Supplements and Imipramine.
Imipramine is a tricyclic antidepressant: it inhibits reuptake of both serotonin and noradrenaline, with significant antimuscarinic effect.
Imipramine is a tricyclic antidepressant (TCA). The class blocks reuptake of both serotonin and noradrenaline. It also has significant antimuscarinic, antihistaminic, and alpha-1 blockade. In current UK prescribing, TCAs are used mostly at low doses (10 to 50mg) for neuropathic pain, migraine prophylaxis, and chronic tension headache. The full antidepressant dose (75 to 150mg) is uncommon outside specialist practice. The off-target effects drive the side effect profile. Dry mouth, constipation, daytime sedation, postural hypotension. Cardiac conduction effects matter at higher doses, with QT prolongation especially in overdose. A few supplement interactions warrant care. Anything serotonergic on top (St John's Wort, 5-HTP, SAMe). Anything sedating at bedtime (valerian, kava, magnesium at higher doses). And anything anticholinergic that adds to the dry mouth and constipation load. The pain indication at low dose has a lower risk profile than the historical antidepressant dose, but the mechanism is the same.
Below are the 3 documented pairs we have explicitly assessed against Imipramine in the Distil database: 3 amber. The pairs cluster around 2 mechanisms: Cholinergic vs anticholinergic (opposing) and Additive serotonergic activity. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not on this list is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by supplement, and the missing-item form at the bottom of the page routes any uncatalogued supplement into our next curation pass.
Documented interactions
Cholinergic vs anticholinergic (opposing)
Huperzine A raises acetylcholine, while imipramine has a strong anticholinergic effect that blocks it. The two can work against each other, and imipramine may blunt any benefit from huperzine A. It is worth mentioning the huperzine A to your prescriber.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Additive serotonergic activity
Imipramine has serotonin-reuptake-inhibiting activity. Combined with 5-HTP, the serotonergic effect is additive. Watch for restlessness, sweating, or muscle twitching, and discuss with your GP before stacking.
Saffron has its own mild antidepressant effect that appears to act on serotonin, and imipramine raises serotonin and noradrenaline too. Taking them together may add up. Most people tolerate it, but discuss it with your GP before stacking, especially if your dose has recently changed.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope (food-supplement interactions only; for drug-drug interactions, the BNF is authoritative). Use the checker below to surface any supplement, and submit a missing item if you take something we have not catalogued.
How we grade severity, choose what's in scope, and what we exclude.
Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.
Read the full methodologyWant this reasoning across everything you take?
This page checks the pairs you enter. A personalised Distil report applies the same graded, cited reasoning to your whole stack: your goals, conditions, medications, diet, and the compounds worth adding or dropping. The interactions check is one section of it. You can read a real one in full before you decide.
See a real sample reportSomething missing?
If a supplement or medication you take isn't in our autocomplete, tell us. We go through what people flag every week and add what's missing.