Drug interactions
Desipramine + Protriptyline
Severity: Major
Desipramine and Protriptyline: 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
Two tricyclic antidepressants give duplicate therapy with additive QT prolongation, anticholinergic effects, sedation and seizure risk. Serotonergic toxicity is also possible, and overdose-type toxicity may occur.
What this interaction means in plain words
Desipramine and Protriptyline 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.
Why it happens
Additive pharmacodynamic effects on cardiac conduction, monoamine reuptake and muscarinic blockade.
What to do
Avoid using two tricyclics together and consolidate to one agent. If a switch is made, cross-taper and monitor the ECG and for anticholinergic or serotonergic signs.
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
Frequently asked questions
Can I take Desipramine with Protriptyline?
MediHelp rates the interaction as major. Desipramine and Protriptyline 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. Two tricyclic antidepressants give duplicate therapy with additive QT prolongation, anticholinergic effects, sedation and seizure risk. Serotonergic toxicity is also possible, and overdose-type toxicity may occur.
How serious is the interaction between Desipramine and Protriptyline?
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 using two tricyclics together and consolidate to one agent. If a switch is made, cross-taper and monitor the ECG and for anticholinergic or serotonergic signs.
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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