Imipramine and Sevoflurane interaction

Imipramine and Sevoflurane: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Imipramine (Imipramine Hydrochloride) label · effective 2026-07-06

Major

Avoid the use of preparations, such as decongestants and local anesthetics, that contain any sympathomimetic amine (e.g., epinephrine, norepinephrine), since it has been reported that tricyclic antidepressants can potentiate the effects of catecholamines.

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Moderate

Imipramine hydrochloride may enhance the CNS depressant effects of alcohol.

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Moderate

Imipramine hydrochloride may potentiate the effects of CNS depressant drugs.

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Moderate

Patients should be warned that imipramine hydrochloride may enhance the CNS depressant effects of alcohol.

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From the Sevoflurane (Ultane) label · effective 2025-01-13

Moderate

Consider having an anticholinergic and epinephrine available when administering sevoflurane for induction in this patient population.

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Minor

In most cases, bradycardia improved with decreasing the concentration of sevoflurane, manipulating the airway, or administering an anticholinergic or epinephrine.

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.