Hepatic enzyme inducers that decrease imipramine plasma concentrations. Dosage adjustment of imipramine may be necessary.
Source: NLP:imipramine pamoate
Imipramine Pamoate Interactions
Brand names: Imipramine Pamoate
Route: Oral
FDA Black Box Warning
Suicidality and Antidepressant Drugs Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of imipramine pamoate or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Imipramine pamoate is not approved for use in pediatric patients (see WARNINGS: Clinical Worsening and Suicide Risk , PRECAUTIONS: Information for Patients , and PRECAUTIONS: Pediatric Use ).
Contraindications
CONTRAINDICATIONS Monoamine Oxidase Inhibitors (MAOIs) The use of MAOIs intended to treat psychiatric disorders with imipramine pamoate or within 14 days of stopping treatment with imipramine pamoate is contraindicated because of an increased risk of serotonin syndrome. The use of imipramine pamoate within 14 days of stopping an MAOI intended to treat psychiatric disorders is also contraindicated (see WARNINGS and DOSAGE AND ADMINISTRATION ). Starting imipramine pamoate in a patient who is being treated with MAOIs such as linezolid or intravenous methylene blue is also contraindicated because of an increased risk of serotonin syndrome (see WARNINGS and DOSAGE AND ADMINISTRATION ). Myocardial Infarction The drug is contraindicated during the acute recovery period after a myocardial infarction. Hypersensitivity to Tricyclic Antidepressants Patients with a known hypersensitivity to this compound should not be given the drug. The possibility of cross-sensitivity to other dibenzazepine compounds should be kept in mind.
Pregnancy & Breastfeeding
Pregnancy Animal reproduction studies have yielded inconclusive results (see also ANIMAL PHARMACOLOGY AND TOXICOLOGY ). There have been no well-controlled studies conducted with pregnant women to determine the effect of imipramine on the fetus. However, there have been clinical reports of congenital malformations associated with the use of the drug. Although a causal relationship between these effects and the drug could not be established, the possibility of fetal risk from the maternal ingestion of imipramine cannot be excluded. Therefore, imipramine should be used in women who are or might become pregnant only if the clinical condition clearly justifies potential risk to the fetus.
9 interactions on record
Imipramine Pamoate + CimetidineModerate
Inhibits P450 2D6 and hepatic enzymes, increasing imipramine plasma concentrations. May require dose adjustment and TCA level monitoring.
Source: NLP:imipramine pamoate
Imipramine Pamoate + FlecainideModerate
Type 1C antiarrhythmic that inhibits P450 2D6, increasing imipramine plasma concentrations. May require dose adjustment and TCA level monitoring.
Source: NLP:imipramine pamoate
Imipramine Pamoate + FluoxetineModerate
SSRI that inhibits P450 2D6 and hepatic enzymes, increasing imipramine plasma concentrations. At least 5 weeks may be necessary before initiating imipramine after fluoxetine withdrawal due to long half-life.
Source: NLP:imipramine pamoate
Imipramine Pamoate + ParoxetineModerate
SSRI that inhibits P450 2D6, increasing imipramine plasma concentrations. Caution and dose adjustment may be necessary during co-administration or switching.
Source: NLP:imipramine pamoate
Imipramine Pamoate + PhenytoinModerate
Hepatic enzyme inducer that decreases imipramine plasma concentrations. Dosage adjustment of imipramine may be necessary.
Source: NLP:imipramine pamoate
Imipramine Pamoate + PropafenoneModerate
Type 1C antiarrhythmic that inhibits P450 2D6, increasing imipramine plasma concentrations. May require dose adjustment and TCA level monitoring.
Source: NLP:imipramine pamoate
Imipramine Pamoate + QuinidineModerate
Inhibits cytochrome P450 2D6, increasing imipramine plasma concentrations. May require dose adjustment and TCA level monitoring.
Source: NLP:imipramine pamoate
Imipramine Pamoate + SertralineModerate
SSRI that inhibits P450 2D6, increasing imipramine plasma concentrations. Caution and dose adjustment may be necessary during co-administration or switching.
Source: NLP:imipramine pamoate