Drug interactions
Desipramine + Ranolazine
Severity: Major
Desipramine and Ranolazine: 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
Ranolazine inhibits CYP2D6 and can increase desipramine levels, and both drugs prolong the QT interval. This raises the risk of arrhythmia and anticholinergic or cardiac toxicity.
What this interaction means in plain words
Desipramine and Ranolazine 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; Ranolazine belongs to Cardiovascular.
Why it happens
CYP2D6 inhibition by ranolazine increases desipramine exposure, with additive QT prolongation.
What to do
Monitor ECG and desipramine adverse effects, and lower the desipramine dose if needed; consider an alternative if QT risk factors are present.
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 Ranolazine
- Adagrasib + Ranolazine Contraindicated
- Amobarbital + Ranolazine Contraindicated
- Apalutamide + Ranolazine Contraindicated
- Butabarbital + Ranolazine Contraindicated
- Carbamazepine + Ranolazine Contraindicated
- Clarithromycin + Ranolazine 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 Ranolazine?
MediHelp rates the interaction as major. Desipramine and Ranolazine 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. Ranolazine inhibits CYP2D6 and can increase desipramine levels, and both drugs prolong the QT interval. This raises the risk of arrhythmia and anticholinergic or cardiac toxicity.
How serious is the interaction between Desipramine and Ranolazine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor ECG and desipramine adverse effects, and lower the desipramine dose if needed; consider an alternative if QT risk factors are present.
What other medicines interact with Ranolazine?
MediHelp also lists interactions of Ranolazine with, for example, Adagrasib, Amobarbital, Apalutamide. The full list is on the Ranolazine page.
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