Drug interactions
Cocaine + Desipramine
Severity: Major
Cocaine and Desipramine: major interaction.
Last updated
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
Tricyclics block catecholamine reuptake, and cocaine does the same, so the sympathomimetic effects may be potentiated. With topical cocaine this is mainly relevant when large doses are absorbed, with risk of hypertension and arrhythmia.
What this interaction means in plain words
Cocaine 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.
Cocaine belongs to Central Nervous System; Desipramine belongs to Central Nervous System.
Why it happens
Additive inhibition of norepinephrine reuptake, increasing adrenergic stimulation and arrhythmia risk.
What to do
Avoid cocaine in patients taking desipramine, including topical anesthetic use, where an alternative anesthetic can be chosen. If unavoidable, use the minimum dose and monitor blood pressure and ECG.
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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Other interactions of Desipramine
- Desipramine + Disopyramide Contraindicated
- Desipramine + Dofetilide Contraindicated
- Desipramine + Ibutilide Contraindicated
- Desipramine + Isocarboxazid Contraindicated
- Desipramine + Methylene blue Contraindicated
- Desipramine + Pentamidine Contraindicated
Other interactions of Cocaine
- Cocaine + Isocarboxazid Contraindicated
- Cocaine + Phenelzine Contraindicated
- Cocaine + Procarbazine Contraindicated
- Amitriptyline + Cocaine Major
- Bisoprolol + Cocaine Major
- Citalopram + Cocaine Major
Frequently asked questions
Can I take Cocaine with Desipramine?
MediHelp rates the interaction as major. Cocaine 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. Tricyclics block catecholamine reuptake, and cocaine does the same, so the sympathomimetic effects may be potentiated. With topical cocaine this is mainly relevant when large doses are absorbed, with risk of hypertension and arrhythmia.
How serious is the interaction between Cocaine 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: Avoid cocaine in patients taking desipramine, including topical anesthetic use, where an alternative anesthetic can be chosen. If unavoidable, use the minimum dose and monitor blood pressure and ECG.
What other medicines interact with Desipramine?
MediHelp also lists interactions of Desipramine with, for example, Disopyramide, Dofetilide, Ibutilide. The full list is on the Desipramine page.
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