See Supplemental Patient Information
- Worsening of depression and/or the emergence of suicidal ideation and behavior (suicidality) or unusual changes in behavior may occur in patients with major depressive disorder (MDD), whether or not they are taking antidepressant medications; this risk may persist until significant remission occurs
- Children, adolescents, and young adults (ages 18-24) with major depressive disorder (MDD) and other psychiatric disorders are more prone to suicidality; suicidality risk did not increase in patients >24 yrs of age, and risk decreased in patients >65 yrs of age
- Monitor and closely observe patients for clinical worsening, suicidality, or unusual changes in behavior specially during the initial few months of a course of drug therapy or at times of dose modifications [US Black Box Warning]
- Anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania, and mania may occur during therapy in adults and pediatric patients
- Consider changing the therapeutic regimen or discontinuation of therapy on persistent worsening of depression, on experiencing emergent suicidality or abrupt onset of severe symptoms suggesting worsening of depression or suicidality, especially if these were not part of the patient's presenting symptoms
- Advise families and caregivers of patient to remain alert about the need of monitoring patients for the emergence of agitation, irritability, unusual changes in behavior, emergence of suicidality and the other symptoms. Instruct them to promptly report such symptoms to health care providers
- Prescribe smallest quantity to reduce the risk of overdose
- Prior to initiating antidepressant therapy, determine if the patients with depressive symptoms are at risk for bipolar disorder. Screening should include a detailed psychiatric history, including a family history of suicide, bipolar disorder, and depression
- Desipramine is unapproved for use in treating bipolar depression
- Desipramine is excreted by the kidney; hence, risk of toxic reactions to this drug may be greater in patients with impaired renal function
- Use of therapy in elderly patients has been associated with a proneness to falling as well as confusional states
- Carefully supervise seriously depressed patients during the early phase of treatment
- Desipramine should be dispensed in containers with child-resistant safety closures
- If cases of serious adverse events occur, dose should be reduced or treatment should be altered
- Patients with manic-depressive illness are more prone to hypomanic state after the depressive phase terminates
- Desipramine may cause worsening of psychosis in schizophrenic patients
- Both elevation as well as lowering of blood sugar levels may occur with use of this drug
- Perform leukocyte and differential blood counts in patients having fever and a sore throat during therapy with desipramine. Discontinue therapy on evidence of pathological neutrophil depression
- Discontinue therapy prior to elective surgery
Cautions: Use cautiously in:
- Renal impairment
- Hepatic impairment
- Cardiovascular disease
- Family history of sudden death, cardiac dysrhythmias, or cardiac conduction disturbances
- Diabetes mellitus
- Electroconvulsive therapy
- Concomitant use of medications that lower seizure threshold
- Parkinson disease
- Seizure disorder
- GU obstruction
- Urinary retention
- Prostatic hypertrophy
- GI obstruction
- Asthma
- Thyroid disease
- Increased IOP
- Angle-closure glaucoma
- Alcohol use
- Geriatric patients
- High environmental temperature
Supplemental Patient Information
- Advise patients to refrain from activities requiring mental alertness such as operating a hazardous machinery or driving an automobile
- Inform patients/caregivers about the benefits and risks associated with therapy and counsel them in its appropriate use
- Instruct patients/caregivers to read the medication guide and assist them in understanding its contents
Pregnancy Category:C
Breastfeeding: Safety unknown. Milk levels of desipramine and its metabolite are low and have not been detected in the serum of breastfed infants. Immediate side effects have not been reported and a limited amount of follow-up has found no adverse effects on infant growth and development. Desipramine use during breastfeeding would usually not be expected to cause any adverse effects in breastfed infants, especially if the infant is older than 2 months. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 12 April 2011). According to manufacturer's data, safe use of this drug during lactation has not been established. Possible benefits must be weighed against the possible hazards to mother and child before administration of this drug in nursing mothers.
Pricing data from www.DrugStore.com in U.S.A.
- Desipramine HCl 75 MG TABS [Bottle] (ACTAVIS)
60 mg = $166
180 mg = $465.95 - Norpramin 10 MG TABS [Bottle] (SANOFI-AVENTIS U.S.)
60 mg = $71.27
180 mg = $205.18 - Norpramin 50 MG TABS [Bottle] (SANOFI-AVENTIS U.S.)
60 mg = $161.99
180 mg = $464.36 - Desipramine HCl 50 MG TABS [Bottle] (ACTAVIS)
60 mg = $124.99
180 mg = $340.96 - Desipramine HCl 25 MG TABS [Bottle] (SANDOZ)
60 mg = $74.99
120 mg = $142.97 - Norpramin 75 MG TABS [Bottle] (SANOFI-AVENTIS U.S.)
60 mg = $205.18
180 mg = $600.46 - Norpramin 150 MG TABS [Bottle] (SANOFI-AVENTIS U.S.)
30 mg = $194.4
90 mg = $572.37 - Norpramin 100 MG TABS [Bottle] (SANOFI-AVENTIS U.S.)
30 mg = $134.99
90 mg = $377.97 - Desipramine HCl 100 MG TABS [Bottle] (ACTAVIS)
30 mg = $100.99
90 mg = $266.97 - Norpramin 25 MG TABS [Bottle] (SANOFI-AVENTIS U.S.)
60 mg = $86.39
180 mg = $237.57 - Desipramine HCl 10 MG TABS [Bottle] (ACTAVIS)
60 mg = $60.46
120 mg = $113.38
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
