Imipramine and Tranylcypromine interaction

Imipramine and Tranylcypromine: 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 Tranylcypromine (Tranylcypromine Sulfate) label · effective 2025-07-25

Major

…including: antidepressants, such as: other monoamine oxidase inhibitors (MAOIs) selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) tricyclic antidepressants other antidepressants, such as amoxapine, bupropion, maprotiline, nefazodone, trazodone, vilazodone, vortioxetine amphetamines and methylphenidates medicines…

Boxed warningby drug classView label on DailyMed
Major

Concomitant use or use in rapid succession with other MAOIs; selective serotonin reuptake inhibitors; serotonin and norepinephrine reuptake inhibitors; tricyclic antidepressants; sympathomimetic drugs; and numerous other drugs.

Contraindicationsby drug classView label on DailyMed
Major

…including but not limited to: Other monoamine oxidase inhibitors (MAOIs) Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) Tricyclic antidepressants Other antidepressants (e.g., amoxapine, bupropion, maprotiline, nefazodone, trazodone, vilazodone, vortioxetine) Amphetamines and methylphenidates and derivatives…

Contraindicationsby drug classView label on DailyMed
Major

Serotonin Syndrome The development of a potentially life-threatening serotonin syndrome has been reported with MAOIs when used concomitantly with other serotonergic drugs.

Warnings and precautionsby drug classView label on DailyMed
Major

The concomitant use, or use in rapid succession, of tranylcypromine sulfate tablets with other serotonergic drugs is contraindicated.

Warnings and precautionsby drug classView label on DailyMed

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

Major

Anyone considering the use of imipramine hydrochloride or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need.

Boxed warningby drug classView label on DailyMed
Major

When it is desired to substitute imipramine hydrochloride in patients receiving a monoamine oxidase inhibitor, as long an interval should elapse as the clinical situation will allow, with a minimum of 14 days.

Contraindicationsby drug classView label on DailyMed
Minor

The drugs that inhibit cytochrome P450 2D6 include some that are not metabolized by the enzyme (quinidine; cimetidine) and many that are substrates for P450 2D6 (many other antidepressants, phenothiazines, and the Type 1C antiarrhythmics propafenone and flecainide).

Drug interactionsby drug classView label on DailyMed

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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.