Norpramin

Generic name: Desipramine
Drug class: Tricyclic antidepressants

Usage of Norpramin

Desipramine is used to treat depression. It works by increasing the activity of a chemical called norepinephrine in the brain. This medicine is a tricyclic antidepressant.

This medicine is available only with your doctor's prescription.

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 immediately if any of the following side effects occur:

Incidence not known

Abdominal or stomach pain

anxiety

black, tarry stools

blurred or double vision

burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

chest pain or discomfort

confusion about identity, place, and time

convulsions

cough or hoarseness

dark urine

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

dry mouth

fainting

fast, irregular, pounding, or racing heartbeat or pulse

inability to move the arms, legs, or facial muscles

inability to speak

irritability

light-colored stools

lightheadedness

loss of appetite

loss of bladder control

muscle spasms or jerking of all extremities

nausea

nightmares

pain or discomfort in the arms, jaw, back, or neck

painful or difficult urination

pinpoint red or purple spots on the skin

pounding in the ears

rash

restlessness

seeing, hearing, or feeling things that are not there

shakiness and unsteady walk

slow speech

sore throat and fever

sores, ulcers, or white spots on the lips or in the mouth

stiffness of the limbs

sudden loss of consciousness

sweating

swelling

swollen glands

talking, feeling, and acting with excitement

trouble sleeping

twisting body movements

unsteadiness, trembling, or problems with muscle control or coordination

unusual bleeding or bruising

unusual tiredness or weakness

vomiting

yellow eyes and skin

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

bigger, dilated, or enlarged pupils (black part of the eye)

bloating

constipation

decrease in the frequency of urination

decrease in urine volume

decreased interest in sexual intercourse

diarrhea

difficulty in passing urine (dribbling)

hair loss or thinning of the hair

inability to have or keep an erection

increased in sexual ability, desire, drive, or performance

increased interest in sexual intercourse

increased sensitivity of the 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.

Before taking 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:

Allergies

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.

Pediatric

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.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of desipramine in the elderly. However, elderly patients are more likely to have confusion, falling episodes, and age-related kidney problems, which may require an adjustment in the dose for patients receiving desipramine.

Breast Feeding

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.

Bepridil

Bromopride

Cisapride

Dronedarone

Furazolidone

Grepafloxacin

Iproniazid

Isocarboxazid

Levoketoconazole

Levomethadyl

Linezolid

Mesoridazine

Methylene Blue

Metoclopramide

Moclobemide

Pargyline

Phenelzine

Pimozide

Piperaquine

Potassium Citrate

Procarbazine

Ranolazine

Rasagiline

Safinamide

Selegiline

Sparfloxacin

Terfenadine

Thioridazine

Tranylcypromine

Ziprasidone

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.

Abiraterone Acetate

Acecainide

Aceclofenac

Acemetacin

Adagrasib

Albuterol

Alfentanil

Alfuzosin

Almotriptan

Amantadine

Amiodarone

Amisulpride

Amitriptyline

Amoxapine

Amphetamine

Amtolmetin Guacil

Anagrelide

Apomorphine

Aprindine

Aripiprazole

Aripiprazole Lauroxil

Arsenic Trioxide

Asenapine

Aspirin

Astemizole

Atazanavir

Azimilide

Azithromycin

Benzhydrocodone

Bretylium

Bufexamac

Buserelin

Butorphanol

Carisoprodol

Celecoxib

Ceritinib

Chloral Hydrate

Chloroquine

Chlorpromazine

Choline Salicylate

Ciprofloxacin

Citalopram

Clarithromycin

Clofazimine

Clomipramine

Clonidine

Clonixin

Clothiapine

Clozapine

Cobicistat

Codeine

Crizotinib

Cyclobenzaprine

Dabrafenib

Darifenacin

Darunavir

Dasatinib

Degarelix

Delamanid

Deslorelin

Desmopressin

Desvenlafaxine

Deutetrabenazine

Dexibuprofen

Dexketoprofen

Dexmedetomidine

Dextroamphetamine

Dextromethorphan

Diclofenac

Diflunisal

Dihydrocodeine

Dipyrone

Disopyramide

Dofetilide

Dolasetron

Domperidone

Donepezil

Doxorubicin

Doxorubicin Hydrochloride Liposome

Droperidol

Droxicam

Duloxetine

Efavirenz

Encorafenib

Enflurane

Entacapone

Entrectinib

Epinephrine

Erythromycin

Escitalopram

Etodolac

Etofenamate

Etoricoxib

Etrasimod

Fedratinib

Felbinac

Fenfluramine

Fenoprofen

Fentanyl

Fepradinol

Feprazone

Fexinidazole

Fingolimod

Flecainide

Floctafenine

Fluconazole

Flufenamic Acid

Fluoxetine

Flurbiprofen

Fluvoxamine

Formoterol

Foscarnet

Fostemsavir

Frovatriptan

Gatifloxacin

Gemifloxacin

Gepirone

Givosiran

Glasdegib

Glucagon

Glycopyrrolate

Glycopyrronium Tosylate

Gonadorelin

Goserelin

Granisetron

Halofantrine

Haloperidol

Halothane

Histrelin

Hydrocodone

Hydromorphone

Hydroxyamphetamine

Hydroxychloroquine

Hydroxytryptophan

Hydroxyzine

Ibuprofen

Ibutilide

Iloperidone

Imipramine

Indomethacin

Inotuzumab Ozogamicin

Iobenguane I 123

Iobenguane I 131

Isoflurane

Isradipine

Ivabradine

Ivosidenib

Ketoconazole

Ketoprofen

Ketorolac

Lapatinib

Lasmiditan

Lefamulin

Lenvatinib

Leuprolide

Levalbuterol

Levofloxacin

Levomilnacipran

Levorphanol

Lidoflazine

Lisdexamfetamine

Lithium

Lofexidine

Lopinavir

Lorcainide

Lorcaserin

Lornoxicam

Loxapine

Loxoprofen

Lumefantrine

Lumiracoxib

Macimorelin

Meclofenamate

Mefenamic Acid

Mefloquine

Meloxicam

Meperidine

Metaxalone

Methacholine

Methadone

Methamphetamine

Methylphenidate

Metronidazole

Mifepristone

Milnacipran

Mirtazapine

Mobocertinib

Moricizine

Morniflumate

Morphine

Morphine Sulfate Liposome

Moxifloxacin

Nabumetone

Nafarelin

Nalbuphine

Naproxen

Naratriptan

Nefopam

Nepafenac

Niflumic Acid

Nilotinib

Nimesulide

Nimesulide Beta Cyclodextrin

Norepinephrine

Norfloxacin

Nortriptyline

Octreotide

Ofloxacin

Olanzapine

Ondansetron

Osilodrostat

Osimertinib

Oxaliplatin

Oxaprozin

Oxycodone

Oxymetazoline

Oxymorphone

Oxyphenbutazone

Ozanimod

Pacritinib

Paliperidone

Palonosetron

Panobinostat

Parecoxib

Paroxetine

Pasireotide

Pazopanib

Peginterferon Alfa-2b

Pentamidine

Pentazocine

Phenylbutazone

Piketoprofen

Pimavanserin

Piroxicam

Pitolisant

Ponesimod

Posaconazole

Pranoprofen

Procainamide

Prochlorperazine

Proglumetacin

Promethazine

Propafenone

Propyphenazone

Proquazone

Protriptyline

Quetiapine

Quinidine

Quinine

Quizartinib

Relugolix

Remifentanil

Revefenacin

Ribociclib

Risperidone

Rofecoxib

Salicylic Acid

Salsalate

Scopolamine

Secretin Human

Selpercatinib

Sematilide

Sertindole

Sertraline

Sevoflurane

Siponimod

Sodium Phosphate

Sodium Phosphate, Dibasic

Sodium Phosphate, Monobasic

Sodium Salicylate

Solifenacin

Sorafenib

Sotalol

Spiramycin

Sufentanil

Sulfamethoxazole

Sulindac

Sulpiride

Sultopride

Sumatriptan

Sunitinib

Tacrolimus

Tapentadol

Tedisamil

Tegafur

Telavancin

Telithromycin

Tenoxicam

Tetrabenazine

Tiaprofenic Acid

Tiotropium

Tocilizumab

Tolfenamic Acid

Tolmetin

Toremifene

Tramadol

Trazodone

Triclabendazole

Trifluoperazine

Trimethoprim

Trimipramine

Triptorelin

Valdecoxib

Vandetanib

Vardenafil

Vemurafenib

Venlafaxine

Vilanterol

Vilazodone

Vinflunine

Voclosporin

Voriconazole

Vortioxetine

Zolmitriptan

Zotepine

Zuclopenthixol

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.

Acenocoumarol

Arbutamine

Atomoxetine

Bethanidine

Carbamazepine

Cimetidine

CinaCalcet

Clonazepam

Dicumarol

Mibefradil

Mirabegron

Phenprocoumon

Ritonavir

S-Adenosylmethionine

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.

Relate drugs

How to use 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 the instructions carefully. Ask your doctor or pharmacist if you have any questions.

Tell your doctor if you are also using other medicine to treat depression, such as amitriptyline, citalopram, fluoxetine, nortriptyline, paroxetine, or sertraline. You must wait at least 5 weeks after you stop using fluoxetine before you can start using desipramine.

Dosing

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 depression:

Adults—100 to 200 milligrams (mg) once a day or in divided doses during the day. Your doctor may adjust your dose if needed. However, the dose is usually not more than 300 mg per day.

Older adults and teenagers—25 to 100 mg once a day or in divided doses during the day. Your doctor may adjust your dose if needed. However, the dose is usually not more than 150 mg per day.

Children—Use and dose must be determined by your doctor.

Missed Dose

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.

Storage

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.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Warnings

It is very important that your doctor check your progress at regular visits to allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood tests may be needed to check for unwanted effects.

For some teenagers and young adults, this medicine can increase thoughts of suicide. Tell your doctor right away if you start to feel more depressed and have thoughts about hurting yourself. Report any unusual thoughts or behaviors that trouble you, especially if they are new or are getting worse quickly. Make sure the doctor knows if you have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Tell the doctor if you have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. Let the doctor know if you or anyone in your family has bipolar disorder (manic-depressive) or has tried to commit suicide.

Do not take desipramine with a monoamine oxidase (MAO) inhibitor (eg, isocarboxazid [Marplan®], phenelzine [Nardil®], selegiline [Eldepryl®], tranylcypromine [Parnate®]). Do not start taking desipramine during the 2 weeks after you stop a MAO inhibitor and wait 2 weeks after stopping desipramine before you start taking a MAO inhibitor. If you take them together or do not wait 2 weeks, you may develop confusion, agitation, restlessness, stomach or intestinal symptoms, a sudden high body temperature, an extremely high blood pressure, or severe convulsions.

Desipramine may cause a serious condition called serotonin syndrome if taken together with some medicines. Do not use desipramine with Buspirone (Buspar®), fentanyl (Abstral®, Duragesic®), linezolid (Zyvox®), lithium (Eskalith®, Lithobid®), methylene blue, tryptophan, St. John's wort, or some pain or migraine medicines (eg, sumatriptan, tramadol, Frova®, Maxalt®, Relpax®, Zomig®). Check with your doctor first before taking any other medicines with desipramine.

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, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using this medicine.

This medicine may raise or lower your blood sugar. If you are diabetic and notice a change in the results of your blood or urine sugar tests, check with your doctor.

Before having any kind of surgery, tell the medical doctor in charge that you are using this medicine. Taking desipramine together with medicines used during surgery may increase the risk of side effects.

Check with your doctor immediately if you have vision changes, such as blurred vision, difficulty reading, or eye pain, during or after treatment. This could be a sign of a serious eye problem.

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.

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 (eg, St. John's wort) or vitamin supplements.

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