Drug interactions
Desipramine + Fosamprenavir
Severity: Major
Desipramine and Fosamprenavir: 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
Fosamprenavir (given with ritonavir in many regimens) may raise desipramine concentrations, leading to anticholinergic effects, sedation, hypotension and cardiac conduction abnormalities or arrhythmias. The effect is more important with ritonavir boosting.
What this interaction means in plain words
Desipramine and Fosamprenavir 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.
Why it happens
Inhibition of CYP2D6 (largely via ritonavir) and other hepatic enzymes reduces desipramine clearance.
What to do
Start desipramine at a low dose and titrate to response, using plasma concentration and ECG monitoring where available. Consider an alternative antidepressant if toxicity develops.
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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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 Fosamprenavir?
MediHelp rates the interaction as major. Desipramine and Fosamprenavir 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. Fosamprenavir (given with ritonavir in many regimens) may raise desipramine concentrations, leading to anticholinergic effects, sedation, hypotension and cardiac conduction abnormalities or arrhythmias. The effect is more important with ritonavir boosting.
How serious is the interaction between Desipramine and Fosamprenavir?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start desipramine at a low dose and titrate to response, using plasma concentration and ECG monitoring where available. Consider an alternative antidepressant if toxicity develops.
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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