and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)desipramine, lisdexamfetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.lithiumMonitor Closely (2)desipramine and lithium both increase serotonin levels. Modify Therapy/Monitor Closely. lithium and desipramine both increase QTc interval. Use Caution/Monitor.Minor (1)lithium, desipramine. Other (see comment). Minor/Significance Unknown. Comment: Risk of neurotoxicity in geriatric pts. Multiple mechanisms involved.lofepramineMonitor Closely (2)desipramine and lofepramine both decrease cholinergic effects/transmission. Use Caution/Monitor. desipramine and lofepramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)desipramine and lofepramine both increase QTc interval. Avoid or Use Alternate Drug. desipramine and lofepramine both increase serotonin levels. Avoid or Use Alternate Drug.lofexidineMonitor Closely (2)desipramine decreases effects of lofexidine by unspecified interaction mechanism. Use Caution/Monitor. desipramine and lofexidine both increase sedation. Use Caution/Monitor.lomitapideContraindicated (1)desipramine increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Increases lomitapide levels several folds.loprazolamMonitor Closely (1)loprazolam and desipramine both increase sedation. Use Caution/Monitor.lorazepamMonitor Closely (1)lorazepam and desipramine both increase sedation. Use Caution/Monitor.lorcaserinMonitor Closely (1)lorcaserin will increase the level or effect of desipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)desipramine and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.lormetazepamMonitor Closely (1)lormetazepam and desipramine both increase sedation. Use Caution/Monitor.loxapineMonitor Closely (1)loxapine and desipramine both increase sedation. Use Caution/Monitor.loxapine inhaledMonitor Closely (1)loxapine inhaled and desipramine both increase sedation. Use Caution/Monitor.lsdMonitor Closely (1)desipramine and lsd both increase serotonin levels. Modify Therapy/Monitor Closely.lumefantrineSerious - Use Alternative (2)desipramine and lumefantrine both increase QTc interval. Avoid or Use Alternate Drug. lumefantrine will increase the level or effect of desipramine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.lurasidoneMonitor Closely (1)lurasidone increases effects of desipramine by Other (see comment). Use Caution/Monitor. Comment: Potential for increased risk of hypotension with concurrent use. Monitor blood pressure and adjust dose of antihypertensive agent as needed.macimorelinSerious - Use Alternative (1)macimorelin and desipramine both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.maprotilineMonitor Closely (2)desipramine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor. desipramine and maprotiline both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)desipramine and maprotiline both increase QTc interval. Avoid or Use Alternate Drug. desipramine and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.maravirocMonitor Closely (1)maraviroc will increase the level or effect of desipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.marijuanaMonitor Closely (2)marijuana will increase the level or effect of desipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. desipramine and marijuana both increase sedation. Use Caution/Monitor.meclizineMonitor Closely (1)meclizine and desipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.melatoninMonitor Closely (1)desipramine and melatonin both increase sedation. Use Caution/Monitor.meperidineMonitor Closely (1)meperidine and desipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)desipramine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.meprobamateMonitor Closely (1)desipramine and meprobamate both increase sedation. Use Caution/Monitor.mestranolMinor (1)mestranol, desipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.metaproterenolMonitor Closely (1)desipramine increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)desipramine, metaproterenol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.metaxaloneMonitor Closely (1)metaxalone and desipramine both increase sedation. Use Caution/Monitor.metforminMinor (1)desipramine increases effects of metformin by pharmacodynamic synergism. Minor/Significance Unknown.methadoneMonitor Closely (2)desipramine and methadone both increase QTc interval. Modify Therapy/Monitor Closely. methadone and desipramine both increase sedation. Use Caution/Monitor.methamphetamineMonitor Closely (1)desipramine increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)desipramine, methamphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.methocarbamolMonitor Closely (1)methocarbamol and desipramine both increase sedation. Use Caution/Monitor.methscopolamineMonitor Closely (1)methscopolamine and desipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.methylene blueSerious - Use Alternative (1)methylene blue and desipramine both increase serotonin levels. Avoid or Use Alternate Drug. Methylene blue may increase serotonin as a result of MAO-A inhibition. If methylene blue must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last methylene blue dose or after 2 weeks of monitoring, whichever comes first.methylenedioxymethamphetamineMonitor Closely (1)desipramine increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)desipramine, methylenedioxymethamphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.methylphenidateMonitor Closely (1)desipramine, methylphenidate. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.methylphenidate transdermalMonitor Closely (1)methylphenidate transdermal will increase the level or effect of desipramine by decreasing elimination. Modify Therapy/Monitor Closely. Consider decreasing the dose of these drugs when given coadministered with methylphenidate. Monitor for drug toxiticities when initiating or discontinuing methylphenidate. metoclopramide intranasalSerious - Use Alternative (1)desipramine, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.midazolamMonitor Closely (1)midazolam and desipramine both increase sedation. Use Caution/Monitor.midazolam intranasalMonitor Closely (1)midazolam intranasal, desipramine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.midodrineMonitor Closely (1)desipramine increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)desipramine, midodrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.mifepristoneMonitor Closely (1)mifepristone, desipramine. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.miglitolMinor (1)desipramine increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.milnacipranSerious - Use Alternative (1)milnacipran and desipramine both increase serotonin levels. Avoid or Use Alternate Drug.mirabegronMonitor Closely (1)mirabegron will increase the level or effect of desipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.mirtazapineMonitor Closely (2)desipramine and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely. desipramine and mirtazapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)mirtazapine and desipramine both increase QTc interval. Avoid or Use Alternate Drug.mobocertinibSerious - Use Alternative (1)mobocertinib and desipramine both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently.modafinilMonitor Closely (1)desipramine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.morphineMonitor Closely (2)desipramine and morphine both increase serotonin levels. Modify Therapy/Monitor Closely. morphine and desipramine both increase sedation. Use Caution/Monitor.motherwortMonitor Closely (1)desipramine and motherwort both increase sedation. Use Caution/Monitor.moxifloxacinSerious - Use Alternative (1)desipramine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.moxonidineMonitor Closely (1)desipramine and moxonidine both increase sedation. Use Caution/Monitor.nabiloneMonitor Closely (1)desipramine and nabilone both increase sedation. Use Caution/Monitor.nalbuphineMonitor Closely (1)nalbuphine and desipramine both increase sedation. Use Caution/Monitor.naldemedineMonitor Closely (1)desipramine increases levels of naldemedine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor naldemedine for potential adverse effects if coadministered with strong or moderate CYP3A4 inhibitors.naratriptanMonitor Closely (1)naratriptan and desipramine both increase serotonin levels. Modify Therapy/Monitor Closely.nateglinideMinor (1)desipramine increases effects of nateglinide by pharmacodynamic synergism. Minor/Significance Unknown.nefazodoneSerious - Use Alternative (1)nefazodone and desipramine both increase serotonin levels. Avoid or Use Alternate Drug.nefopamMonitor Closely (1)nefopam, desipramine. Mechanism: unspecified interaction mechanism. Use Caution/Monitor. Use combination with caution.nelfinavirMonitor Closely (1)nelfinavir will increase the level or effect of desipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.neostigmineMinor (1)neostigmine increases and desipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.netupitant/palonosetronSerious - Use Alternative (1)netupitant/palonosetron, desipramine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.nilotinibMonitor Closely (1)nilotinib will increase the level or effect of desipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)desipramine and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.norepinephrineMonitor Closely (2)desipramine increases effects of norepinephrine by unknown mechanism. Use Caution/Monitor. desipramine increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)desipramine, norepinephrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.nortriptylineMonitor Closely (2)desipramine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor. desipramine and nortriptyline both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)desipramine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug. desipramine and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.octreotideSerious - Use Alternative (1)desipramine and octreotide both increase QTc interval. Avoid or Use Alternate Drug.octreotide (Antidote)Serious - Use Alternative (1)desipramine and octreotide (Antidote) both increase QTc interval. Avoid or Use Alternate Drug.ofloxacinMonitor Closely (1)desipramine and ofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.olanzapineMonitor Closely (2)olanzapine and desipramine both increase sedation. Use Caution/Monitor. olanzapine and desipramine both increase QTc interval. Use Caution/Monitor.oliceridineMonitor Closely (2)desipramine, oliceridine. Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely. desipramine increases toxicity of oliceridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. Monitor for signs of urinary retention or reduced gastric motility if oliceridine is coadministered with anticholinergics.olodaterol inhaledMonitor Closely (1)desipramine and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. TCAs prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiasolopatadine intranasalSerious - Use Alternative (1)desipramine and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. onabotulinumtoxinAMinor (1)onabotulinumtoxinA and desipramine both decrease cholinergic effects/transmission. Minor/Significance Unknown.ondansetronSerious - Use Alternative (2)desipramine and ondansetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias. ondansetron, desipramine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.opium tinctureMonitor Closely (1)opium tincture and desipramine both increase sedation. Use Caution/Monitor.orphenadrineMonitor Closely (2)desipramine and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor. orphenadrine and desipramine both increase sedation. Use Caution/Monitor.osilodrostatMonitor Closely (1)osilodrostat and desipramine both increase QTc interval. Use Caution/Monitor.osimertinibMonitor Closely (1)osimertinib and desipramine both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.oxazepamMonitor Closely (1)oxazepam and desipramine both increase sedation. Use Caution/Monitor.oxybutyninMonitor Closely (1)oxybutynin and desipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.oxybutynin topicalMonitor Closely (1)oxybutynin topical and desipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.oxybutynin transdermalMonitor Closely (1)oxybutynin transdermal and desipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.oxycodoneMonitor Closely (1)oxycodone and desipramine both increase sedation. Use Caution/Monitor.oxymetazoline intranasalMonitor Closely (1)desipramine increases effects of oxymetazoline intranasal by pharmacodynamic synergism. Use Caution/Monitor. TCAs inhibit norepinephrine uptake in adrenergic neurons, thereby increasing synaptic norepinephrine levels. Coadministration with alpha1 agonists may cause increased adrenergic receptor stimulation. When oxymetazoline is combined with intranasal tetracaine for dental anesthesia, avoid or use alternant anesthetic in patients taking TCAs.oxymorphoneMonitor Closely (1)oxymorphone and desipramine both increase sedation. Use Caution/Monitor.ozanimodMonitor Closely (1)ozanimod and desipramine both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.Serious - Use Alternative (1)ozanimod increases toxicity of desipramine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for