Drug interactions
Desipramine + Flecainide
Severity: Major
Desipramine and Flecainide: 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 slow conduction and can prolong QT, increasing the risk of serious ventricular arrhythmia. Flecainide may also raise desipramine concentrations via CYP2D6.
What this interaction means in plain words
Desipramine and Flecainide 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; Flecainide belongs to Cardiovascular.
Why it happens
Additive sodium channel blockade and QT prolongation, with flecainide competing for CYP2D6 metabolism.
What to do
Avoid if possible; otherwise monitor ECG and tricyclic levels, and reduce the desipramine dose if toxicity appears.
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 Flecainide
- Flecainide + Nirmatrelvir Contraindicated
- Flecainide + Nirmatrelvir / ritonavir Contraindicated
- Flecainide + Pimozide Contraindicated
- Flecainide + Ritonavir Contraindicated
- Flecainide + Thioridazine Contraindicated
- Flecainide + Tipranavir Contraindicated
Other interactions of Desipramine
- Desipramine + Disopyramide Contraindicated
- Desipramine + Dofetilide Contraindicated
- Desipramine + Ibutilide Contraindicated
- Desipramine + Isocarboxazid Contraindicated
- Desipramine + Methylene blue Contraindicated
- Desipramine + Pentamidine Contraindicated
Frequently asked questions
Can I take Desipramine with Flecainide?
MediHelp rates the interaction as major. Desipramine and Flecainide 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 slow conduction and can prolong QT, increasing the risk of serious ventricular arrhythmia. Flecainide may also raise desipramine concentrations via CYP2D6.
How serious is the interaction between Desipramine and Flecainide?
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; otherwise monitor ECG and tricyclic levels, and reduce the desipramine dose if toxicity appears.
What other medicines interact with Flecainide?
MediHelp also lists interactions of Flecainide with, for example, Nirmatrelvir, Nirmatrelvir / ritonavir, Pimozide. The full list is on the Flecainide page.
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