Trade Names:Norpramin- Tablets 10 mg- Tablets 25 mg- Tablets 50 mg- Tablets 75 mg- Tablets 100 mg- Tablets 150 mgApo-Desipramine (Canada)PMS-Desipramine (Canada)ratio-Desipramine (Canada)
Inhibits reuptake of norepinephrine and serotonin in CNS.
Metabolized in the liver.
Approximately 70% excreted in the urine. The t ½ is 12 to 24 h.
2 to 5 days.
2 to 3 wk.
Rate of metabolism is slower. Dosage adjustment is recommended.
Relief of symptoms of depression.
Alcohol dependence and major secondary depression, anxiety, attention deficit hyperactivity disorder, bulimia nervosa, enuresis, diabetic neuropathy, Tourette syndrome.
Hypersensitivity to any tricyclic antidepressant; in combination with or within 14 days of treatment with an MAOI (cross-sensitivity may occur across the dibenzazepines); during acute recovery phases of MI.
PO 100 to 300 mg/day. May be given in divided doses or once daily at bedtime.Elderly and Adolescent Patients
PO 25 to 150 mg/day.
Store at room temperature, preferably below 30°C (86°F). Protect from excessive heat. Dispense in tight container.
May decrease desipramine effects.Cisapride, sparfloxacin
These agents are contraindicated in patients receiving desipramine because of the increased risk of life-threatening cardiac arrhythmias resulting from prolongation of the QT interval.Clonidine
May result in hypertensive crisis.CNS depressants
CNS and respiratory effects may be increased.Drugs that inhibit CYP2D6 (eg, cimetidine, flecainide, fluoxetine, haloperidol, hormonal contraceptives, paroxetine, phenothiazines, propafenone, quinidine, sertraline, terbinafine, venlafaxine)
Desipramine plasma levels may be elevated, increasing the pharmacologic effects and adverse reactions.Guanethidine
The hypotensive action of guanethidine may be inhibited.Gatifloxacin, levofloxacin, moxifloxacin
Coadministration of desipramine and levofloxacin should be avoided, while gatifloxacin and moxifloxacin should be used with caution. The risk of life-threatening cardiac arrhythmias may be increased.MAOIs
Hyperpyretic crises, severe convulsions, and death may occur if administered together or within 14 days of each other.Sympathomimetics (eg, epinephrine)
The pressor response to direct- and indirect-acting sympathomimetics may be increased or decreased, respectively.Valproic acid
Desipramine plasma levels may be elevated, increasing the pharmacologic effects and adverse reactions.
None well documented.
Arrhythmias; flushing; heart block; hypertension; hypotension; MI; palpitations; PVCs; stroke; sudden death; tachycardia; ventricular fibrillation.
Agitation; alterations in EEG patterns; anxiety; ataxia; confusion; delusions; disorientation; drowsiness; exacerbation of psychosis; extrapyramidal symptoms; fatigue; hallucinations; headache; hypomania; incoordination; insomnia; nightmares; NMS symptoms; numbness; paresthesias of extremities; peripheral nephropathy; restlessness, seizures; tingling; tremors; weakness.
Alopecia; itching; petechiae; photosensitization; skin rash; urticaria.
Blurred vision; disturbances in accommodation; increased intraocular pressure; mydriasis; tinnitus.
Abdominal cramps; anorexia; black tongue; constipation; diarrhea; dry mouth; epigastric distress; increased pancreatic enzymes; nausea; paralytic ileus; peculiar taste; stomatitis; sublingual adenitis; vomiting.
Breast enlargement and galactorrhea in women; decreased or increased libido; delayed micturition; dilation of the urinary tract; gynecomastia in men; impotence; nocturia; painful ejaculation; testicular swelling; urinary frequency; urinary retention.
Bone marrow depression, including agranulocytosis; eosinophilia; purpura; thrombocytopenia.
Altered hepatic function; hepatitis; jaundice.
Elevated alkaline phosphatase; elevated liver function tests.
Elevation or depression of blood glucose levels; SIADH; weight gain or loss.
Acute collapse; drug fever; edema; fever; parotid swelling; proneness to falling; sudden death; sweating; withdrawal symptoms, including headache, malaise, and nausea.
Increased risk of suicidal thinking and behavior has been observed in children, adolescents, and young adults taking antidepressants for major depressive disorders and other psychiatric disorders. Monitor patients of all ages who are started on antidepressant therapy appropriately and observe them closely for clinical worsening, suicidality, or unusual changes in behavior. Advise families and caregivers of the need for close observation and communication with the health care provider.
Monitor renal function in elderly patients.
Category C .
Excreted in breast milk.
Safety and efficacy not established. Sudden death has been reported in children taking desipramine.
Use with caution because of the greater incidence of renal function impairment in elderly patients.
Use drug with caution in patients with history of seizures, urinary retention, urethral or ureteral spasm, angle-closure glaucoma, increased intraocular pressure, or CV disorders; in patients receiving thyroid medication; and in patients who have hepatic or renal function impairment, schizophrenia, or paranoia.
Because of CV effects, discontinue desipramine as soon as possible prior to elective surgery.
Both increased and decreased blood sugar levels may occur.
Prescribe the smallest quantity consistent with good patient management in order to reduce the risk of overdose.
May be exacerbated.
May be exacerbated.
Agitation, cardiac arrhythmias, choreoathetosis, clonus, coma, confusion, dilated pupils, dry mouth, flushing, hallucinations, hyperactive reflexes, hyperpyrexia, positive Babinski signs, renal failure, seizures, status epilepticus.
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