Drug interactions
Desipramine + Doxepin
Severity: Major
Desipramine and Doxepin: 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
Two tricyclic antidepressants given together have additive anticholinergic, sedative, cardiac conduction and QT effects. Doxepin may also inhibit CYP2D6 to some extent, raising desipramine levels, and the combination adds serotonergic load.
What this interaction means in plain words
Desipramine and Doxepin 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; Doxepin belongs to Dermatology.
Why it happens
Additive QT and conduction effects with duplicated pharmacology, plus possible CYP2D6-mediated increase in desipramine exposure.
What to do
Avoid therapeutic duplication and use a single tricyclic. If a switch is needed, cross-taper carefully with ECG monitoring.
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 Doxepin
- Doxepin + Isocarboxazid Contraindicated
- Doxepin + Phenelzine Contraindicated
- Doxepin + Procarbazine Contraindicated
- Doxepin + Safinamide Contraindicated
- Doxepin + Selegiline Contraindicated
- Doxepin + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Desipramine with Doxepin?
MediHelp rates the interaction as major. Desipramine and Doxepin 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. Two tricyclic antidepressants given together have additive anticholinergic, sedative, cardiac conduction and QT effects. Doxepin may also inhibit CYP2D6 to some extent, raising desipramine levels, and the combination adds serotonergic load.
How serious is the interaction between Desipramine and Doxepin?
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 therapeutic duplication and use a single tricyclic. If a switch is needed, cross-taper carefully with ECG monitoring.
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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