Drug interactions
Desipramine + Netupitant-palonosetron
Severity: Moderate
Desipramine and Netupitant-palonosetron: moderate 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
Palonosetron has been linked with serotonin syndrome when combined with serotonergic antidepressants such as desipramine. Netupitant, a moderate CYP3A4 inhibitor, may also slightly increase desipramine exposure. Neuromuscular, autonomic and mental status changes are the concern.
What this interaction means in plain words
Desipramine and Netupitant-palonosetron can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Desipramine belongs to Central Nervous System; Netupitant-palonosetron belongs to Gastrointestinal Tract.
Why it happens
Additive serotonergic activity, with a possible minor pharmacokinetic contribution from netupitant.
What to do
Monitor for serotonin syndrome and anticholinergic or cardiac effects of desipramine during the antiemetic cycle. Discontinue the antiemetic and give supportive care if toxicity emerges.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Netupitant-palonosetron
- Apomorphine + Netupitant-palonosetron Contraindicated
- Flibanserin + Netupitant-palonosetron Contraindicated
- Apalutamide + Netupitant-palonosetron Major
- Avapritinib + Netupitant-palonosetron Major
- Carbamazepine + Netupitant-palonosetron Major
- Cobimetinib + Netupitant-palonosetron Major
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 Netupitant-palonosetron?
MediHelp rates the interaction as moderate. Desipramine and Netupitant-palonosetron can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Palonosetron has been linked with serotonin syndrome when combined with serotonergic antidepressants such as desipramine. Netupitant, a moderate CYP3A4 inhibitor, may also slightly increase desipramine exposure. Neuromuscular, autonomic and mental status changes are the concern.
How serious is the interaction between Desipramine and Netupitant-palonosetron?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for serotonin syndrome and anticholinergic or cardiac effects of desipramine during the antiemetic cycle. Discontinue the antiemetic and give supportive care if toxicity emerges.
What other medicines interact with Netupitant-palonosetron?
MediHelp also lists interactions of Netupitant-palonosetron with, for example, Apomorphine, Flibanserin, Apalutamide. The full list is on the Netupitant-palonosetron page.
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