Drug interactions
Desipramine + Epinephrine
Severity: Major
Desipramine and Epinephrine: 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
Tricyclics block neuronal norepinephrine reuptake and can markedly enhance the pressor and arrhythmic effects of injected epinephrine. This may cause severe hypertension and ventricular arrhythmias.
What this interaction means in plain words
Desipramine and Epinephrine 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; Epinephrine belongs to Endocrine.
Why it happens
Blockade of catecholamine reuptake potentiates adrenergic receptor stimulation by epinephrine.
What to do
Avoid epinephrine where alternatives exist, and use the lowest dose with continuous blood pressure and ECG monitoring when it is required, such as in anaphylaxis. Limit epinephrine in local anesthetic preparations.
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 Epinephrine
- Epinephrine + Isocarboxazid Contraindicated
- Epinephrine + Phenelzine Contraindicated
- Epinephrine + Tranylcypromine Contraindicated
- Acebutolol + Epinephrine Major
- Amitriptyline + Epinephrine Major
- Amoxapine + Epinephrine Major
Frequently asked questions
Can I take Desipramine with Epinephrine?
MediHelp rates the interaction as major. Desipramine and Epinephrine 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 neuronal norepinephrine reuptake and can markedly enhance the pressor and arrhythmic effects of injected epinephrine. This may cause severe hypertension and ventricular arrhythmias.
How serious is the interaction between Desipramine and Epinephrine?
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 epinephrine where alternatives exist, and use the lowest dose with continuous blood pressure and ECG monitoring when it is required, such as in anaphylaxis. Limit epinephrine in local anesthetic preparations.
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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