Drug interactions
Desipramine + Desvenlafaxine
Severity: Major
Desipramine and Desvenlafaxine: 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
Both agents increase synaptic serotonin and norepinephrine, so serotonin syndrome can occur. Desvenlafaxine can weakly inhibit CYP2D6 and may raise desipramine levels, with possible blood pressure and heart rate increases.
What this interaction means in plain words
Desipramine and Desvenlafaxine 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 belongs to Central Nervous System; Desvenlafaxine belongs to Central Nervous System.
Why it happens
Additive serotonergic and noradrenergic reuptake inhibition with weak CYP2D6 inhibition.
What to do
Avoid if possible; if combined, use low doses, monitor desipramine levels and watch for serotonin toxicity and hypertension.
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 Desipramine
- Desipramine + Disopyramide Contraindicated
- Desipramine + Dofetilide Contraindicated
- Desipramine + Ibutilide Contraindicated
- Desipramine + Isocarboxazid Contraindicated
- Desipramine + Methylene blue Contraindicated
- Desipramine + Pentamidine Contraindicated
Other interactions of Desvenlafaxine
- Desvenlafaxine + Isocarboxazid Contraindicated
- Desvenlafaxine + Methylene blue Contraindicated
- Desvenlafaxine + Phenelzine Contraindicated
- Desvenlafaxine + Rasagiline Contraindicated
- Desvenlafaxine + Safinamide Contraindicated
- Desvenlafaxine + Selegiline Contraindicated
Frequently asked questions
Can I take Desipramine with Desvenlafaxine?
MediHelp rates the interaction as major. Desipramine and Desvenlafaxine 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. Both agents increase synaptic serotonin and norepinephrine, so serotonin syndrome can occur. Desvenlafaxine can weakly inhibit CYP2D6 and may raise desipramine levels, with possible blood pressure and heart rate increases.
How serious is the interaction between Desipramine and Desvenlafaxine?
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 if possible; if combined, use low doses, monitor desipramine levels and watch for serotonin toxicity and hypertension.
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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