Drug Notebook

FDA Alerts

    Suicidality
  • Antidepressants may increase risk of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults (18–24 years of age) with major depressive disorder and other psychiatric disorders; balance this risk with clinical need. Desipramine is not approved for use in pediatric patients. (See Pediatric Use under Cautions.)
  • In pooled data analyses, risk of suicidality was not increased in adults >24 years of age and apparently was reduced in adults ≥65 years of age with antidepressant therapy compared with placebo.
  • Depression and certain other psychiatric disorders are themselves associated with an increased risk of suicide.
  • Appropriately monitor and closely observe all patients who are started on desipramine therapy for clinical worsening, suicidality, or unusual changes in behavior; involve family members and/or caregivers in this process. (See Worsening of Depression and Suicidality Risk under Cautions.)

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desipramine
(des IP ra meen)

What is desipramine?
Desipramine is a tricyclic antidepressant. Desipramine affects chemicals in the brain that may become unbalanced. Desipramine is used to treat symptoms of depression. Desipramine may also be used for purposes other than those listed in this medication guide.

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What is the price of this medication and similar alternatives?

This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

Desipramine HCl 10MG Tablets SANDOZ60/$19.99 or 120/$29.99
Desipramine HCl 100MG Tablets SANDOZ30/$24.99 or 90/$59.98
Desipramine HCl 150MG Tablets SANDOZ30/$29.99 or 90/$69.98
Desipramine HCl 25MG Tablets SANDOZ60/$20.99 or 120/$31.98
Desipramine HCl 50MG Tablets SANDOZ60/$28.99 or 180/$64.98
Desipramine HCl 75MG Tablets EON LABS60/$32.99 or 180/$75.96
Norpramin 10MG Tablets AVENTIS60/$61.84 or 180/$179.01
Norpramin 100MG Tablets AVENTIS30/$110.46 or 90/$317.57
Norpramin 150MG Tablets AVENTIS30/$162.74 or 90/$474.08
Norpramin 25MG Tablets AVENTIS60/$74.85 or 180/$213.7
Norpramin 50MG Tablets AVENTIS60/$135.62 or 180/$392.74
Norpramin 75MG Tablets AVENTIS60/$170.34 or 180/$490.41

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What are the possible side effects of desipramine?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have any of these serious side effects:

  • fast, pounding, or uneven heart rate;

  • chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;

  • sudden numbness or weakness, especially on one side of the body;

  • sudden headache, confusion, problems with vision, speech, or balance;

  • confusion, hallucinations, or seizure (convulsions);

  • easy bruising or bleeding, unusual weakness;

  • feeling light-headed, fainting;

  • tremors, restless muscle movements in your eyes, tongue, jaw, or neck;

  • fever with confusion, muscle stiffness, sweating, and fast or uneven heartbeats;

  • urinating more or less than usual;

  • extreme thirst with headache, nausea, vomiting, and weakness;

  • skin rash, bruising, severe tingling, numbness, pain, and muscle weakness; or

  • nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may be more likely to occur, such as:

  • vomiting, constipation;

  • dry mouth, unpleasant taste;

  • weakness, lack of coordination;

  • feeling anxious, restless, dizzy, or drowsy;

  • sleep problems (insomnia), nightmares;

  • blurred vision, trouble concentrating, headache, ringing in your ears;

  • breast swelling (in men or women); or

  • decreased sex drive, impotence, or difficulty having an orgasm.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

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How should I take desipramine?
Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from this medication. Follow the directions on your prescription label. If you need to have any type of surgery, tell the surgeon ahead of time that you are taking desipramine. You may need to stop using the medicine for a short time. Do not stop using desipramine without first talking to your doctor. You may need to use less and less before you stop the medication completely. Stopping this medication suddenly could cause you to have unpleasant side effects.

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What is the most important information I should know about desipramine?
Do not use this medication if you have recently had a heart attack, or if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment. Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

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What happens if I miss a dose?
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

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What other drugs will affect desipramine?
Before taking desipramine, tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft). Before taking desipramine, tell your doctor if you are currently using any of the following drugs: cimetidine (Tagamet); guanethidine (Ismelin); or heart rhythm medications such as flecainide (Tambocor), propafenone (Rhythmol), or quinidine (Cardioquin, Quinidex, Quinaglute).

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Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Desipramine has not been formally assigned to a pregnancy category by the FDA. Use of desipramine during pregnancy has been associated with neonatal withdrawal. There are no controlled data in human pregnancy. Desipramine should only be given during pregnancy when there are no alternatives and benefit outweighs risk.

Desipramine is excreted into human milk in small amounts. The American Academy of Pediatrics classifies desipramine as a drug "whose effect on nursing infants is unknown but may be of concern".

One case has been reported in which the level of desipramine and its metabolite , 2-hydroxydesipramine, were measured in the milk and the plasma of an infant and his mother. Concentrations were similar between the maternal plasma and breast milk; however, neither compound was detected in the infant's serum. The authors calculated that the 4 kg infant would ingest about 1/100th of the maternal dose of 300 mg/day in a 24 hour period.

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Who should NOT use this medication?

  • Concurrent or recent (i.e., within 2 weeks) therapy with an MAO inhibitor. (See Specific Drugs under Interactions.)
  • During the acute recovery phase following MI.
  • Known hypersensitivity to desipramine. (See Cross-Hypersensitivity under Cautions.)

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What does my medication look like?
Desipramine is available with a prescription generically and under the brand name Norpramin. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you. Norpramin 10 mg--round, blue, coated tablets Norpramin 25 mg--round, yellow, coated tablets Norpramin 50 mg--round, green, coated tablets Norpramin 75 mg--round, orange, coated tablets Norpramin 100 mg--round, peach, coated tablets Norpramin 150 mg--round, white, coated tablets

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What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine. An overdose of desipramine can be fatal. Symptoms may include uneven heartbeats, extreme drowsiness, vomiting, blurred vision, confusion, hallucinations, muscle stiffness, feeling hot or cold, seizure (convulsions), or coma.

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What should I discuss with my healthcare provider before taking desipramine?
Do not use this medication if you are allergic to desipramine, or if you have recently had a heart attack. Do not use desipramine if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take desipramine before the MAO inhibitor has cleared from your body. Before taking desipramine, tell your doctor if you are allergic to any drugs, or if you have:

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Can I stop taking the medication if I feel better?
As a general rule, you should always take your medications exactly as prescribed and do not change the dosage or stop taking the medication without first discussing it with your healthcare provider.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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Where can I get more information?
More Information

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