Drug interactions
Desipramine + Trimipramine
Severity: Major
Desipramine and Trimipramine: 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
Combining two tricyclic antidepressants duplicates therapy and adds to anticholinergic, sedative, cardiac conduction and seizure-threshold effects. QT and QRS prolongation and arrhythmia risk increase, and trimipramine may compete for the metabolism of desipramine.
What this interaction means in plain words
Desipramine and Trimipramine 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; Trimipramine belongs to Central Nervous System.
Why it happens
Additive pharmacodynamic effects on cardiac conduction, anticholinergic and serotonergic/noradrenergic activity, with competition for CYP2D6 metabolism.
What to do
Avoid concurrent use of two tricyclics. If a cross-over is needed, taper one before starting the other and monitor the ECG and tricyclic levels.
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 Trimipramine
- Disopyramide + Trimipramine Contraindicated
- Dofetilide + Trimipramine Contraindicated
- Ibutilide + Trimipramine Contraindicated
- Isocarboxazid + Trimipramine Contraindicated
- Pentamidine + Trimipramine Contraindicated
- Phenelzine + Trimipramine 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 Trimipramine?
MediHelp rates the interaction as major. Desipramine and Trimipramine 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. Combining two tricyclic antidepressants duplicates therapy and adds to anticholinergic, sedative, cardiac conduction and seizure-threshold effects. QT and QRS prolongation and arrhythmia risk increase, and trimipramine may compete for the metabolism of desipramine.
How serious is the interaction between Desipramine and Trimipramine?
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 concurrent use of two tricyclics. If a cross-over is needed, taper one before starting the other and monitor the ECG and tricyclic levels.
What other medicines interact with Trimipramine?
MediHelp also lists interactions of Trimipramine with, for example, Disopyramide, Dofetilide, Ibutilide. The full list is on the Trimipramine page.
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