Drug interactions
Desipramine + Propafenone
Severity: Moderate
Desipramine and Propafenone: 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
Propafenone inhibits CYP2D6, the main pathway for desipramine clearance. Desipramine levels can rise considerably, leading to anticholinergic effects, sedation, and cardiac toxicity. Both agents also affect cardiac conduction.
What this interaction means in plain words
Desipramine and Propafenone 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; Propafenone belongs to Cardiovascular.
Why it happens
Propafenone inhibits CYP2D6-mediated metabolism of desipramine, with additive conduction effects.
What to do
Use a lower desipramine starting dose and titrate according to response, with plasma level monitoring where available. Perform ECG monitoring if the dose is raised.
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 Propafenone
- Dofetilide + Propafenone Contraindicated
- Dronedarone + Propafenone Contraindicated
- Nilotinib + Propafenone Contraindicated
- Nirmatrelvir / ritonavir + Propafenone Contraindicated
- Nirmatrelvir + Propafenone Contraindicated
- Pimozide + Propafenone Contraindicated
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 Propafenone?
MediHelp rates the interaction as moderate. Desipramine and Propafenone 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. Propafenone inhibits CYP2D6, the main pathway for desipramine clearance. Desipramine levels can rise considerably, leading to anticholinergic effects, sedation, and cardiac toxicity. Both agents also affect cardiac conduction.
How serious is the interaction between Desipramine and Propafenone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use a lower desipramine starting dose and titrate according to response, with plasma level monitoring where available. Perform ECG monitoring if the dose is raised.
What other medicines interact with Propafenone?
MediHelp also lists interactions of Propafenone with, for example, Dofetilide, Dronedarone, Nilotinib. The full list is on the Propafenone page.
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