoid or Use Alternate Drug.levomilnacipranSerious - Use Alternative (1)levomilnacipran and imipramine both increase serotonin levels. Avoid or Use Alternate Drug.levorphanolMonitor Closely (1)levorphanol and imipramine both increase sedation. Use Caution/Monitor.levothyroxineMonitor Closely (1)levothyroxine increases effects of imipramine by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.linezolidSerious - Use Alternative (1)linezolid and imipramine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.liothyronineMonitor Closely (1)liothyronine increases effects of imipramine by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.liotrixMonitor Closely (1)liotrix increases effects of imipramine by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.lisdexamfetamineMonitor Closely (2)imipramine, lisdexamfetamine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s). imipramine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)imipramine, lisdexamfetamine. 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.lithiumMonitor Closely (2)imipramine and lithium both increase serotonin levels. Modify Therapy/Monitor Closely. lithium and imipramine both increase QTc interval. Use Caution/Monitor.Minor (1)lithium, imipramine. Other (see comment). Minor/Significance Unknown. Comment: Risk of neurotoxicity in geriatric pts. Multiple mechanisms involved.lofepramineMonitor Closely (2)imipramine and lofepramine both decrease cholinergic effects/transmission. Use Caution/Monitor. imipramine and lofepramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)imipramine and lofepramine both increase QTc interval. Avoid or Use Alternate Drug. imipramine and lofepramine both increase serotonin levels. Avoid or Use Alternate Drug.lofexidineMonitor Closely (2)imipramine decreases effects of lofexidine by unspecified interaction mechanism. Use Caution/Monitor. imipramine and lofexidine both increase sedation. Use Caution/Monitor.lonafarnibSerious - Use Alternative (1)lonafarnib will increase the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Lonafarnib may increase the AUC and peak concentration of CYP2C19 substrates. If coadministration unavoidable, monitor for adverse reactions and reduce the CYP2C19 substrate dose in accordance with its approved product labeling.loprazolamMonitor Closely (1)loprazolam and imipramine both increase sedation. Use Caution/Monitor.lorazepamMonitor Closely (1)lorazepam and imipramine both increase sedation. Use Caution/Monitor.lorcaserinMonitor Closely (1)lorcaserin will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)imipramine and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.lormetazepamMonitor Closely (1)lormetazepam and imipramine both increase sedation. Use Caution/Monitor.loxapineMonitor Closely (1)loxapine and imipramine both increase sedation. Use Caution/Monitor.loxapine inhaledMonitor Closely (1)loxapine inhaled and imipramine both increase sedation. Use Caution/Monitor.lsdMonitor Closely (1)imipramine and lsd both increase serotonin levels. Modify Therapy/Monitor Closely.lumacaftor/ivacaftorMonitor Closely (1)lumacaftor/ivacaftor, imipramine. affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. In vitro studies suggest that lumacaftor may induce and ivacaftor may inhibit CYP2C19 substrates. .lumefantrineSerious - Use Alternative (2)imipramine and lumefantrine both increase QTc interval. Avoid or Use Alternate Drug. lumefantrine will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.Minor (1)lumefantrine will decrease the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.lurasidoneMonitor Closely (1)lurasidone, imipramine. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for additive CNS effects ; Potential for increased risk of hypotension with concurrent use. Monitor blood pressure and adjust dose of antihypertensive agent as needed.maprotilineMonitor Closely (2)imipramine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor. imipramine and maprotiline both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)imipramine and maprotiline both increase QTc interval. Avoid or Use Alternate Drug. imipramine and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.maravirocMonitor Closely (1)maraviroc will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.marijuanaMonitor Closely (2)marijuana will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. imipramine and marijuana both increase sedation. Use Caution/Monitor.Minor (1)marijuana will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.mavacamtenMonitor Closely (1)imipramine will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Inititiation of weak CYP2C19 inhibitors may require decreased mavacamten dose. meclizineMonitor Closely (1)meclizine and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.mefloquineSerious - Use Alternative (1)mefloquine increases toxicity of imipramine by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.melatoninMonitor Closely (1)imipramine and melatonin both increase sedation. Use Caution/Monitor.meperidineMonitor Closely (1)meperidine and imipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)imipramine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.meprobamateMonitor Closely (1)imipramine and meprobamate both increase sedation. Use Caution/Monitor.mestranolMinor (1)mestranol, imipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.metaproterenolMonitor Closely (1)imipramine increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)imipramine, metaproterenol. 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.metaxaloneMonitor Closely (1)metaxalone and imipramine both increase sedation. Use Caution/Monitor.metforminMinor (1)imipramine increases effects of metformin by pharmacodynamic synergism. Minor/Significance Unknown.methadoneMonitor Closely (2)imipramine and methadone both increase QTc interval. Modify Therapy/Monitor Closely. methadone and imipramine both increase sedation. Use Caution/Monitor.methamphetamineMonitor Closely (1)imipramine increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)imipramine, methamphetamine. 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.methocarbamolMonitor Closely (1)methocarbamol and imipramine both increase sedation. Use Caution/Monitor.methscopolamineMonitor Closely (1)methscopolamine and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.methylene blueSerious - Use Alternative (1)methylene blue and imipramine both increase serotonin levels. Avoid or Use Alternate Drug. Methylene blue may increase serotonin as a result of MAO-A inhibition. If methylene blue must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last methylene blue dose or after 2 weeks of monitoring, whichever comes first.methylenedioxymethamphetamineMonitor Closely (1)imipramine increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)imipramine, methylenedioxymethamphetamine. 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.methylphenidateMonitor Closely (1)imipramine, methylphenidate. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.methylphenidate transdermalMonitor Closely (1)methylphenidate transdermal will increase the level or effect of imipramine by decreasing elimination. Modify Therapy/Monitor Closely. Consider decreasing the dose of these drugs when given coadministered with methylphenidate. Monitor for drug toxiticities when initiating or discontinuing methylphenidate. methylprednisoloneMinor (1)methylprednisolone will decrease the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.metoclopramide intranasalSerious - Use Alternative (1)imipramine, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.metronidazoleMinor (1)metronidazole will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.mexiletineMonitor Closely (1)mexiletine will increase the level or effect of imipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.miconazole vaginalMinor (1)miconazole vaginal will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.midazolamMonitor Closely (1)midazolam and imipramine both increase sedation. Use Caution/Monitor.midazolam intranasalMonitor Closely (1)midazolam intranasal, imipramine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.midodrineMonitor Closely (1)imipramine increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)imipramine, midodrine. 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.miglitolMinor (1)imipramine increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.milnacipranSerious - Use Alternative (1)milnacipran and imipramine both increase serotonin levels. Avoid or Use Alternate Drug.mirabegronMonitor Closely (1)mirabegron will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.mirtazapineMonitor Closely (2)imipramine and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely. imipramine and mirtazapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)mirtazapine and imipramine both increase QTc interval. Avoid or Use Alternate Drug.modafinilMonitor Closely (3)modafinil will decrease the level or effect of imipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. modafinil will increase the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. imipramine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.morphineMonitor Closely (2)imipramine and morphine both increase serotonin levels. Modify Therapy/Monitor Closely. morphine and imipramine both increase sedation. Use Caution/Monitor.motherwortMonitor Closely (1)imipramine and motherwort both increase sedation. Use Caution/Monitor.moxifloxacinSerious - Use Alternative (1)imipramine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.moxonidineMonitor Closely (1)imipramine and moxonidine both increase sedation. Use Caution/Monitor.nabiloneMonitor Closely (1)imipramine and nabilone both increase sedation. Use Caution/Monitor.nalbuphineMonitor Closely (1)nalbuphine and imipramine both increase sedation. Use Caution/Monitor.naratriptanMonitor Closely (1)naratriptan and imipramine both increase serotonin levels. Modify Therapy/Monitor Closely.nateglinideMinor (1)imipramine increases effects of nateglinide by pharmacodynamic synergism. Minor/Significance Unknown.nefazodoneMonitor Closely (1)nefazodone will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)nefazodone and imipramine both increase serotonin levels. Avoid or Use Alternate Drug.nefopamMonitor Closely (1)nefopam, imipramine. Mechanism: unspecified interaction mechanism. Use