Drug interactions
Desipramine + Paroxetine
Severity: Major
Desipramine and Paroxetine: 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
Paroxetine strongly inhibits CYP2D6 and can markedly raise desipramine concentrations, increasing the risk of cardiac conduction abnormalities, anticholinergic effects and seizures. Additive serotonergic activity also raises the risk of serotonin syndrome.
What this interaction means in plain words
Desipramine and Paroxetine 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; Paroxetine belongs to Central Nervous System.
Why it happens
CYP2D6 inhibition by paroxetine reduces desipramine clearance, with additive serotonin reuptake inhibition.
What to do
Avoid if possible; otherwise reduce the desipramine dose substantially and guide it by serum levels and ECG. Monitor for signs of serotonin toxicity.
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 Desipramine
- Desipramine + Disopyramide Contraindicated
- Desipramine + Dofetilide Contraindicated
- Desipramine + Ibutilide Contraindicated
- Desipramine + Isocarboxazid Contraindicated
- Desipramine + Methylene blue Contraindicated
- Desipramine + Pentamidine Contraindicated
Other interactions of Paroxetine
- Isocarboxazid + Paroxetine Contraindicated
- Methylene blue + Paroxetine Contraindicated
- Paroxetine + Phenelzine Contraindicated
- Paroxetine + Pimozide Contraindicated
- Paroxetine + Procarbazine Contraindicated
- Paroxetine + Selegiline Contraindicated
Frequently asked questions
Can I take Desipramine with Paroxetine?
MediHelp rates the interaction as major. Desipramine and Paroxetine 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. Paroxetine strongly inhibits CYP2D6 and can markedly raise desipramine concentrations, increasing the risk of cardiac conduction abnormalities, anticholinergic effects and seizures. Additive serotonergic activity also raises the risk of serotonin syndrome.
How serious is the interaction between Desipramine and Paroxetine?
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 reduce the desipramine dose substantially and guide it by serum levels and ECG. Monitor for signs of serotonin toxicity.
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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