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All about: Norpramin

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Generic Name: Desipramine (des-IP-ra-meen)
Brand Name: Norpramin

Antidepressants may increase the risk of suicidal thoughts or actions in children and teenagers. The risk may be greater during the first few months that patients take Norpramin . Be sure that the benefits of using Norpramin outweigh the risks. Talk with the patient's doctor if you have any questions.

Family and caregivers must closely observe patients who take Norpramin . It is important to keep in close contact with the patient's doctor. Tell the doctor right away if the patient has symptoms like worsened depression, suicidal thoughts, or changes in behavior.

Norpramin is used for:

Treating depression. It may be also be used for other conditions as determined by your doctor.

Norpramin is a tricyclic antidepressant. Exactly how it works is not fully understood. It is thought to increase the activity of certain chemicals in the brain (norepinephrine, serotonin), which help elevate mood.

Do NOT use Norpramin if:

  • you are allergic to any ingredient in Norpramin
  • you are taking astemizole, guanethidine, an H1 antagonist (eg, diphenhydramine), pimozide, or terfenadine, or have taken a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) within the last 14 days
  • you are recovering from a heart attack

Contact your doctor or health care provider right away if any of these apply to you.

Before using Norpramin :

Some medical conditions may interact with Norpramin . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have a history of glaucoma or increased pressure in the eye, an enlarged prostate, problems urinating, heart problems, alcoholism, a history of seizures (eg, epilepsy), an overactive thyroid, suicidal thoughts or tendencies, or porphyria (a blood disease)

Some MEDICINES MAY INTERACT with Norpramin . Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Anticholinergics (eg, oxybutynin, scopolamine), benzodiazepines (eg, alprazolam), or cimetidine because they may decrease Norpramin 's effectiveness
  • Arsenic, benzodiazepines (eg, alprazolam), bupropion, carbamazepine, cimetidine, diltiazem, disulfiram, droperidol, erythromycin, fluconazole, H1 antagonists (eg, diphenhydramine), HIV protease inhibitors (eg, ritonavir), labetalol, lithium, mibefradil, MAOIs (eg, phenelzine), phenothiazine (eg, thioridazine), pimozide, propafenone, quinine derivatives, serotonin norepinephrine reuptake inhibitors (eg, atomoxetine), selective serotonin reuptake inhibitors (eg, fluoxetine), terbinafine, thyroid hormones (eg, levothyroxine), or verapamil because side effects, such as sedation and low blood pressure, may occur
  • Anticoagulants (eg, warfarin), arsenic, carbamazepine, cisapride, clonidine, dofetilide, droperidol, galantamine, H1 antagonists (eg, diphenhydramine), levodopa, lithium, MAOIs (eg, phenelzine ), phenothiazine (eg, thioridazine), pimozide, quinolones (eg, ciprofloxacin), sympathomimetics (eg, albuterol, amphetamine, pseudoephedrine), terfenadine, thyroid hormones (eg, levothyroxine), or tramadol because the risk of their side effects may be increased by Norpramin
  • Clonidine, guanethidine, guanfacine, levodopa, methyldopa, or sympathomimetics (eg, albuterol, amphetamine, pseudoephedrine) because their effectiveness may be decreased by Norpramin
  • Furazolidone because an effect (toxic psychosis) not expected from either medicine may occur

This may not be a complete list of all interactions that may occur. Ask your health care provider if Norpramin may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Norpramin :

Use Norpramin as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Norpramin comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Norpramin refilled.
  • Take Norpramin by mouth with or without food.
  • Do not eat grapefruit or drink grapefruit juice while you are taking Norpramin .
  • Diets high in fiber may decrease the effectiveness of Norpramin . Talk with your doctor about the proper amount of fiber to consume.
  • If you also take cholestyramine, do not take it within 6 hours before or 1 hour after taking Norpramin . Check with your doctor if you have questions.
  • If you are switching from fluoxetine to Norpramin , you may need to discontinue fluoxetine for up to 5 weeks before starting Norpramin . Ask your doctor if you have any questions.
  • Taking Norpramin at bedtime may help reduce side effects such as daytime drowsiness. Discuss this possibility with your health care provider.
  • Continue to take Norpramin even if you feel well. Do not miss any doses.
  • If you miss a dose of Norpramin , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. If you take 1 dose daily at bedtime, do not take missed dose the next morning.

Ask your health care provider any questions you may have about how to use Norpramin .

Important safety information:

  • Norpramin may cause drowsiness, dizziness, blurred vision, or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines. Use Norpramin with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Limit the amount of alcohol that you drink while you are taking Norpramin . Check with your doctor before you use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Norpramin ; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
  • Norpramin may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
  • Norpramin may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Norpramin . Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
  • Diabetes patients - This medicine may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
  • Do not become overheated in hot weather or while you are being active; heatstroke may occur.
  • After you start using Norpramin , several weeks may pass before you feel the full benefit.
  • Children and teenagers who take Norpramin may be at increased risk for suicidal thoughts or actions. Adults may also be affected. The risk may be greater in patients who have had suicidal thoughts or actions in the past. The risk may also be greater in patients who have had bipolar (manic-depressive) illness, or if their family members have had it. Watch patients who take Norpramin closely. Contact the doctor at once if new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.
  • Tell your doctor or dentist that you take Norpramin before you receive any medical or dental care, emergency care, or surgery.
  • Lab tests, including liver function, kidney function, and complete blood cell count, may be performed while you use Norpramin . These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Use Norpramin with caution in the ELDERLY; they may be more sensitive to its effects, especially confusion. Elderly patients may also be at greater risk for falls while taking Norpramin .
  • Norpramin should not be used in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using this medicine while you are pregnant. Norpramin is found in breast milk. Do not breast feed while taking Norpramin .

If you are on long-term therapy and you stop taking Norpramin suddenly, you may have WITHDRAWAL symptoms. These may include nausea, headache, and fatigue. Do not suddenly stop taking Norpramin or change dosage without asking your pharmacist or doctor first.

Possible side effects of Norpramin :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Blurred vision; change in sexual desire or ability; constipation; diarrhea; dizziness; drowsiness; dry mouth; headache; loss of appetite; nausea; tiredness; trouble sleeping; weakness.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; confusion; dark urine; delusions; difficulty speaking or swallowing; excessive sweating; fainting; fast or irregular heartbeat; fever, chills, or sore throat; hallucinations; new or worsening agitation, anxiety, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being, restlessness, or inability to sit still; numbness or tingling in an arm or leg; one-sided weakness; seizures; severe or persistent dizziness or headache; severe or persistent trouble sleeping; slurred speech; stiff muscles; suicidal thoughts or actions; tremor; trouble urinating; uncontrolled muscle movements (eg, of face, tongue, arms, legs); unusual bleeding or bruising; unusual or severe mental or mood changes; vision problems; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include agitation; confusion; drowsiness; dry mouth; enlarged pupils; fast or irregular heartbeat; flushing; loss of consciousness; seizures.

Proper storage of Norpramin :

Store Norpramin at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Norpramin out of the reach of children and away from pets.

General information:

  • If you have any questions about this medicine, please talk with your doctor, pharmacist, or other health care provider.
  • Norpramin is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Norpramin . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: September 5, 2007
Database Edition
Copyright © 2007 Wolters Kluwer Health, Inc.

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