Patient Medication Information: uses, side effects, how to take - Desipramine (Apotex)
What is DESIPRAMINE used for?
DESIPRAMINE is used in adults to treat symptoms of depression.
How does DESIPRAMINE work?
Desipramine hydrochloride is an antidepressant drug that belongs to a group of medicines called tricyclic antidepressant drugs It is not known exactly how DESIPRAMINE works. It is thought to increase the concentration of certain chemicals in the brain which can help with the symptoms of depression.
What are the ingredients in DESIPRAMINE ?
Medicinal ingredients: desipramine hydrochloride
Non-medicinal ingredients: colloidal silicon dioxide, dextrates, hydroxypropyl methylcellulose, magnesium stearate and polyethylene glycol.
The tablets also contain the following non-medicinal ingredients:
10 mg: Brilliant Blue, titanium dioxide
25 mg: Sunset Yellow, titanium dioxide, Yellow #10 Lake,
50 mg: Brilliant Blue, ferric ferrous oxide, titanium dioxide, Yellow #10 Lake
75 mg: Sunset Yellow
Serious Warnings and Precautions
To help avoid side effects and ensure proper use, before you take DESIRPAMINE tell your healthcare professional if you have:
- heart problems such as changes in heart rhythm, heart block or heart disease.
- a history of trouble emptying your bladder (urinary retention).
- a history of glaucoma (increased pressure in the eye).
- thyroid problems or are taking thyroid medication.
- a history of seizures or fits.
100 mg: Sunset Yellow, titanium dioxide
DESIPRAMINE comes in the following dosage forms:
Tablets: 10 mg, 25 mg, 50 mg, 75 mg, 100 mg, 150 mg.
Do not use DESIPRAMINE if:
- you are taking or have taken monoamine oxidase inhibitors (MAOIs) within the last 14 days.
- you have recently experienced a heart attack or heart failure.
- you are allergic to desipramine hydrochloride, any of the ingredients in DESIPRAMINE, or other tricyclic antidepressants.
To help avoid side effects and ensure proper use, talk to your healthcare professional before you take DESIPRAMINE . Talk about any health conditions or problems you may have, including if you:
- have periods of increased and exaggerated behaviour (mania).
- have schizophrenia.
- are undergoing electroconvulsive therapy (ECT) to treat mental health problems.
are pregnant or planning to become pregnant.
- are breastfeeding or planning to breastfeed.
- have any kidney problems.
- are 65 years of age or older.
Other warnings you should known about:
Self-harm: If you have thoughts of harming or killing yourself at any time, contact your doctor or go to a hospital right away. You may find it helpful to tell a relative or close friend that you are depressed or have other mental illnesses. Ask them to read this leaflet. You might ask them to tell you if they:
- think your depression or mental illness is getting worse, or
- are worried about changes in your behaviour
Angle-closure glaucoma: DESIPRAMINE can cause angle-closure glaucoma (sudden eye pain). Having your eyes examined before you take DESIPRAMINE could help identify if you are at risk of having angle-closure glaucoma. Talk to your healthcare professional right away if you have:
- eye pain,
- changes in vision,
- swelling or redness in or around the eye.
Laboratory Tests: If you develop a fever and sore throat, your doctor will do blood tests. These tests will monitor your white blood cell count.
Blood Sugar Levels: DESIPRAMINE is known to cause changes in blood sugar levels.
Serotonin toxicity (also known as Serotonin syndrome): DESIPRAMINE can cause serotonin toxicity, a rare but potentially life-threatening condition. It can cause serious changes in how your brain, muscles and digestive system work. You may develop serotonin toxicity if you take DESIPRAMINE with certain anti-depressants or migraine medications.
Serotonin toxicity symptoms include:
- fever, sweating, shivering, diarrhea, nausea, vomiting;
- muscle shakes, jerks, twitches or stiffness, overactive reflexes, loss of coordination;
- fast heartbeat, changes in blood pressure;
- confusion, agitation, restlessness, hallucinations, mood changes, unconsciousness, and coma.
Surgery: If you have a planned surgery, talk to your doctor as soon as possible. They may ask you to stop taking DESIPRAMINE.
Driving and Using Machines: You should avoid driving or using machinery until you know how DESIPRAMINE affects you.
Tell your healthcare professional about all the medicines you take, including any drugs, vitamins, minerals, natural supplements or alternative medicines.
The following may interact with DESIPRAMINE:
Serious Drug Interactions Do not use DESIPRAMINE if you are taking or have recently taken:
|
- anticholinergic medication
- sympathomimetic medication
- serotonergic medication used to treat depression
- medicines used to treat high blood pressure medication (such as guanethidine),
- fluoxetine, used to treat depression.
How to take DESIPRAMINE:
- Swallow the tablets with a glass of water.
- Continue to take your medicine even if you do not feel better. It may take a number of weeks for your medicine to start working.
- Do not stop taking this medicine without talking to your doctor. If you are stopping this medication you may need to lower the dose gradually. Stopping DESIPRAMINE suddenly can cause withdrawal symptoms.
Usual dose:
Your doctor will determine which dose is right for you. Take DESIPRAMINE exactly as directed. Based on how you respond to DESIPRAMINE and your tolerability, your doctor may change your dose. If you are elderly your doctor may prescribe a lower dose.
Overdose:
Some of the signs of an overdose could be:
- changes in heart rhythm,
- dry mouth,
- agitation,
- seeing or believing things that are not there (hallucinations)
- sensitivity to sound
- involuntary movements throughout your body
- seizures and
- coma.
| If you think you, or a person you are caring for, have taken too much DESIPRAMINE, contact a healthcare professional, hospital emergency department, or regional poison control centre immediately, even if there are no symptoms. |
Missed Dose:
If you forget to take DESIPRAMINE, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your next scheduled dose. Do not take two doses at the same time to make up for a missed dose.
What are possible side effects from using DESIPRAMINE?
These are not all the possible side effects you may have when taking DESIPRAMINE. If you experience any side effects not listed here, tell your healthcare professional.
Common side effects may include:
- dry mouth
- visual disturbances
- constipation
- problem emptying your bladder
- dizziness
- drowsiness
- tiredness
- sweating more than usual
- shaking
- trouble sleeping
Other side effects include:
- headache
- weight gain or loss
Serious side effects and what to do about them
| Symptom / effect | Talk to your healthcare professional | Stop taking drug and get immediate medical help | |
|---|---|---|---|
| Only if severe | In all cases | ||
| UNKNOWN | |||
| Mental health problems: Anxiety, Confusion, Excitement, Hallucinations, Nightmares, Problems with attention, | √ | ||
Serious side effects and what to do about them
| Symptom / effect | Talk to your healthcare professional | Stop taking drug and get immediate medical help |
|---|
| Only if severe | In all cases | ||
|---|---|---|---|
| Trouble sleeping | |||
| Nervous system problems: Clumsiness and lack of coordination, Coma, Numbness and tingling of the hands and feet, Numbness or weakness of the arms and legs, Ringing in the ears, Shaking, Uncontrolled twitching or jerking | √ | ||
| Seizures (fit): uncontrollable shaking with or without loss of consciousness | √ | ||
| Allergic Reaction: difficulty swallowing or breathing, wheezing, drop in blood pressure, feeling sick to your stomach and throwing up, hives or rash, swelling of the face, lips, tongue or throat | √ | ||
| Bone marrow depression: easy bruising, bleeding, nose bleeds, bleeding gums, red spots on the skin, fever and chills, extreme fatigue, pale skin and lips | √ | ||
| Reproductive problems: Change in sex drive, Impotence in men, Increase in breast tissue (in men and women), Swelling of testicles swelling of testicles | √ | ||
| Increased or decreased blood sugar: frequent urination, thirst, hunger, shakiness, sweating and chills, irritability, confusion, dizziness | √ | ||
| Liver problems: Nausea or vomiting, Right upper stomach area pain or swelling, Unusual dark urine, Unusual tiredness, Yellowing of your skin and eyes (jaundice) | √ | ||
| Unusual hair loss or thinning | √ | ||
Digestive system problems: Diarrhea, Loss of appetite, Nausea, Stomach pain, Unpleasant taste in the mouth, Upset stomach, Vomiting | √ | ||
Mania: elevated or irritable mood, decreased need for sleep, racing thoughts | √ | ||
| New or worsened emotional or behavioural problems | √ | ||
| Hypotension (low blood pressure): dizziness, fainting, light-headedness, blurred vision, nausea, vomiting, | √ | ||
Serious side effects and what to do about them
| Symptom / effect | Talk to your healthcare professional | Stop taking drug and get immediate medical help |
|---|
| Only if severe | In all cases | ||
|---|---|---|---|
| fatigue (may occur when you go from lying or sitting to standing up) | |||
| Hypertension (high blood pressure): shortness of breath, fatigue, dizziness or fainting, chest pain or pressure, swelling in your ankles and legs, bluish colour to your lips and skin, racing pulse or heart palpitations | √ | ||
| Stroke: sudden numbness or weakness of your arm, leg or face, especially if only on one side of the body; sudden confusion, difficulty speaking or understanding others; sudden difficulty in walking or loss of balance or coordination; suddenly feeling dizzy or sudden severe headache with no known cause. | √ | ||
| Myocardial infarction (heart attack): pressure or squeezing pain between the shoulder blades, in the chest, jaw, left arm or upper abdomen, shortness of breath, dizziness, fatigue, light-headedness, clammy skin, sweating, indigestion, anxiety, feeling faint and possible irregular heartbeat. | √ | ||
Heart rhythm problems: Palpitations (rapid, pounding, or irregular heartbeat), changes in the rhythm or rate of the heartbeat, abnormal fast heartbeat, dizziness, fainting | √ | ||
| RARE | |||
| Serotonin toxicity: a reaction which may cause feelings of agitation or restlessness, flushing, muscle twitching, involuntary eye movements, heavy sweating, high body temperature (>38 °C), or rigid muscles. | √ | ||
Angle-closure glaucoma (sudden eye pain): increased pressure in your eyes, eye and head pain, swelling or redness in or around the eye, hazy or blurred vision, sudden loss of sight | √ | ||
If you have a troublesome symptom or side effect that is not listed here or becomes bad enough to interfere with your daily activities, tell your healthcare professional.
Reporting Side Effects
You can report any suspected side effects associated with the use of health products to Health Canada by:
NOTE: Contact your health professional if you need information about how to manage your side effects. The Canada Vigilance Program does not provide medical advice. |
Storage:
Store at 15° to 30°C. Keep in a tightly closed container away from heat.
Keep out of reach and sight of children.
If you want more information about DESIPRAMINE:
- Talk to your healthcare professional
Find the full product monograph that is prepared for healthcare professionals and includes this Patient Medication Information by visiting the Health Canada website: (https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-product-database.html. Find the Patient Medication Information on the manufacturer’s website (http://www.apotex.ca/products), or by calling 1-800-667-4708.