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Fosamprenavir and Imipramine Hydrochloride

Determining the interaction of Fosamprenavir and Imipramine Hydrochloride and the possibility of their joint administration.

Check result:

Fosamprenavir <> Imipramine Hydrochloride

Relevance: 21.07.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Fosamprenavir may increase the blood levels and effects of imipramine. This may increase the frequency and/or severity of side effects such as drowsiness, confusion, memory impairment, dry mouth, blurred vision, constipation, heat intolerance, difficulty urinating, sexual problems, blood pressure changes, and irregular heartbeat. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

MONITOR: Product labeling for certain protease inhibitors (PIs) such as amprenavir and atazanavir states that serious and/or life-threatening drug interactions may occur with tricyclic antidepressants (TCAs), presumably due to PI inhibition of TCA metabolism via CYP450 3A4. High plasma levels of TCAs could conceivably lead to serious adverse reactions including QT interval prolongation and ventricular arrhythmias such as ventricular tachycardia and torsade de pointes. However, the clinical significance of such an interaction is unknown, as it has not been studied and there are no case reports of it published in the medical literature. Moreover, many TCAs are thought to be substrates of multiple CYP450 isoenzymes, thus the effects of CYP450 3A4 inhibition alone are unknown. Some TCAs such as desipramine, doxepin, and nortriptyline are also thought to be primarily metabolized by CYP450 2D6, which is not known to be inhibited by most PIs (except ritonavir) to any significant extent.

MANAGEMENT: Until further information is available, caution is advised if protease inhibitors must be used with certain TCAs. Pharmacologic response and plasma TCA levels should be monitored more closely whenever a PI is added to or withdrawn from therapy, and the TCA dosage adjusted as necessary.

References

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"Product Information. Agenerase (amprenavir)." Glaxo Wellcome, Research Triangle Pk, NC.
Shimoda K, Someya T, Yokono A, et al. "The Impact of CYP2C19 and CYP2D6 Genotypes on Metabolism of Amitriptyline in Japanese Psychiatric Patients." J Clin Psychopharmacol 22 (2002): 371-378
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Fosamprenavir

Generic Name: fosamprenavir

Brand name: Lexiva, Telzir

Synonyms: n.a.

What is Fosamprenavir?

Imipramine Hydrochloride

Generic Name: imipramine

Brand name: Tofranil, Tofranil-PM

Synonyms: Imipramine

What is Imipramine Hydrochloride?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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