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Drug Interactions between imipramine and sodium salicylate

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

imipramine sodium salicylate

Applies to: imipramine and sodium salicylate

MONITOR: Preliminary evidence suggests that aspirin may increase the plasma free concentration and pharmacologic effects of imipramine by displacing it from plasma protein binding sites. In 20 patients with endogenous depression given imipramine 150 mg/day for 5 days, administration of aspirin (500 mg every 12 hours for 2 days) decreased the plasma protein binding of imipramine from 84% to 72%. Additionally, the incidence of mild and severe adverse effects associated with imipramine increased nearly 60% and 150%, respectively. Other salicylates are expected to have similar effects due to their high affinity for plasma proteins.

MANAGEMENT: Pharmacologic response to imipramine should be monitored more closely whenever a salicylate is added to or withdrawn from therapy, and the imipramine dosage adjusted as necessary. Patients should be advised to notify their physician if they experience increased adverse effects of imipramine such as dry mouth, constipation, urinary retention, blurred vision, palpitations, and tachycardia.

References

  1. Juarez-Olguin H, Jung-Cook H, Flores-Perez J, Asseff IL (2002) "Clinical Evidence of an Interaction Between Imipramine and Acetylsalicylic Acid on Protein Binding in Depressed Patients." Clin Neuropharmacol, 25, p. 32-36

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Drug and food interactions

Moderate

imipramine food

Applies to: imipramine

GENERALLY AVOID: Concomitant use of ethanol and a tricyclic antidepressant (TCA) may result altered TCA plasma levels and efficacy, and additive impairment of motor skills, especially driving skills. Acute ethanol ingestion may inhibit TCA metabolism, while chronic ingestion of large amounts of ethanol may induce hepatic TCA metabolism.

MANAGEMENT: Patients should be advised to avoid alcohol during TCA therapy. Alcoholics who have undergone detoxification should be monitored for decreased TCA efficacy. Dosage adjustments may be required.

References

  1. Dorian P, Sellers EM, Reed KL, et al. (1983) "Amitriptyline and ethanol: pharmacokinetic and pharmacodynamic interaction." Eur J Clin Pharmacol, 25, p. 325-31
  2. Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
  3. Sandoz M, Vandel S, Vandel B, Bonin B, Allers G, Volmat R (1983) "Biotransformation of amitriptyline in alcoholic depressive patients." Eur J Clin Pharmacol, 24, p. 615-21
  4. Ciraulo DA, Barnhill JG, Jaffe JH (1988) "Clinical pharmacokinetics of imipramine and desipramine in alcoholics and normal volunteers." Clin Pharmacol Ther, 43, p. 509-18
  5. Seppala T, Linnoila M, Elonen E, Mattila MJ, Makl M (1975) "Effect of tricyclic antidepressants and alcohol on psychomotor skills related to driving." Clin Pharmacol Ther, 17, p. 515-22
  6. Ciraulo DA, Barnhill JG, Jaffe JH, Ciraulo AM, Tarmey MF (1990) "Intravenous pharmacokinetics of 2-hydroxyimipramine in alcoholics and normal controls." J Stud Alcohol, 51, p. 366-72
  7. Ciraulo DA, Alderson LM, Chapron DJ, Jaffe JH, Subbarao B, Kramer PA (1982) "Imipramine disposition in alcoholics." J Clin Psychopharmacol, 2, p. 2-7
View all 7 references

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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