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Approved Formulary
Search results for:
desipramine
desipramine
- Restricted Medications Non-Formulary / Not-stocked
Brand names: Norpramin
No brands, forms, or strengths have been added for this generic.
Display Tricyclics and Other Norepinephrine-reuptake Inhibitors Class:
28160428
Medication comments:
| 2023 American Geriatrics Society Beers Criteria® for potentially inappropriate medication use in older adults. | |
|---|---|
| Medication: | desipramine (Norpramin) |
| Criteria 1: Potentially inappropriate medication use in older adults. (Table 2) | |
| Drug(s) | antidepressants with strong anticholinergic activity, alone or in combination |
| Rationale | Highly anticholinergic, sedating, and cause orthostatic hypotension. |
| Recommendation | Avoid |
| Quality of evidence: High, Strength of Recommendation: Strong | |
| Criteria 2: Potentially inappropriate medication use in older adults due to drug–disease or drug–syndrome interactions that may exacerbate the disease or syndrome. (Table 3) | |
| Drug(s) ⇆ disease or syndrome | anticholinergics ⇄ Delirium |
| Rationale | Avoid in older adults with or at high risk of delirium because of the potential of inducing or worsening delirium. |
| Recommendation | Avoid |
| Quality of evidence: Moderate, Strength of Recommendation: Strong | |
| Drug(s) ⇆ disease or syndrome | anticholinergics ⇄ Dementia or cognitive impairment |
| Rationale | Avoid because of adverse CNS effects. If used, periodic deprescribing attempts should be considered to assess ongoing need and/or the lowest effective dose. |
| Recommendation | Avoid |
| Quality of evidence: Moderate, Strength of Recommendation: Strong | |
| Drug(s) ⇆ disease or syndrome | anticholinergics ⇄ History of falls or fractures |
| Rationale | May cause ataxia, impaired psychomotor function, syncope, or additional falls. If one of the drugs must be used, consider reducing the use of other CNS-active medications that increase the risk of falls and fractures. (i.e., anticholinergics, selected antidepressants, antiepileptics, antipsychotics, sedative/hypnotics including benzodiazepines and, Nonbenzodiazepine benzodiazepine receptor agonist hypnotics, opioids) and implement other strategies to reduce fall risk. |
| Recommendation | Avoid unless safer alternatives are not available. |
| Quality of evidence: High, Strength of Recommendation: Strong | |
| Drug(s) ⇆ disease or syndrome | tricyclic antidepressants (TCAs) ⇄ History of falls or fractures |
| Rationale | May cause ataxia, impaired psychomotor function, syncope, or additional falls. If one of the drugs must be used, consider reducing the use of other CNS-active medications that increase the risk of falls and fractures. (i.e., anticholinergics, selected antidepressants, antiepileptics, antipsychotics, sedative/hypnotics including benzodiazepines and, Nonbenzodiazepine benzodiazepine receptor agonist hypnotics, opioids) and implement other strategies to reduce fall risk. |
| Recommendation | Avoid unless safer alternatives are not available. |
| Quality of evidence: High, Strength of Recommendation: Strong | |
| Drug(s) ⇆ disease or syndrome | strongly anticholinergic drugs, except antimuscarinics for urinary incontinence ⇄ Lower urinary tract symptoms, benign prostatic hyperplasia |
| Rationale | May decrease urinary flow and cause urinary retention |
| Recommendation | Avoid in men |
| Quality of evidence: Moderate, Strength of Recommendation: Strong | |
| Criteria 3: Potentially inappropriate medications: drugs to be used with caution in older adults. (Table 4) | |
| Drug(s) | antidepressants (selected: TCAs) |
| Rationale | May exacerbate or cause SIADH or hyponatremia; monitor sodium levels closely when starting or changing dosages in older adults. |
| Recommendation | Use with caution |
| Quality of evidence: Moderate, Strength of Recommendation: Strong | |
| Criteria 4: Potentially clinically important drug-drug interactions that should be avoided in older adults. (Table 5) | |
| Interacting drug(s) or class(es) | anticholinergics ⇄ anticholinergics |
| Risk Rationale | Use of more than one medication with anticholinergic properties increases the risk of cognitive decline, delirium, and falls or fractures. |
| Recommendation | Avoid; minimize the number of anticholinergic drugs Click for list. |
| Quality of evidence: Moderate, Strength of Recommendation: Strong | |
| Interacting drug(s) or class(es) | antidepressants (TCAs, SSRIs, and SNRIs) ⇄ CNS-active agents |
| Risk Rationale | Increased risk of falls and of fracture with the concurrent use of ≥3 CNS-active agents (antiepileptics including gabapentinoids, antidepressants, antipsychotics, benzodiazepines, Nonbenzodiazepine benzodiazepine receptor agonist hypnotics, opioids, and skeletal muscle relaxants). |
| Recommendation | Avoid concurrent use of ≥3 CNS-active drugs Click for list; minimize the number of CNS-active drugs. |
| Quality of evidence: High, Strength of Recommendation: Strong | |
| Pediatric Pharmacy Association 2025 KIDs List of Key Potentially Inappropriate Drugs in Pediatrics | |
|---|---|
| Medication: | desipramine (Norpramin) |
| Key Potentially Inappropriate Drugs in Pediatrics (KIDs) List: Second Edition (Table 1) | |
| Drug | tricyclic antidepressants |
| Risk/Rationale | Sudden cardiac death |
| Recommendation | Avoid in 18 yr of age and younger |
| Quality of evidence: High, Strength of Recommendation: Strong | |
Last updated: Sep. 25, 2025
- Look-Alike/Sound-Alike desipramine confused with disopyramide