Meperidine/Clomipramine; Imipramine; SSRIs; SNRIs; Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Both of these medicines can increase the level of serotonin in your body.

What might happen:

High serotonin levels may cause changes in body temperature, blood pressure and behavior, leading to a medical condition called Serotonin Syndrome. Serotonin Syndrome may be life threatening.

What you should do about this interaction:

Make sure your healthcare professional (e.g. doctor or pharmacist) knows that you are taking these medicines together.If you experience muscle twitching, tremors, shivering and stiffness, fever, heavy sweating, heart palpitations, restlessness, confusion, agitation, trouble with coordination, or severe diarrhea contact your doctor right away.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

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  • 3.Tissot TA. Probable meperidine-induced serotonin syndrome in a patient with a history of fluoxetine use. Anesthesiology 2003 Jun;98(6):1511-2.
  • 4.Altman EM, Manos GH. Serotonin syndrome associated with citalopram and meperidine. Psychosomatics 2007 Jul-Aug;48(4):361-3.
  • 5.Dougherty JA, Young H, Shafi T. Serotonin syndrome induced by amitriptyline, meperidine, and venlafaxine. Ann Pharmacother 2002 Oct; 36(10):1647-8.
  • 6.Gillman PK. Monoamine oxidase inhibitors, opioid analgesics and serotonin toxicity. Br J Anaesth 2005 Oct;95(4):434-41.
  • 7.O'Donnell JM Shelton RC. Chapter 15 - Drug Therapy of Depression and Anxiety Disorders. In Bruton L, Chabner B, Knollman B eds. Goodman & Gilman's The Pharmacological Basis of Therapeutics. 12th ed. 2011.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.