Desipramine is a tricyclic antidepressant that is used to treat symptoms of depression.

Desipramine may also be used for purposes not listed in this medication guide.

You should not use desipramine if you have recently had a heart attack.

Do not use this medicine within 14 days before or after taking an MAO inhibitor, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

If you need surgery, tell your surgeon you currently use desipramine. You may need to stop for a short time.

It may take up to 3 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.

Do not stop using desipramine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

Usual Adult Dose for Depression:

100 to 200 mg orally per day
-Maximum dose: 300 mg/day

Comments:
-Doses should be initiated at a lower level and increased according to tolerance and clinical response.
-In severely ill patients, doses may be further increased to 300 mg per day if needed.
-Treatment of patients requiring as much as 300 mg should generally be initiated in a hospital setting.

Use: Treatment of depression

Usual Geriatric Dose for Depression:

25 to 100 mg orally per day
-Maximum dose: 150 mg/day

Comments:
-Doses should be initiated at a lower level and increased according to tolerance and clinical response.
-Initial treatment may be given once a day or in divided doses.
-In severely ill patients, doses may be further increased to 150 mg/day if needed.
-Most patients should not exceed doses of 100 mg/day.

Use: Treatment of depression

You should not use desipramine if you are allergic to it, or:

• if you have recently had a heart attack.

Do not use desipramine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others. Do not take an MAOI for at least 2 weeks after you stop taking desipramine.

Tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone.

Tell your doctor if you have ever had:

• bipolar disorder (manic-depression) or schizophrenia;

• mental illness or psychosis;

• liver disease;

• heart disease;

• a family history of sudden death related to a heart rhythm disorder;

• a heart attack, stroke, or seizures;

• a thyroid disorder;

• glaucoma; or

• problems with urination.

Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. These medicines may interact with desipramine and cause a serious condition called serotonin syndrome.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Tell your doctor if you are pregnant or breastfeeding.

Desipramine is not approved for use by anyone younger than 18 years old.

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of desipramine can be fatal.

Overdose symptoms may include irregular heartbeats, feeling like you might pass out, seizures, or coma.

Keep this medication in the container it came in, tightly closed, and out of the reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

Unless your doctor tells you otherwise, continue your normal diet.

Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with desipramine.

Avoid driving or hazardous activity until you know how desipramine will affect you. Your reactions could be impaired.

Avoid exposure to sunlight or tanning beds. Desipramine can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Desipramine may cause serious side effects. Call your doctor at once if you have:

• easy bruising, unusual bleeding, purple or red spots under your skin;

• a light-headed feeling, like you might pass out;

• confusion, hallucinations, unusual thoughts or behavior;

• blurred vision, tunnel vision, eye pain or swelling, seeing halos around lights;

• new or worsening chest pain, pounding heartbeats or fluttering in your chest;

• sudden numbness or weakness, problems with vision, speech, or balance;

• fever, sore throat;

• easy bruising, unusual bleeding (nose, mouth, vagina, or rectum);

• painful or difficult urination;

• upper stomach pain, loss of appetite, jaundice (yellowing of the skin or eyes);

• a seizure; or

• severe nervous system reaction--very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Serious side effects may be more likely in older adults and those who are ill or debilitated.

Common side effects of desipramine may include:

• increased blood pressure;

• tingly feeling, weakness, lack of coordination;

• dry mouth, loss of appetite, nausea, vomiting;

• breast swelling (in men or women); or

• weight gain or weight loss.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Using desipramine with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Many drugs can affect desipramine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.

Keep all appointments with your doctor.

Do not allow anyone else to take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.