Moclobemide
Contraindicated
Textbook
Increased risk of serotonin syndrome and potentiated sympathomimetic effects.
Should not be used concurrently with MAOIs or within 14 days of stopping MAOIs.
Source: G&G 14e
Drug reference
imipramine
TCA · Antidepressant
Also known as imipramine hydrochloride
TCAAntidepressant
CDSCO approvedSchedule H
EXCRETION
—
not curated
INTERACTIONS
12 major
incl. contraindicated
PREGNANCY
Manufacturer advises avoid.
FDA category + note
Top interactionssee all 12 →
- MoclobemideContraindicatedTextbookG&G 14e
- CodeineSevereTextbook-citedKDT 7e · p950
- EpinephrineSevereTextbook-citedKDT 7e · p950
- MorphineSevereTextbook-citedKDT 7e · p950
Mechanism
Tricyclic and related antidepressants block the re-uptake of both serotonin and noradrenaline. Imipramine hydrochloride is more selective for noradrenergic transmission.
Indications
Panic disorder (second-line, unlicensed)depressionpsychotic depression (with first-generation antipsychotics)pain conditionsSleep Enuresis
Dosing
- Adult
- doses that are sufficiently high for effective treatment but not so high as to cause toxic effects. Low doses should be used for initial treatment in the elderly. In most patients the long half-life of tricyclic antidepressant drugs allows oncedaily administration, usually at night; the use of modifiedrelease preparations is therefore unnecessary.…
Pharmacokinetics
Half-life
12 hours (parent), 30 hours (active metabolite)
Bioavailability
Imipramine exhibits high first-pass metabolism.
Protein binding
Imipramine's rate of metabolism is limited by hepatic blood flow.
Metabolism
hepatic (CYP2D6, CYP2C19, CYP3A3/4, CYP1A2)
Side effects
Common
antimuscarinic side-effectssedationcognitive dullingblurred visiondry mouthtachycardiaconstipationdifficulty urinatingorthostatic hypotensionweight gain
Serious
- cardiotoxicity in overdosage
- quinidine-like effects on cardiac conduction (life threatening in overdose)
- lowered seizure threshold
- serotonin syndrome (with MAOIs)
- cardiac arrhythmia (overdose)
Pregnancy & lactation
Pregnancy
Manufacturer advises avoid.
Drug interactions
Codeine
Severe
Textbook-cited
Enhanced sedation and respiratory depression
Avoid concurrent use
Source: KDT 7e · p950
Epinephrine
Severe
Textbook-cited
Exaggerated hypertensive response
Use local anaesthetic without adrenaline in patients on TCAs
Source: KDT 7e · p950
Morphine
Severe
Textbook-cited
Excessive sedation and respiratory depression; potentially fatal.
Avoid concurrent use
Source: KDT 7e · p950
Pethidine
Severe
Textbook-cited
Severe sedation and respiratory depression
Avoid concurrent use
Source: KDT 7e · p950
Adrenaline
Severe
Textbook
Potentiation of adrenaline's effects.
Vasoconstrictor (adrenaline) containing LA should be avoided in patients receiving tricyclic antidepressants.
Source: KDT 7e · p365
Artemisinins
Severe
Textbook
Increased risk of cardiac conduction defects.
Source: KDT 7e · p816-835
Meglumine Antimoniate
Severe
Textbook
Increased cardiotoxicity (e.g., QT prolongation).
Source: Harrison 22e · p1740
Amiodarone
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Amisulpride
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Anagrelide
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Arbutamine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Related guidelines
Other TCA drugs
Ask House about imipramine
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Harrison 22e, BNF·Verified: 2026-05-13 · House clinical team