sedation. Use Caution/Monitor. aripiprazole and desipramine both increase QTc interval. Use Caution/Monitor.armodafinilMonitor Closely (1)desipramine increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.arsenic trioxideSerious - Use Alternative (1)desipramine and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.artemetherSerious - Use Alternative (1)artemether and desipramine both increase QTc interval. Avoid or Use Alternate Drug.artemether/lumefantrineSerious - Use Alternative (2)desipramine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug. artemether/lumefantrine will increase the level or effect of desipramine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.asenapineMonitor Closely (3)asenapine will increase the level or effect of desipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. asenapine and desipramine both increase sedation. Use Caution/Monitor. asenapine and desipramine both increase QTc interval. Use Caution/Monitor.asenapine transdermalMonitor Closely (2)asenapine transdermal and desipramine both increase QTc interval. Use Caution/Monitor. asenapine transdermal and desipramine both increase sedation. Use Caution/Monitor.atazanavirMonitor Closely (1)atazanavir increases levels of desipramine by unspecified interaction mechanism. Use Caution/Monitor.atomoxetineMonitor Closely (1)atomoxetine and desipramine both increase QTc interval. Use Caution/Monitor.atracuriumMinor (1)atracurium and desipramine both decrease cholinergic effects/transmission. Minor/Significance Unknown.atropineMinor (2)atropine and desipramine both decrease cholinergic effects/transmission. Minor/Significance Unknown. desipramine increases levels of atropine by unknown mechanism. Minor/Significance Unknown.atropine IV/IMMonitor Closely (1)atropine IV/IM and desipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.Minor (1)desipramine increases levels of atropine IV/IM by unknown mechanism. Minor/Significance Unknown.avapritinibMonitor Closely (1)avapritinib and desipramine both increase sedation. Use Caution/Monitor.axitinibSerious - Use Alternative (1)desipramine increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If unable to avoid coadministration with moderate CYP3A4 inhibitors, monitor closely and reduce dose if necessary .azelastineMonitor Closely (1)azelastine and desipramine both increase sedation. Use Caution/Monitor.azithromycinMonitor Closely (1)desipramine and azithromycin both increase QTc interval. Use Caution/Monitor.baclofenMonitor Closely (1)baclofen and desipramine both increase sedation. Use Caution/Monitor.bazedoxifene/conjugated estrogensMinor (1)bazedoxifene/conjugated estrogens, desipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.bedaquilineMonitor Closely (1)desipramine and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closelybelladonna alkaloidsMinor (1)belladonna alkaloids and desipramine both decrease cholinergic effects/transmission. Minor/Significance Unknown.belladonna and opiumMonitor Closely (2)belladonna and opium and desipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. belladonna and opium and desipramine both increase sedation. Use Caution/Monitor.benperidolMonitor Closely (1)benperidol and desipramine both increase sedation. Use Caution/Monitor.benzhydrocodone/acetaminophenMonitor Closely (1)benzhydrocodone/acetaminophen, desipramine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.Serious - Use Alternative (1)benzhydrocodone/acetaminophen and desipramine both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebenzphetamineMonitor Closely (1)desipramine increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)desipramine, benzphetamine. 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.benztropineMinor (1)benztropine and desipramine both decrease cholinergic effects/transmission. Minor/Significance Unknown.bethanecholMinor (1)bethanechol increases and desipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.bosutinibSerious - Use Alternative (1)desipramine increases levels of bosutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.brexpiprazoleMonitor Closely (2)desipramine will increase the level or effect of brexpiprazole by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Administer a quarter of brexpiprazole dose if coadministered with a moderate CYP2D6 inhibitor PLUS a strong/moderate CYP3A4 inhibitor. brexpiprazole and desipramine both increase sedation. Use Caution/Monitor.brimonidineMonitor Closely (1)brimonidine and desipramine both increase sedation. Use Caution/Monitor.Minor (1)desipramine decreases effects of brimonidine by pharmacodynamic antagonism. Minor/Significance Unknown.brivaracetamMonitor Closely (1)brivaracetam and desipramine both increase sedation. Use Caution/Monitor.brompheniramineMonitor Closely (1)brompheniramine and desipramine both increase sedation. Use Caution/Monitor.buprenorphineMonitor Closely (1)buprenorphine and desipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine and desipramine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine buccalMonitor Closely (1)buprenorphine buccal and desipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine buccal and desipramine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine subdermal implantMonitor Closely (1)desipramine, buprenorphine subdermal implant. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.Serious - Use Alternative (2)buprenorphine subdermal implant and desipramine both increase QTc interval. Avoid or Use Alternate Drug. buprenorphine subdermal implant and desipramine both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebuprenorphine transdermalSerious - Use Alternative (2)buprenorphine transdermal and desipramine both increase QTc interval. Avoid or Use Alternate Drug. buprenorphine transdermal and desipramine both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebuprenorphine, long-acting injectionMonitor Closely (1)desipramine, buprenorphine, long-acting injection. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.Serious - Use Alternative (2)buprenorphine, long-acting injection and desipramine both increase QTc interval. Avoid or Use Alternate Drug. buprenorphine, long-acting injection and desipramine both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebupropionMonitor Closely (2)bupropion will increase the level or effect of desipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. desipramine increases toxicity of bupropion by unspecified interaction mechanism. Use Caution/Monitor. May lower seizure threshold; keep bupropion dose as low as possible.buspironeSerious - Use Alternative (1)desipramine and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.butabarbitalMonitor Closely (1)butabarbital and desipramine both increase sedation. Use Caution/Monitor.Minor (1)butabarbital, desipramine. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.butalbitalMonitor Closely (1)butalbital and desipramine both increase sedation. Use Caution/Monitor.Minor (1)butalbital, desipramine. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.butorphanolMonitor Closely (1)butorphanol and desipramine both increase sedation. Use Caution/Monitor.caffeineMonitor Closely (1)desipramine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.calcium/magnesium/potassium/sodium oxybatesSerious - Use Alternative (1)desipramine, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.carbacholMinor (1)carbachol increases and desipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.carbamazepineMinor (1)carbamazepine decreases levels of desipramine by increasing metabolism. Minor/Significance Unknown.carbinoxamineMonitor Closely (1)carbinoxamine and desipramine both increase sedation. Use Caution/Monitor.carisoprodolMonitor Closely (1)carisoprodol and desipramine both increase sedation. Use Caution/Monitor.celecoxibMonitor Closely (1)celecoxib will increase the level or effect of desipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.cenobamateMonitor Closely (1)cenobamate, desipramine. Either increases effects of the other by sedation. Use Caution/Monitor.ceritinibMonitor Closely (1)ceritinib and desipramine both increase QTc interval. Use Caution/Monitor.cevimelineMinor (1)cevimeline increases and desipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.chloral hydrateMonitor Closely (1)chloral hydrate and desipramine both increase sedation. Use Caution/Monitor.chlordiazepoxideMonitor Closely (1)chlordiazepoxide and desipramine both increase sedation. Use Caution/Monitor.chloroquineMonitor Closely (2)chloroquine will increase the level or effect of desipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. chloroquine increases toxicity of desipramine by QTc interval. Use Caution/Monitor.chlorpheniramineMonitor Closely (1)chlorpheniramine and desipramine both increase sedation. Use Caution/Monitor.chlorpromazineMonitor Closely (1)chlorpromazine and desipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)chlorpromazine and desipramine both increase QTc interval. Avoid or Use Alternate Drug.Minor (2)desipramine, chlorpromazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects. desipramine, chlorpromazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.chlorpropamideMinor (1)desipramine increases effects of chlorpropamide by pharmacodynamic synergism. Minor/Significance Unknown.chlorzoxazoneMonitor Closely (1)chlorzoxazone and desipramine both increase sedation. Use Caution/Monitor.cimetidineMonitor Closely (1)cimetidine will increase the level or effect of desipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.cinnarizineMonitor Closely (1)cinnarizine and desipramine both increase sedation. Use Caution/Monitor.cisaprideMonitor Closely (1)desipramine and cisapride both increase QTc interval. Use Caution/Monitor.cisatracuriumMinor (1)cisatracurium and desipramine both decrease cholinergic effects/transmission. Minor/Significance Unknown.citalopramSerious - Use Alternative (2)citalopram and desipramine both increase serotonin levels. Avoid or Use Alternate Drug. Citalopram may increase TCA levels. Increased risk of serotonin syndrome or neuroleptic malignant syndrome. Potential risk for QT prolongation. ECG monitoring is recommended. desipramine and citalopram both increase QTc interval. Avoid or Use Alternate Drug.clarithromycinSerious - Use Alternative (1)desipramine and clarithromycin both increase QTc interval. Avoid or Use Alternate Drug.clemastineMonitor Closely (1)clemastine and desipramine both increase sedation. Use Caution/Monitor.clobazamMonitor Closely (2)clobazam will increase the level or effect of desipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Lower doses of drugs metabolized by CYP2D6 may be required when used concomitantly. desipramine, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).clomipramineMonitor Closely (2)clomipramine and desipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. clomipramine and desipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)clomipramine and desipramine both increase QTc interval. Avoid or Use Alternate Drug. clomipramine and desipramine both increase serotonin levels. Avoid or Use Alternate Drug.clonazepamMonitor Closely (1)clonazepam and desipramine both increase sedation. Use Caution/Monitor.clonidineSerious - Use Alternative (1)desipramine decreases effects of clonidine by Other (see comment). Avoid or Use Alternate Drug. Comment: Inhibition of uptake by adrenergic neurons.clorazepateMonitor Closely (1)clorazepate and desipramine both increase sedation. Use Caution/Monitor.clozapineMonitor Closely (2)clozapine and desipramine both increase sedation. Use Caution/Monitor. clozapine and desipramine both increase QTc interval. Use Caution/Monitor.cobicistatMonitor Closely (2)cobicistat will increase the level or effect of desipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Carefully titrate antidepressant to the desired effect, including using the lowest feasible initial or maintenance dose, and monitoring for antidepressant response cobicistat will increase the level or effect of desipramine by Other (see comment). Use Caution/Monitor. Carefully titrate dose of the antidepressant to the desired effect, including using the lowest feasible initial or maintenance dose, and monitor its response during coadministration with TCAs and cobicistat. cocaine topicalMonitor Closely (1)desipramine and cocaine topical both increase serotonin levels. Modify Therapy/Monitor Closely.codeineMonitor Closely (2)codeine and desipramine both increase sedation. Use Caution/Monitor. desipramine decreases effects of codeine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Prevents conversion of codeine to its active metabolite morphine.conjugated estrogensMinor (1)conjugated estrogens, desipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.conjugated estrogens, vaginalMinor (1)conjugated estrogens, vaginal, desipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.crizotinibMonitor Closely (1)crizotinib and desipramine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.cyclizineMonitor Closely (1)cyclizine and desipramine both increase sedation. Use Caution/Monitor.Minor (1)cyclizine and desipramine both decrease cholinergic effects/transmission. Minor/Significance Unknown.cyclobenzaprineMonitor Closely (1)cyclobenzaprine and desipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)desipramine and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.Minor (1)cyclobenzaprine and desipramine both decrease cholinergic effects/transmission. Minor/Significance Unknown.cyproheptadineMonitor Closely (1)cyproheptadine and desipramine both increase sedation. Use Caution/Monitor.dacomitinibSerious - Use Alternative (1)dacomitinib will increase the level or effect of desipramine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid use with CYP2D6 substrates where minimal increases in concentration of the CYP2D6 substrate may lead to serious or life-threatening toxicities. dantroleneMonitor Closely (1)dantrolene and desipramine both increase sedation. Use Caution/Monitor.daridorexantMonitor Closely (1)desipramine and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. darifenacinMonitor Closely (1)darifenacin will increase the level or effect of desipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.Minor (1)darifenacin and desipramine both decrease cholinergic effects/transmission. Minor/Significance Unknown.dasatinibMonitor Closely (1)desipramine and dasatinib both increase QTc interval.