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Drug interactions

Desipramine + Fluconazole

Severity: Major

Desipramine and Fluconazole: major interaction.

Last updated

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 drugs can prolong the QT interval, and fluconazole may raise desipramine concentrations. The combination increases the risk of arrhythmia and tricyclic toxicity.

What this interaction means in plain words

Desipramine and Fluconazole 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; Fluconazole belongs to Anti Fungals.

Evidence level: Moderate

Why it happens

Additive QT prolongation, with fluconazole inhibition of CYP2D6/CYP2C19 pathways that clear desipramine.

What to do

Obtain a baseline ECG and monitor QTc. Consider a lower desipramine dose with drug level monitoring, or choose an alternative antifungal.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Desipramine with Fluconazole?

MediHelp rates the interaction as major. Desipramine and Fluconazole 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 drugs can prolong the QT interval, and fluconazole may raise desipramine concentrations. The combination increases the risk of arrhythmia and tricyclic toxicity.

How serious is the interaction between Desipramine and Fluconazole?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain a baseline ECG and monitor QTc. Consider a lower desipramine dose with drug level monitoring, or choose an alternative antifungal.

What other medicines interact with Fluconazole?

MediHelp also lists interactions of Fluconazole with, for example, Dihydroergotamine intranasal, Dihydroergotamine, Dofetilide. The full list is on the Fluconazole page.

Full monographs, dosing and an interaction checker in the MediHelp app

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