Drug interactions
Desipramine + Erythromycin lactobionate
Severity: Major
Desipramine and Erythromycin lactobionate: major interaction.
Last updated Sources: UK SmPC
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
Intravenous erythromycin prolongs the QT interval, and desipramine adds to this effect. The risk of torsades de pointes is higher with high IV doses and electrolyte disturbances.
What this interaction means in plain words
Desipramine and Erythromycin lactobionate 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; Erythromycin lactobionate belongs to Anti Bacterial.
Why it happens
Additive QT prolongation, with possible CYP inhibition by erythromycin increasing tricyclic levels.
What to do
Choose a non-QT-prolonging antibiotic if feasible. Otherwise correct potassium and magnesium and monitor the ECG during infusion.
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
- Erythromycin 1g Powder for Solution for Infusion - SmPC sections 4.3/4.5 (class statement: tri- and tetracyclic antidepressants; "Concomitant use with drugs which likewise can lead to QT interval prolongation, such as anti-arrhythmics classes IA and III, certain neuroleptics, tri- and tetr") — electronic medicines compendium (UK SmPC)
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 Erythromycin lactobionate
- Cisapride + Erythromycin lactobionate Contraindicated
- Dihydroergotamine + Erythromycin lactobionate Contraindicated
- Dronedarone + Erythromycin lactobionate Contraindicated
- Eletriptan + Erythromycin lactobionate Contraindicated
- Ergotamine + Erythromycin lactobionate Contraindicated
- Erythromycin lactobionate + Flibanserin Contraindicated
Frequently asked questions
Can I take Desipramine with Erythromycin lactobionate?
MediHelp rates the interaction as major. Desipramine and Erythromycin lactobionate 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. Intravenous erythromycin prolongs the QT interval, and desipramine adds to this effect. The risk of torsades de pointes is higher with high IV doses and electrolyte disturbances.
How serious is the interaction between Desipramine and Erythromycin lactobionate?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Choose a non-QT-prolonging antibiotic if feasible. Otherwise correct potassium and magnesium and monitor the ECG during infusion.
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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