Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

desipramine (Rx)Brand and Other Names:Norpramin

 
 
 

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 10mg
  • 25mg
  • 50mg
  • 75mg
  • 100mg
  • 150mg
more...

Depression

100-200 mg PO qHS or divided q12hr

Up to 300 mg/day in severely ill

Renal Impairment

Supplemental dose not necessary in peritoneal or hemodialysis

Other Indications & Uses

Off-label: Postherpetic neuralgia, vulvodynia, eating disorder

Dosage Forms & Strengths

tablet

  • 10mg
  • 25mg
  • 50mg
  • 75mg
  • 100mg
  • 150mg
more...

Adolescents

<12 years: Safety and efficacy not established

Initial: 25-50 mg PO qDay; may gradually increase if needed to 100 mg/day PO qDay or divided q8-12hr

No more than 150 mg/day

Depression

25-100 mg PO qHS or divided q12hr

Up to 150 mg/day in severely ill

Next

Interactions

Interaction Checker

desipramine and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            Sort by :  
             activity indicator 
            Previous
            Next

            Adverse Effects

            Frequency Not Defined

            Common

            • Fatigue
            • Lethargy
            • Sedation
            • Weakness
            • Constipation
            • Dry mouth
            • Blurred vision

            Less Common

            • Agitation
            • Anxiety
            • Headache
            • Insomnia
            • Nausea
            • Vomiting
            • Sweating

            Infrequent

            • ECG changes, orthostatic hypotension, tachycardia
            • Confusion, dizziness, paresthesia
            • Extrapyramidal symptoms
            • Rash
            • Elevated LFTs
            • Sexual dysfunction
            • Tinnitus

            Rare

            • Seizure
            • Agranulocytosis
            • Eosinophilia
            • Leukopenia
            • Thrombocytopenia
            • SIADH
            Previous
            Next

            Warnings

            Black Box Warnings

            In short-term studies, antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults (<24 years) taking antidepressants for major depressive disorders and other psychiatric illnesses. This increase was not seen in patients aged >24 years. A slight decrease in suicidal thinking was seen in adults >65 years. In children and young adults, risks must be weighed against the benefits of taking antidepressants. Patients should be monitored closely for changes in behavior, clinical worsening, and suicidal tendencies. This should be done during initial 1-2 months of therapy and dosage adjustments. The patient’s family should communicate any abrupt changes in behavior to the healthcare provider

            Worsening behavior and suicidal tendencies that are not part of the presenting symptoms may require discontinuation of therapy

            This drug is not approved for use in pediatric patients

            Contraindications

            Hypersensitivity

            Severe cardiovascular disorder

            Narrow angle glaucoma

            Any drugs or conditions that prolong QT interval

            Acute recovery post-MI

            Coadministration with serotonergic drugs

            • Risk of serotonin syndrome when coadministered within 14 days of MAOIs, or coadministered with other strong serotonergic drugs (eg, SNRIs, SSRIs)
            • Starting desipramine in a patient who is being treated with linezolid or IV methylene blue is contraindicated because of an increased risk of serotonin syndrome
            • If linezolid or IV methylene blue must be administered, discontinue desipramine immediately and monitor for CNS toxicity; may resume clomipramine 24 hr after last linezolid or methylene blue dose or after 2 weeks of monitoring, whichever comes first

            Cautions

            Caution with family history of sudden death, cardiac dysrhythmias, and cardiac conduction disturbances; reports of cardiac dysrhythmias and death preceded by seizures

            BPH, urinary/GI retention, hyperthyroidism, seizure disorder, brain tumor, respiratory impairment

            Risk of anticholinergic side effects

            Risk of mydriasis; may trigger angle closure attack in patients with angle closure glaucoma with anatomically narrow angles without a patent iridectomy

            Potentially life-threatening serotonin syndrome reported when coadministered with drugs that impair serotonin metabolism (in particular, MAOIs, including nonpsychiatric MAOIs, such as linezolid and IV methylene blue) (see Contraindications)

            Previous
            Next

            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: distributed in breast milk, do not nurse (AAP states effect on nursing infants is unknown but may be of concern)

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
            Previous
            Next

            Pharmacology

            Mechanism of Action

            Neurotransmitter (esp NE & serotonin) reuptake inhibitor; inhibits reuptake by neuronal membrane; may also downregulate beta-adrenergic receptors and serotonin receptors

            Pharmacokinetics

            Half-Life elimination: 15-24hr

            Onset: 2-5 days (initial therapeutic effect); 2-3 wk (full effect)

            Peak Plasma Time: 4-6 hr

            Excretion: Urine (70%)

            Metabolism: Hepatic CYP2D6

            Metabolites: 2-hydroxydesipramine

            Previous
            Next

            Images

            Previous
            Next

            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Add or Remove Plans
            Plans for
            Select State:
            Non-Medicare PlansMedicare Plans

            Select a box to add or remove a plan.

            Select a class to view formulary status for similar drugs

            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous
             
             
             
            All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.