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Desipramine (RX) : Warnings

Desipramine is an antidepressant of the TCA class. It carries a black box warning for increased suicidal risk in pediatric and young adult patients. It is contraindicated in patients with hypersensitivity, severe cardiovascular disorders, narrow angle glaucoma, drugs prolonging QT interval, or within 14 days of an MAOI. It requires caution in patients with a family history of cardiac issues or conditions affecting the urinary/GI tracts, thyroid, or respiratory system due to risk of anticholinergic side effects and mydriasis.

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187 views2 pages

Desipramine (RX) : Warnings

Desipramine is an antidepressant of the TCA class. It carries a black box warning for increased suicidal risk in pediatric and young adult patients. It is contraindicated in patients with hypersensitivity, severe cardiovascular disorders, narrow angle glaucoma, drugs prolonging QT interval, or within 14 days of an MAOI. It requires caution in patients with a family history of cardiac issues or conditions affecting the urinary/GI tracts, thyroid, or respiratory system due to risk of anticholinergic side effects and mydriasis.

Uploaded by

William Omar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

1/10/2019 Norpramin (desipramine) dosing, indications, interactions, adverse effects, and more

This site is intended for healthcare professionals

desipramine (Rx)
Brand and Other Names: Norpramin
Classes: Antidepressants, TCAs

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

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1/10/2019 Norpramin (desipramine) dosing, indications, interactions, adverse effects, and more

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)

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