occurs, discontinue along with concomitant serotonergic drug(s).lithiumimipramine and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.lithium and imipramine both increase QTc interval. Use Caution/Monitor.lofepramineimipramine and lofepramine both decrease cholinergic effects/transmission. Use Caution/Monitor.imipramine and lofepramine both increase sedation. Use Caution/Monitor.lofexidineimipramine and lofexidine both increase sedation. Use Caution/Monitor.imipramine decreases effects of lofexidine by unspecified interaction mechanism. Use Caution/Monitor.loprazolamloprazolam and imipramine both increase sedation. Use Caution/Monitor.lorazepamlorazepam and imipramine both increase sedation. Use Caution/Monitor.lorcaserinlorcaserin will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.lormetazepamlormetazepam and imipramine both increase sedation. Use Caution/Monitor.loxapineloxapine and imipramine both increase sedation. Use Caution/Monitor.loxapine inhaledloxapine inhaled and imipramine both increase sedation. Use Caution/Monitor.lsdimipramine and lsd both increase serotonin levels. Modify Therapy/Monitor Closely.lumacaftor/ivacaftorlumacaftor/ivacaftor, imipramine. affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. In vitro studies suggest that lumacaftor may induce and ivacaftor may inhibit CYP2C19 substrates. .lurasidonelurasidone, 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.maprotilineimipramine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.imipramine and maprotiline both increase sedation. Use Caution/Monitor.maravirocmaraviroc will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.marijuanamarijuana 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.mavacamtenimipramine 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. meclizinemeclizine and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.melatoninimipramine and melatonin both increase sedation. Use Caution/Monitor.meperidinemeperidine and imipramine both increase sedation. Use Caution/Monitor.meprobamateimipramine and meprobamate both increase sedation. Use Caution/Monitor.metaproterenolimipramine increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.metaxalonemetaxalone and imipramine both increase sedation. Use Caution/Monitor.methadoneimipramine and methadone both increase QTc interval. Modify Therapy/Monitor Closely.methadone and imipramine both increase sedation. Use Caution/Monitor.methamphetamineimipramine increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.methocarbamolmethocarbamol and imipramine both increase sedation. Use Caution/Monitor.methscopolaminemethscopolamine and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.methylenedioxymethamphetamineimipramine increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.methylphenidateimipramine, 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 transdermalmethylphenidate 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. mexiletinemexiletine will increase the level or effect of imipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.midazolammidazolam and imipramine both increase sedation. Use Caution/Monitor.midazolam intranasalmidazolam 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.midodrineimipramine increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.mirabegronmirabegron will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.mirtazapineimipramine and mirtazapine both increase sedation. Use Caution/Monitor.imipramine and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely.modafinilmodafinil 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.morphinemorphine and imipramine both increase sedation. Use Caution/Monitor.imipramine and morphine both increase serotonin levels. Modify Therapy/Monitor Closely.motherwortimipramine and motherwort both increase sedation. Use Caution/Monitor.moxonidineimipramine and moxonidine both increase sedation. Use Caution/Monitor.nabiloneimipramine and nabilone both increase sedation. Use Caution/Monitor.nalbuphinenalbuphine and imipramine both increase sedation. Use Caution/Monitor.naratriptannaratriptan and imipramine both increase serotonin levels. Modify Therapy/Monitor Closely.nefazodonenefazodone will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nefopamnefopam, imipramine. Mechanism: unspecified interaction mechanism. Use Caution/Monitor. Use combination with caution.nelfinavirnelfinavir will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.neostigmineneostigmine increases and imipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.nilotinibnilotinib will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.norepinephrineimipramine increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.imipramine increases effects of norepinephrine by unknown mechanism. Use Caution/Monitor.nortriptylineimipramine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.imipramine and nortriptyline both increase sedation. Use Caution/Monitor.ofloxacinimipramine and ofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.olanzapineolanzapine and imipramine both increase sedation. Use Caution/Monitor.olanzapine and imipramine both increase QTc interval. Use Caution/Monitor.oliceridineimipramine will increase the level or effect of oliceridine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. If concomitant use is necessary, may require less frequent oliceridine dosing. Closely monitor for respiratory depression and sedation and titrate subsequent doses accordingly. If inhibitor is discontinued, consider increase oliceridine dosage until stable drug effects are achieved. Monitor for signs of opioid withdrawal. imipramine, oliceridine. Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely.imipramine increases toxicity of oliceridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. Monitor for signs of urinary retention or reduced gastric motility if oliceridine is coadministered with anticholinergics.olodaterol inhaledimipramine and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. TCAs prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiasomeprazoleomeprazole will increase the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.onabotulinumtoxinAonabotulinumtoxinA and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.opium tinctureopium tincture and imipramine both increase sedation. Use Caution/Monitor.orphenadrineimipramine and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.orphenadrine and imipramine both increase sedation. Use Caution/Monitor.oxazepamoxazepam and imipramine both increase sedation. Use Caution/Monitor.oxcarbazepineoxcarbazepine will increase the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.oxybutyninoxybutynin and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.oxybutynin topicaloxybutynin topical and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.oxybutynin transdermaloxybutynin transdermal and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.oxycodoneoxycodone and imipramine both increase sedation. Use Caution/Monitor.oxymetazoline intranasalimipramine increases effects of oxymetazoline intranasal by pharmacodynamic synergism. Use Caution/Monitor. TCAs inhibit norepinephrine uptake in adrenergic neurons, thereby increasing synaptic norepinephrine levels. Coadministration with alpha1 agonists may cause increased adrenergic receptor stimulation. When oxymetazoline is combined with intranasal tetracaine for dental anesthesia, avoid or use alternant anesthetic in patients taking TCAs.oxymorphoneoxymorphone and imipramine both increase sedation. Use Caution/Monitor.paliperidoneimipramine and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.paliperidone and imipramine both increase sedation. Use Caution/Monitor.pancuroniumpancuronium and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.papaveretumpapaveretum and imipramine both increase sedation. Use Caution/Monitor.papaverineimipramine and papaverine both increase sedation. Use Caution/Monitor.parecoxibparecoxib will increase the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.parecoxib will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.paroxetineimipramine and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.pazopanibimipramine and pazopanib both increase QTc interval. Use Caution/Monitor.peginterferon alfa 2apeginterferon alfa 2a will increase the level or effect of imipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.peginterferon alfa 2bpeginterferon alfa 2b, imipramine. Other (see comment). Use Caution/Monitor. Comment: When patients are administered peginterferon alpha-2b with CYP2D6 substrates, the therapeutic effect of these drugs may be altered. Peginterferon alpha-2b may increase or decrease levels of CYP2D6 substrate.pentazocinepentazocine and imipramine both increase sedation. Use Caution/Monitor.imipramine and pentazocine both increase serotonin levels. Modify Therapy/Monitor Closely.pentobarbitalpentobarbital will decrease the level or effect of imipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.pentobarbital will decrease the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.pentobarbital will decrease the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.pentobarbital and imipramine both increase sedation. Use Caution/Monitor.perphenazineperphenazine will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.perphenazine and imipramine both increase sedation. Use Caution/Monitor.phendimetrazineimipramine increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenobarbitalphenobarbital will decrease the level or effect of imipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.phenobarbital will decrease the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.phenobarbital will decrease the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.phenobarbital and imipramine both increase sedation. Use Caution/Monitor.phentermineimipramine increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenylephrineimipramine increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenylephrine ophthalmicimipramine, phenylephrine ophthalmic. 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.phenylephrine POimipramine increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .phenytoinphenytoin will decrease the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Consider phenytoin serum levels if a tricyclic antidepressant is added to therapy or if the patient begins to exhibit signs of toxicity; lower doses of phenytoin may be required. If phenytoin is added to tricyclic antidepressant therapy, monitor for clinical efficacy of the tricyclic agent. Tricyclic antidepressants when given concomitantly with anticonvulsants can increase CNS depression.pholcodineimipramine and pholcodine both increase sedation. Use Caution/Monitor.physostigminephysostigmine increases and imipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.pilocarpinepilocarpine increases and imipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.pimozidepimozide and imipramine both increase sedation. Use Caution/Monitor.pipemidic acidpipemidic acid will increase the level or effect of imipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.pirbuterolimipramine increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.posaconazoleimipramine and posaconazole both increase QTc interval. Modify Therapy/Monitor Closely.pralidoximepralidoxime and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.pregabalinpregabalin, 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.primidoneprimidone will decrease the level or effect of imipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.primidone will decrease the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.primidone will decrease the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.primidone and imipramine both increase sedation. Use Caution/Monitor.prochlorperazineprochlorperazine and imipramine both increase QTc interval. Use Caution/Monitor.prochlorperazine and imipramine both increase sedation. Use Caution/Monitor.promethazinepromethazine and imipramine both increase QTc interval. Use Caution/Monitor.promethazine and imipramine both increase sedation. Use Caution/Monitor.propafenonepropafenone will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.propanthelinepropantheline and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.propofolpropofol and imipramine both increase sedation. Use Caution/Monitor.propylhexedrineimipramine increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.protriptylineimipramine and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.imipramine and protriptyline both increase sedation. Use Caution/Monitor.pyridostigminepyridostigmine increases and imipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.quazepamquazepam and imipramine both increase sedation. Use Caution/Monitor.quetiapinequetiapine and imipramine both increase sedation. Use Caution/Monitor.quinacrinequinacrine will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.ramelteonimipramine and ramelteon both increase sedation. Use Caution/Monitor.ranolazineranolazine will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.imipramine and ranolazine both increase QTc interval. Modify Therapy/Monitor Closely.rapacuroniumrapacuronium and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.remifentanilimipramine, remifentanil. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. May also increase risk of serotonin syndrome.remimazolamremimazolam, imipramine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.ribociclibribociclib will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.rifabutinrifabutin will decrease the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.rifabutin decreases levels of imipramine by increasing metabolism. Use Caution/Monitor.rifampinrifampin will