Drug interactions
Desipramine + Physostigmine
Severity: Moderate
Desipramine and Physostigmine: 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
Desipramine has anticholinergic activity that opposes the cholinesterase inhibition of physostigmine, so the effect of physostigmine may be reduced. Physostigmine is also used to reverse tricyclic anticholinergic toxicity, but in tricyclic overdose it can provoke seizures and cardiac conduction problems.
What this interaction means in plain words
Desipramine and Physostigmine 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.
Why it happens
Pharmacodynamic antagonism between muscarinic blockade by desipramine and cholinesterase inhibition by physostigmine.
What to do
Avoid physostigmine for tricyclic overdose because of the risk of seizures and asystole. When both are used therapeutically, monitor cholinergic response and adjust the dose.
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 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 Physostigmine?
MediHelp rates the interaction as moderate. Desipramine and Physostigmine 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 has anticholinergic activity that opposes the cholinesterase inhibition of physostigmine, so the effect of physostigmine may be reduced. Physostigmine is also used to reverse tricyclic anticholinergic toxicity, but in tricyclic overdose it can provoke seizures and cardiac conduction problems.
How serious is the interaction between Desipramine and Physostigmine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid physostigmine for tricyclic overdose because of the risk of seizures and asystole. When both are used therapeutically, monitor cholinergic response and adjust the dose.
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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