Drug interactions
Buprenorphine + Desipramine
Severity: Major
Buprenorphine and Desipramine: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Desipramine, a tricyclic antidepressant, prolongs QRS and QT intervals, particularly in overdose, and buprenorphine adds a small QT effect. The two also add to sedation and may carry a minor serotonergic contribution.
What this interaction means in plain words
Buprenorphine and Desipramine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Buprenorphine belongs to Musculoskeletal; Desipramine belongs to Central Nervous System.
Why it happens
Additive QT prolongation (sodium and potassium channel blockade by the tricyclic) and additive CNS depression.
What to do
Obtain a baseline ECG and keep the desipramine dose as low as possible. Monitor the QTc, correct electrolytes, and watch for sedation and serotonin toxicity.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Buprenorphine
- Alvimopan + Buprenorphine Contraindicated
- Buprenorphine + Calcium / magnesium / potassium / sodium oxybates Contraindicated
- Buprenorphine + Olanzapine / samidorphan Contraindicated
- Buprenorphine + Phenelzine Contraindicated
- Buprenorphine + Pimozide Contraindicated
- Buprenorphine + Thioridazine Contraindicated
Other interactions of Desipramine
- Desipramine + Disopyramide Contraindicated
- Desipramine + Dofetilide Contraindicated
- Desipramine + Ibutilide Contraindicated
- Desipramine + Isocarboxazid Contraindicated
- Desipramine + Methylene blue Contraindicated
- Desipramine + Pentamidine Contraindicated
Frequently asked questions
Can I take Buprenorphine with Desipramine?
MediHelp rates the interaction as major. Buprenorphine and Desipramine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Desipramine, a tricyclic antidepressant, prolongs QRS and QT intervals, particularly in overdose, and buprenorphine adds a small QT effect. The two also add to sedation and may carry a minor serotonergic contribution.
How serious is the interaction between Buprenorphine and Desipramine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain a baseline ECG and keep the desipramine dose as low as possible. Monitor the QTc, correct electrolytes, and watch for sedation and serotonin toxicity.
What other medicines interact with Buprenorphine?
MediHelp also lists interactions of Buprenorphine with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Olanzapine / samidorphan. The full list is on the Buprenorphine page.
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