Generic Name: desipramine (Oral route)
Antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults in short-term studies with major depressive disorder (MDD) and other psychiatric disorders. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24, and there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. This risk must be balanced with the clinical need. Monitor patients closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Not approved for use in pediatric patients .
Commonly used brand name(s)
In the U.S.
Available Dosage Forms:
Therapeutic Class: Antidepressant
Pharmacologic Class: Antidepressant, Tricyclic
Uses For Norpramin
Desipramine is used to treat mental depression. This medicine is a tricyclic antidepressant (TCA) .
This medicine is available only with your doctor's prescription .
Before Using Norpramin
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies have not been performed on the relationship of age to the effects of desipramine in the pediatric population. Safety and efficacy have not been established .
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of desipramine in the elderly. However, confusion and falling are more likely to occur in the elderly, who are usually more sensitive than younger adults to the effects of desipramine. Also, elderly patients may require an adjustment of dosage because of age-related kidney problems .
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Interactions with Medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Methylene Blue
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Arsenic Trioxide
- Chloral Hydrate
- Perflutren Lipid Microsphere
- Sodium Phosphate
- Sodium Phosphate, Dibasic
- Sodium Phosphate, Monobasic
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Interactions with Food/Tobacco/Alcohol
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Other Medical Problems
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
- Bipolar disorder (mood disorder with alternating episodes of mania and depression), or risk of or
- Heart attack, recent—Should not be used in patients with these conditions .
- Glaucoma, history of or
- Heart disease or
- Schizophrenia or
- Seizures, history of or
- Thyroid disease or
- Urinary retention (trouble urinating), history of—Use with caution. May make these conditions worse .
- Kidney disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body .
Proper Use of Norpramin
Take this medicine only as directed by your doctor to benefit your condition as much as possible. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered .
This medicine should come with a medication guide. Read and follow these instructions carefully. Ask your doctor if you have any questions .
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For oral dosage form (tablets):
- For mental depression:
- Adults—100 to 200 milligrams (mg) once a day or in divided doses per day. Your doctor may increase your dose if needed. However, the dose is usually not more than 300 mg a day.
- Teenagers—25 to 100 milligrams (mg) once a day or in divided doses per day. Your doctor may increase your dose if needed. However, the dose is usually not more than 150 mg a day.
- Children—Use and dose must be determined by your doctor .
- For mental depression:
If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Keep out of the reach of children.
Ask your healthcare professional how you should dispose of any medicine you do not use.
Do not keep outdated medicine or medicine no longer needed.
Precautions While Using Norpramin
It is very important that your doctor check your progress at regular visits to allow for changes in your dose. Blood tests will be needed to check for any unwanted effects .
Desipramine may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you, your child, or your caregiver notice any of these side effects, tell your doctor or your child's doctor right away .
Do not take desipramine if you have taken a monoamine oxidase (MAO) inhibitor (isocarboxazid [e.g., Marplan], phenelzine [e.g., Nardil], selegiline [e.g., Eldepryl], or tranylcypromine [e.g., Parnate]) in the past 2 weeks. Do not start taking a MAO inhibitor within 2 weeks of stopping desipramine. If you do, you may develop confusion, agitation, restlessness, stomach or intestinal symptoms, sudden high body temperature, extremely high blood pressure, or severe convulsions .
Do not stop taking this medicine without first checking with your doctor. Your doctor may want you to reduce gradually the amount you are using before stopping completely. This may help prevent a possible worsening of your condition and reduce the possibility of withdrawal symptoms such as headache, nausea, or a general feeling of discomfort or illness .
This medicine will add to the effects of alcohol and other central nervous system (CNS) depressants (medicines that cause drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies or colds; sedatives, tranquilizers, or sleeping medicines; prescription pain medicine or narcotics; barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using this medicine.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements .
This medicine may raise or lower your blood sugar. If you notice a change in the results of your blood or urine sugar tests or if you have any questions, check with your doctor .
Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests .
This medicine may cause some people to become drowsy or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are drowsy or not alert.
Norpramin Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:Incidence not known
- Abdominal or stomach pain
- actions that are out of control
- black, tarry stools
- bleeding and bruising
- bleeding gums
- blurred vision
- burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- chest pain or discomfort
- confusion about identity, place, and time
- cough or hoarseness
- dark urine
- difficulty in speaking
- dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
- double vision
- dry mouth
- false beliefs that cannot be changed by facts
- fear or nervousness
- inability to move arms, legs, or facial muscles
- inability to speak
- irregular heartbeat
- lack of coordination
- light-colored stools
- loss of appetite
- loss of balance control
- loss of bladder control
- lower back or side pain
- muscle spasm or jerking of all extremities
- muscle trembling, jerking, or stiffness
- pain or discomfort in arms, jaw, back, or neck
- painful or difficult urination
- pinpoint red or purple spots on skin
- pounding in the ears
- seeing, hearing, or feeling things that are not there
- shakiness and unsteady walk
- shortness of breath
- shuffling walk
- slow or fast heartbeat
- slow speech
- sore throat and fever
- sores, ulcers, or white spots on lips or in mouth
- stiffness of limbs
- sudden loss of consciousness
- swelling of testes
- swollen glands
- talking, feeling, and acting with excitement
- trouble sleeping irregular heartbeats
- twisting movements of body
- unable to sleep
- uncontrolled movements, especially of face, neck, and back
- unpleasant breath odor
- unsteadiness, trembling, or other problems with muscle control or coordination
- unusual bleeding or bruising
- unusual tiredness or weakness
- upper right abdominal pain
- vomiting of blood
- yellow eyes and skin
Get emergency help immediately if any of the following symptoms of overdose occur:Symptoms of overdose
- decreased awareness or responsiveness
- drowsiness to profound coma
- low body temperature
- mood or other mental changes
- muscle aches
- severe sleepiness
- weak or feeble pulse
- weight gain
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:Incidence not known
- Abdominal or stomach cramps or pain
- bigger, dilated, or enlarged pupils (black part of eye)
- decrease in frequency of urination
- decrease in urine volume
- decreased interest in sexual intercourse
- difficulty in passing urine (dribbling)
- hair loss, thinning of hair
- inability to have or keep an erection
- increased in sexual ability, desire, drive, or performance
- increased interest in sexual intercourse
- increased sensitivity of eyes to light
- loss in sexual ability, desire, drive, or performance
- painful urination
- swelling of the breasts or breast soreness in both females and males
- swelling or inflammation of the mouth
- unexpected or excess milk flow from breasts in females
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
See also: Norpramin side effects (in more detail)
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