Drug interactions
Desipramine + Terbinafine
Severity: Major
Desipramine and Terbinafine: major 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 is mainly cleared by CYP2D6, and terbinafine has been shown to markedly increase desipramine exposure, mimicking poor metabolizer status. This can cause tricyclic toxicity including arrhythmia, anticholinergic effects and sedation.
What this interaction means in plain words
Desipramine and Terbinafine 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; Terbinafine belongs to Anti Fungals.
Why it happens
CYP2D6 inhibition by terbinafine strongly reduces desipramine metabolism.
What to do
Reduce the desipramine dose and monitor ECG and plasma concentrations, or use a non-CYP2D6-dependent antifungal; effect may persist for weeks after stopping terbinafine.
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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Other interactions of Terbinafine
- Terbinafine + Thioridazine Contraindicated
- Eliglustat + Terbinafine Major
- Flecainide + Terbinafine Major
- Imipramine + Terbinafine Major
- Maprotiline + Terbinafine Major
- Metoclopramide intranasal + Terbinafine Major
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 Terbinafine?
MediHelp rates the interaction as major. Desipramine and Terbinafine 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 is mainly cleared by CYP2D6, and terbinafine has been shown to markedly increase desipramine exposure, mimicking poor metabolizer status. This can cause tricyclic toxicity including arrhythmia, anticholinergic effects and sedation.
How serious is the interaction between Desipramine and Terbinafine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the desipramine dose and monitor ECG and plasma concentrations, or use a non-CYP2D6-dependent antifungal; effect may persist for weeks after stopping terbinafine.
What other medicines interact with Terbinafine?
MediHelp also lists interactions of Terbinafine with, for example, Thioridazine, Eliglustat, Flecainide. The full list is on the Terbinafine page.
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