to prolong QT interval must be used, more frequent ECG monitoring is recommended.venlafaxinevenlafaxine and imipramine both increase serotonin levels. Avoid or Use Alternate Drug.vilanterol/fluticasone furoate inhaledimipramine and vilanterol/fluticasone furoate inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Exercise extreme caution if vilanterol coadministered with MAOIs or TCAs, or within 2 weeks of discontinuation of these drugs; adrenergic agonist effects on the cardiovascular system may be potentiatedvilazodoneimipramine, vilazodone. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .vortioxetineimipramine, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.xylometazolineimipramine, xylometazoline. 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.yohimbeyohimbe, imipramine. Mechanism: unspecified interaction mechanism. Contraindicated. May cause increase or decrease in blood pressure.yohimbineimipramine, yohimbine. 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.ziprasidoneimipramine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.Monitor Closely (400)5-HTPimipramine and 5-HTP both increase serotonin levels. Modify Therapy/Monitor Closely.abirateroneabiraterone increases levels of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Avoid coadministration of abiraterone with substrates of CYP2D6. If alternative therapy cannot be used, exercise caution and consider a dose reduction of the CYP2D6 substrate.abobotulinumtoxinAabobotulinumtoxinA increases effects of imipramine by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects. .aclidiniumaclidinium and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.acrivastineacrivastine and imipramine both increase sedation. Use Caution/Monitor.albuterolimipramine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.alfentanilalfentanil and imipramine both increase sedation. Use Caution/Monitor.almotriptanalmotriptan and imipramine both increase serotonin levels. Modify Therapy/Monitor Closely.alprazolamalprazolam and imipramine both increase sedation. Use Caution/Monitor.amifampridineimipramine increases toxicity of amifampridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Amifampridine can cause seizures. Coadministration with drugs that lower seizure threshold may increase this risk.amiodaroneamiodarone will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.amisulprideimipramine and amisulpride both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended if coadministered.amitriptylineamitriptyline and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.amitriptyline and imipramine both increase sedation. Use Caution/Monitor.amobarbitalamobarbital will decrease the level or effect of imipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.amobarbital will decrease the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.amobarbital will decrease the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.amobarbital and imipramine both increase sedation. Use Caution/Monitor.amoxapineamoxapine and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.amoxapine and imipramine both increase sedation. Use Caution/Monitor.anagrelideanagrelide and imipramine both increase QTc interval. Use Caution/Monitor.anticholinergic/sedative combosanticholinergic/sedative combos and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.apomorphineimipramine and apomorphine both increase sedation. Use Caution/Monitor.aprepitantaprepitant will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.arformoterolimipramine increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.aripiprazolearipiprazole and imipramine both increase sedation. Use Caution/Monitor.armodafinilarmodafinil will decrease the level or effect of imipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.armodafinil will increase the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.imipramine increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.asenapineasenapine will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.asenapine and imipramine both increase QTc interval. Use Caution/Monitor.asenapine and imipramine both increase sedation. Use Caution/Monitor.asenapine transdermalasenapine transdermal and imipramine both increase QTc interval. Use Caution/Monitor.asenapine transdermal and imipramine both increase sedation. Use Caution/Monitor.atazanaviratazanavir will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.atazanavir increases levels of imipramine by unspecified interaction mechanism. Use Caution/Monitor.atracuriumatracurium and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.atropineatropine and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.atropine IV/IMatropine IV/IM and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.avapritinibavapritinib and imipramine both increase sedation. Use Caution/Monitor.azelastineazelastine and imipramine both increase sedation. Use Caution/Monitor.azithromycinimipramine and azithromycin both increase QTc interval. Use Caution/Monitor.baclofenbaclofen and imipramine both increase sedation. Use Caution/Monitor.belladonna alkaloidsbelladonna alkaloids and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.belladonna and opiumbelladonna and opium and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.belladonna and opium and imipramine both increase sedation. Use Caution/Monitor.benperidolbenperidol and imipramine both increase sedation. Use Caution/Monitor.benzhydrocodone/acetaminophenbenzhydrocodone/acetaminophen, 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.benzphetamineimipramine increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.benztropinebenztropine and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. bethanecholbethanechol increases and imipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.bortezomibbortezomib will increase the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.brexpiprazoleimipramine will increase the level or effect of brexpiprazole by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Administer a quarter of brexpiprazole dose if coadministered with a moderate CYP2D6 inhibitor PLUS a strong/moderate CYP3A4 inhibitor.brexpiprazole and imipramine both increase sedation. Use Caution/Monitor.brimonidinebrimonidine and imipramine both increase sedation. Use Caution/Monitor.brivaracetambrivaracetam and imipramine both increase sedation. Use Caution/Monitor.brompheniraminebrompheniramine and imipramine both increase sedation. Use Caution/Monitor.buprenorphinebuprenorphine and imipramine both increase sedation. Use Caution/Monitor.buprenorphine buccalbuprenorphine buccal and imipramine both increase sedation. Use Caution/Monitor.buprenorphine subdermal implantimipramine, buprenorphine subdermal implant. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.buprenorphine, long-acting injectionimipramine, buprenorphine, long-acting injection. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.bupropionbupropion will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.imipramine increases toxicity of bupropion by unspecified interaction mechanism. Use Caution/Monitor. May lower seizure threshold; keep bupropion dose as low as possible.butabarbitalbutabarbital will decrease the level or effect of imipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.butabarbital will decrease the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.butabarbital will decrease the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.butabarbital and imipramine both increase sedation. Use Caution/Monitor.butalbitalbutalbital will decrease the level or effect of imipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.butalbital will decrease the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.butalbital will decrease the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.butalbital and imipramine both increase sedation. Use Caution/Monitor.butorphanolbutorphanol and imipramine both increase sedation. Use Caution/Monitor.caffeineimipramine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.cannabidiolcannabidiol will increase the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider reducing the dose of sensitive CYP2C19 substrates, as clinically appropriate, when coadministered with cannabidiol. carbacholcarbachol increases and imipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.carbamazepinecarbamazepine will decrease the level or effect of imipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.carbamazepine will decrease the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.carbinoxaminecarbinoxamine and imipramine both increase sedation. Use Caution/Monitor.carisoprodolcarisoprodol and imipramine both increase sedation. Use Caution/Monitor.celecoxibcelecoxib will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.cenobamatecenobamate will increase the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider a dose reduction of CYP2C19 substrates, as clinically appropriate, when used concomitantly with cenobamate. cevimelinecevimeline increases and imipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.chloral hydratechloral hydrate and imipramine both increase sedation. Use Caution/Monitor.chlordiazepoxidechlordiazepoxide and imipramine both increase sedation. Use Caution/Monitor.chloroquinechloroquine will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.chlorpheniraminechlorpheniramine and imipramine both increase sedation. Use Caution/Monitor.chlorpromazinechlorpromazine and imipramine both increase sedation. Use Caution/Monitor.chlorzoxazonechlorzoxazone and imipramine both increase sedation. Use Caution/Monitor.cholestyraminecholestyramine decreases levels of imipramine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.cigarette smokingcigarette smoking will decrease the level or effect of imipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.cimetidinecimetidine will increase the level or effect of imipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.cimetidine will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.cimetidine will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.cinnarizinecinnarizine and imipramine both increase sedation. Use Caution/Monitor.cisatracuriumcisatracurium and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.clemastineclemastine and imipramine both increase sedation. Use Caution/Monitor.clobazamclobazam will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Lower doses of drugs metabolized by CYP2D6 may be required when used concomitantly. imipramine, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).clomipramineclomipramine and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.clomipramine and imipramine both increase sedation. Use Caution/Monitor.clonazepamclonazepam and imipramine both increase sedation. Use Caution/Monitor.clorazepateclorazepate and imipramine both increase sedation. Use Caution/Monitor.clozapineclozapine and imipramine both increase sedation. Use Caution/Monitor.cobicistatcobicistat will increase the level or effect of imipramine by Other (see comment). Use Caution/Monitor. Carefully titrate dose of the antidepressant to the desired effect, including using the lowest feasible initial or maintenance dose, and monitor its response during coadministration with TCAs and cobicistat. cocaine topicalimipramine and cocaine topical both increase serotonin levels. Modify Therapy/Monitor Closely.codeinecodeine and imipramine both increase sedation. Use Caution/Monitor.imipramine decreases effects of codeine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Prevents conversion of codeine to its active metabolite morphine.conivaptanconivaptan will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.cyclizinecyclizine and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.cyclizine and imipramine both increase sedation. Use Caution/Monitor.cyclobenzaprinecyclobenzaprine and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.cyclobenzaprine and imipramine both increase sedation. Use Caution/Monitor.cyclosporinecyclosporine will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.cyproheptadinecyproheptadine and imipramine both increase sedation. Use Caution/Monitor.dantrolenedantrolene and imipramine both increase sedation. Use Caution/Monitor.daridorexantimipramine and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. darifenacindarifenacin will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.darifenacin will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.darifenacin and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.darunavirdarunavir will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with SSRIs, TCAs, or trazodone may require dose titration of antidepressant to desired effect (eg, using the lowest feasible initial or maintenance dose). Monitor for antidepressant response.dasatinibimipramine and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.debrisoquineimipramine decreases effects of debrisoquine by Other (see comment). Use Caution/Monitor. Comment: Inhibition of uptake by adrenergic neurons.degarelixdegarelix and imipramine both increase QTc interval. Use Caution/Monitor.desfluranedesflurane and imipramine both increase sedation. Use Caution/Monitor.desflurane and imipramine both increase QTc interval. Use Caution/Monitor.desipraminedesipramine and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.desipramine and imipramine both increase sedation. Use Caution/Monitor.desvenlafaxinedesvenlafaxine will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Desvenlafaxine inhibits CYP2D6; with higher desvenlafaxine doses (ie, 400 mg) decrease the CYP2D6 substrate dose by up to 50%; no dosage adjustment needed with desvenlafaxine doses <100 mgdeutetrabenazineimipramine and deutetrabenazine both increase sedation. Use Caution/Monitor.deutetrabenazine and imipramine both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances