What is this medication?
“Alert: Black Box Warning
Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Closely observe and appropriately monitor patients of all ages who are started on antidepressant therapy for clinical worsening, suicidality, or unusual changes in behavior. Advise families and caregivers of the need for close observation and communication with the prescribing health care provider.”
How does this medication work?
Desipramine, Norpramin increases the synaptic concentration of norepinephrine (and to a lesser extent, serotonin) in the central nervous system by inhibition of its reuptake by the presynaptic neuronal membrane. However, additional receptor effects have been found including desensitization of adenyl cyclase, down regulation of beta-adrenergic receptors, and down regulation of serotonin receptors.
How should I take this medication?
Oral: 25mg to 300mg once daily.
How to Take: Follow instructions provided by physician/pharmacy label, take consistently at same times each day unless otherwise directed, store at room temperature. Generally taken 1-3 hour prior to bed to minimize daytime drowsiness.
You Need to Avoid: Do not stop this medication without tapering dose down over time to prevent withdrawal symptoms (nausea, diarrhea, sweating, headaches, agitation, insomnia, anxiety, tremor, vertigo, dizziness, tingling in extremities). Tolerance to sedation may develop however caution operating heavy machinery or driving if feeling impaired. May increase the central nervous system depressant effects of alcohol so caution if alcohol is to be consumed.
What should I watch for while using this medication?
Before starting Desipramine, Norpramin make sure your physician is aware of any allergies or medications you currently take. Desipramine, Norpramin like any other antidepressant can increase the risk of suicidal thinking and behavior in children, adolescents, and young adults (18 to 24 years of age) with major depressive disorder (MDD) and other psychiatric disorders; consider risk prior to prescribing. Desipramine, Norpramin may cause anticholinergic effects (i.e. constipation, xerostomia, blurred vision, urinary retention), central nervous system depression, fragility fracture, ocular effects, orthostatic hypotension, serotonin syndrome. Desipramine, Norpramin should be used with caution in patients with pre-existing cardiovascular disease because of the risk of conduction abnormalities, diabetes, hepatic and/or renal impairment, with a history of seizures.
What if I miss a dose?
If you miss a dose of medication, try to take it as soon as possible. However, if it is almost time for your next dose, take only that scheduled dose. Do not take double or extra doses.
How should I store this medication?
Keep out of the reach of children at all times. Store at room temperature, 59 to 86° F (15 to 30° C). Protect from light. Keep the container tightly closed. Properly dispose of any unused medication after the expiration date.
What are the possible side effects of using this medication?
The frequency of side effects is not well defined but can include the following and are based on reports for other agents in this same pharmacologic class, and may not be specifically reported for Desipramine, Norpramin:
Cardiac arrhythmia, cerebrovascular accident, edema, flushing, heart block, hypertension, hypotension, myocardial infarction, palpitations, premature ventricular contractions, tachycardia, ventricular fibrillation, ventricular tachycardia, agitation, anxiety, ataxia, confusion, delusions, disorientation, dizziness, drowsiness, drug fever, EEG pattern changes, extrapyramidal reaction, falling, fatigue, hallucination, headache, hypomania, insomnia, neuroleptic malignant syndrome, nightmares, numbness, peripheral neuropathy, psychosis (exacerbation), restlessness, seizure, tingling of extremities, tingling sensation, withdrawal syndrome, alopecia, diaphoresis (excessive), pruritus, skin photosensitivity, skin rash, urticaria, decreased libido, decreased serum glucose, galactorrhea, gynecomastia, increased libido, increased serum glucose, SIADH, weight gain, abdominal cramps, anorexia, constipation, diarrhea, epigastric distress, increased pancreatic enzymes, melanoglossia, nausea, paralytic ileus, parotid gland enlargement, stomatitis, sublingual adenitis, unpleasant taste, vomiting, xerostomia, breast hypertrophy, impotence, nocturia, painful ejaculation, testicular swelling, urinary hesitancy, urinary retention, urinary tract dilation, elevated liver enzymes, petechia, purpura, thrombocytopenia, muscle weakness, blurred vision, tinnitus, polyuria and fever.
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