Norpramin

Generic Name: desipramine (des-IP-ra-meen)
Brand Name: Norpramin

Antidepressants may increase the risk of suicidal thoughts or actions in children, teenagers, and young adults. However, depression and certain other mental problems may also increase the risk of suicide. Talk with the patient's doctor to be sure that the benefits of using Norpramin outweigh the risks.

Families and caregivers must closely watch patients who take Norpramin. It is important to keep in close contact with the patient's doctor. Tell the doctor right away if the patient has symptoms like worsened depression, suicidal thoughts, or changes in behavior. Discuss any questions with the patient's doctor.

Norpramin is not approved for use in children. Talk with the doctor.


Norpramin is used for:

Treating depression. It may be also be used for other conditions as determined by your doctor.

Norpramin is a tricyclic antidepressant. Exactly how it works is not fully understood. It is thought to increase the activity of certain chemicals in the brain (eg, norepinephrine, serotonin), which helps elevate mood.

Do NOT use Norpramin if:

  • you are allergic to any ingredient in Norpramin
  • you are recovering from a heart attack
  • you are taking or have taken linezolid or a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) within the last 14 days

Contact your doctor or health care provider right away if any of these apply to you.

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Before using Norpramin:

Some medical conditions may interact with Norpramin. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have had a severe allergic reaction (eg, severe rash, hives, difficulty breathing, dizziness) to another tricyclic medicine (eg, imipramine)
  • if you drink alcohol or have a history of alcohol abuse
  • if someone in your family has a history of sudden death or irregular heartbeat
  • if you have a history of glaucoma or increased pressure in the eye, an enlarged prostate, kidney or liver problems, diabetes, problems urinating, stroke, heart problems (eg, fast or irregular heartbeat, heart attack), other mental or mood problems (eg, bipolar disorder, schizophrenia), seizures (eg, epilepsy), suicidal thoughts or tendencies, thyroid problems, or porphyria (a blood disease)
  • if you are undergoing electroshock therapy or you are scheduled to have surgery
  • if you are taking thyroid medicine or a medicine that contains methylene blue

Some MEDICINES MAY INTERACT with Norpramin. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Linezolid or MAOIs (eg, phenelzine, rasagiline, selegiline) because a serious, sometimes life-threatening reaction, may occur
  • Droperidol or pimozide because the risk of a serious, sometimes life-threatening, irregular heartbeat may be increased
  • Tramadol because the risk of seizures may be increased
  • Abiraterone, antiarrhythmics (eg, flecainide, propafenone, quinidine), benzodiazepines (eg, diazepam), cimetidine, duloxetine, fluconazole, mibefradil, phenothiazines (eg, chlorpromazine, thioridazine), selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine, sertraline), or terbinafine because they may increase the risk of Norpramin's side effects
  • Anticholinergics (eg, oxybutynin, scopolamine) because they may decrease Norpramin's effectiveness
  • Anticoagulants (eg, warfarin) because the risk of their side effects, including bleeding, may be increased by Norpramin
  • Carbamazepine because the risk of its side effects may be increased by Norpramin
  • Clonidine, guanethidine, guanfacine, or sympathomimetics (eg, albuterol, amphetamine, pseudoephedrine) because their effectiveness may be decreased by Norpramin

This may not be a complete list of all interactions that may occur. Ask your health care provider if Norpramin may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Norpramin:

Use Norpramin as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Norpramin comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Norpramin refilled.
  • Take Norpramin by mouth with or without food.
  • If you are switching from fluoxetine to Norpramin, you may need to discontinue fluoxetine for up to 5 weeks before starting Norpramin. Ask your doctor if you have any questions.
  • Taking Norpramin at bedtime may help reduce side effects such as daytime drowsiness. Discuss this possibility with your health care provider.
  • Continue to take Norpramin even if you feel well. Do not miss any doses.
  • If you miss a dose of Norpramin, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Norpramin.

Important safety information:

  • Norpramin may cause drowsiness, dizziness, blurred vision, or light-headedness. These effects may be worse if you take it with alcohol or certain medicines. Use Norpramin with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Check with your doctor before you drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Norpramin; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
  • Norpramin may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
  • Norpramin may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Norpramin. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
  • Diabetes patients - Norpramin may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
  • Neuroleptic malignant syndrome (NMS) is a possibly fatal syndrome that can be caused by Norpramin. Symptoms may include fever; stiff muscles; confusion; abnormal thinking; fast or irregular heartbeat; and sweating. Contact your doctor at once if you have any of these symptoms.
  • Do not become overheated in hot weather or while you are being active; heatstroke may occur.
  • After you start using Norpramin, several weeks may pass before you feel the full benefit.
  • Children and teenagers who take Norpramin may be at increased risk for suicidal thoughts or actions. Adults may also be affected. Watch patients who take Norpramin closely. Contact the doctor at once if new, worsened, or sudden symptoms, such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior, occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.
  • Tell your doctor or dentist that you take Norpramin before you receive any medical or dental care, emergency care, or surgery.
  • Use Norpramin with caution in the ELDERLY; they may be more sensitive to its effects, especially confusion. Elderly patients may also be at a greater risk for falls while taking Norpramin.
  • Norpramin should not be used in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Norpramin while you are pregnant. Norpramin is found in breast milk. Do not breast-feed while taking Norpramin.

If you are on long-term therapy and you stop taking Norpramin suddenly, you may have WITHDRAWAL symptoms. These may include nausea, headache, and fatigue. Do not suddenly stop taking Norpramin or change dosage without asking your pharmacist or doctor first.

Possible side effects of Norpramin:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; diarrhea; dizziness; drowsiness; dry mouth; headache; loss of appetite; nausea; tiredness; trouble sleeping; vomiting; weakness; weight changes.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision or other vision changes; burning, numbness, or tingling; changes in sexual desire or ability; chest, jaw, or arm pain; confusion; decreased coordination; fainting; fast or irregular heartbeat; fever, chills, or sore throat; new or worsening mood or mental changes (eg, agitation, anxiety, delusions, hallucinations, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being); one-sided weakness; restlessness or inability to sit still; ringing in the ears; seizures; severe or persistent constipation or stomach pain; severe or persistent dizziness or headache; severe or persistent trouble sleeping; shortness of breath; slurred speech; sudden, severe nausea or vomiting; sudden unusual sweating; suicidal thoughts or actions; symptoms of liver problems (eg, dark urine, pale stools, persistent loss of appetite, severe stomach pain, yellowing of the skin or eyes); tremor; trouble urinating; uncontrolled muscle movements (eg, twitching of the face or tongue; loss of balance; uncontrollable movements of arms or legs; trouble speaking or swallowing); unusual bleeding or bruising.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include agitation; body temperature changes; confusion; decreased concentration; enlarged pupils; fainting; fast or irregular heartbeat; hallucinations; rigid muscles; seizures; severe dizziness or drowsiness.

Proper storage of Norpramin:

Store Norpramin at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Norpramin out of the reach of children and away from pets.

General information:

  • If you have any questions about Norpramin, please talk with your doctor, pharmacist, or other health care provider.
  • Norpramin is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take Norpramin or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about Norpramin. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to Norpramin. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using Norpramin.

Issue Date: July 2, 2014
Database Edition 14.3.1.001
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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