Drug interactions
Desipramine + Primidone
Severity: Moderate
Desipramine and Primidone: 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
Primidone is metabolized to phenobarbital, so combined use with desipramine increases sedation and may impair alertness. Enzyme induction can lower desipramine levels, and tricyclics may lower the seizure threshold in patients with epilepsy.
What this interaction means in plain words
Desipramine and Primidone 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; Primidone belongs to Central Nervous System.
Why it happens
Additive CNS depression plus induction of hepatic metabolism of desipramine by primidone and its phenobarbital metabolite.
What to do
Monitor sedation, seizure control and antidepressant response, and consider desipramine concentration monitoring. Adjust the desipramine dose if efficacy falls.
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
Other interactions of Primidone
- Lorlatinib + Primidone Contraindicated
- Lurasidone + Primidone Contraindicated
- Primidone + Ranolazine Contraindicated
- Primidone + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Primidone + Voriconazole Contraindicated
- Abiraterone + Primidone Major
Frequently asked questions
Can I take Desipramine with Primidone?
MediHelp rates the interaction as moderate. Desipramine and Primidone 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. Primidone is metabolized to phenobarbital, so combined use with desipramine increases sedation and may impair alertness. Enzyme induction can lower desipramine levels, and tricyclics may lower the seizure threshold in patients with epilepsy.
How serious is the interaction between Desipramine and Primidone?
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 sedation, seizure control and antidepressant response, and consider desipramine concentration monitoring. Adjust the desipramine dose if efficacy falls.
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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