Norpramin

The active ingredient in Norpramin is desipramine hydrochloride. As mentioned, Norpramin is a tricyclic antidepressant (TCA), and how it works is unknown. However, Norpramin is hypothesized to work by increasing serotonin and norepinephrine levels in the brain, improving mood.

Follow all directions given to you by your doctor and read all documents provided, including the full Prescribing Information, FDA-Approved Product Labeling, Instructions for Use, and Medication Guide before using Norpramin. However, the following is a synopsis of the general guidelines for the use of Norpramin:

• Take Norpramin at the same time each day, with or without food. However, it is recommended that you take it with food because the medication may irritate your stomach and cause nausea, vomiting, or diarrhea.
• Your provider will gradually adjust your Norpramin dose to find the one that works best for you.
• Do not discontinue taking Norpramin abruptly without consulting your doctor. You may face an increased risk of adverse effects. If you need to discontinue taking Norpramin, do so gradually, as your doctor prescribes.
• If you miss a dosage, take it as soon as you remember. If it is almost time for your next dose, omit the missed dose and return to your regular schedule; however, do not take two doses at the same time or extra doses.

The most common side effects of Norpramin include:

• Nausea or vomiting.
• Blurred vision.
• Dry mouth.
• Dizziness
• Drowsiness.
• Constipation.
• Anxiety.
• Confusion.
• Trouble sleeping.
• Bladder issues.
• Weight gain or weight loss.
• Sun sensitivity.

Some individuals may experience serious side effects while using Norpramin. These side effects may require immediate medical attention. If you experience any of the following, contact your healthcare provider or seek emergency medical help:

• Worsening depression, suicidal thoughts, or other changes in behavior (panic attacks, anxiety, agitation, and irritability).
• Serotonin syndrome: rapid heartbeat, sweating, muscle stiffness or spasms, fever, and confusion.
• Heart attack: chest pain, cold chills, left arm pain, and difficulty breathing.
• Stroke: abrupt numbness, weakness, bewilderment, or difficulty speaking.
• Severe, life-threatening allergic reactions: trouble breathing, hives, itching, a fast heartbeat, throat tightness, disorientation, and swelling of the face or tongue.
• Heart rhythm problems or arrhythmias.

These are not all of the possible side effects of Norpramin. You should always seek medical advice from your healthcare provider for any questions or concerns about your medical condition or treatment. Read all patient information, medication guides, or drug information sheets that come with this medication. You can also report adverse effects to the Food and Drug Administration at www.fda.gov/medwatch or 1-800-FDA-1088.

Before starting Norpramin, it is crucial to discuss any existing health conditions with your healthcare provider. You should be sure that your healthcare provider is aware of all your medical conditions, including if you have:

Tell your doctor:

• If you are allergic to desipramine or any other component of Norpramin.
• If you experienced a recent heart attack.
• If you have used an MAOI during the prior 14 days. This includes isocarboxazid, phenelzine, tranylcypromine, selegiline, linezolid, methylene blue, and rasagiline. It is possible to get extremely high blood pressure.
• Avoid driving and other occupations or activities that require you to be alert until you know how Norpramin affects you.
• Some patients may develop high or low blood sugar levels after taking Norpramin.
• This medication may cause you to burn more easily. Take precautions if you will be in the sun.
• If you have symptoms of liver disease such as dark urine, fatigue, lack of appetite, upset stomach or stomach pain, light-colored feces, vomiting, or yellow skin or eyes, see your doctor immediately.
• Some people may be more likely to develop eye issues after using Norpramin such as glaucoma. If you experience eye pain, vision changes, swelling, or redness in or around your eye, contact your doctor straight away.
• Norpramin has caused an abnormal heartbeat (long QT on ECG). People taking Norpramin rarely have sudden deaths.
• If you have an upcoming surgery, inform your doctor that you are taking Norpramin. They may need to delay your treatment since this medication has the potential to cause heart-related complications, such as high blood pressure during operation.
• If you have thyroid disease or are on any medications for it, use this with caution. Speak to your healthcare provider first.

Boxed Warning

• Antidepressants such as Norpramin can increase the risk of suicidal thinking and behavior in children, adolescents, and young adults (<24 years) taking them for major depressive disorders and other mental illnesses. You should be monitored for any worsening depression, changes in behavior, or suicidal thoughts and actions while on this medication.

If you have any of the following conditions or if any of the following apply to you, please notify your healthcare professional since Norpramin is not safe to consume.

• Currently taking or have taken a monoamine oxidase inhibitor (MAOI) in the previous 14 days.
• Recent heart attack.

You may notice when you take desipramine or Norpramin it begins to work within 2-5 days. However, it can take 2 to 3 weeks, and often longer, to experience the full effects of the medicine.

When Norpramin is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, it may change how they work or increase the frequency or severity of side effects. Make sure that you tell your healthcare professional about anything that you are taking to avoid any negative drug interactions, including:

• MAO inhibitors such as isocarboxazid, phenelzine, tranylcypromine, selegiline, linezolid, methylene blue, and rasagiline.
• Imipramine.
• Fluoxetine.
• Amitriptyline.
• Cimetidine.
• Lithium.
• Paroxetine.
• Sertraline.
• St. John’s Wort.

The dose is normally started low and gradually increased according to how effectively it is treating your symptoms and whether you are experiencing adverse effects.

Adults: The normal oral dose ranges from 100 mg to 200 mg per day. The highest daily dosage is 300 mg.

Adolescents and older adults: The normal oral dose varies from 25 mg to 100 mg per day. The maximum daily dosage is 150 mg.

Store your Norpramin at room temperature and out of reach of children.

Eli Lilly and Company is the pharmaceutical company that manufactures Norpramin.

There are several lower-cost generic versions available.

Do not adjust your Norpramin dose or stop taking it abruptly without first consulting your doctor. This might lead to unpleasant withdrawal symptoms such as nausea, irritability, and sleep disturbances. To avoid withdrawal symptoms, follow your provider's recommendations for gradually lowering your dose over time.

It is not known if Norpramin is safe to use during pregnancy. Talk to your doctor if you are already pregnant or if you have any plans to become pregnant. They will know or recommend what is best for you.

It is not known if desipramine passes into breast milk or what effects it may have on your breastfed infant. Talk to your doctor if you are already breastfeeding or if you have any plans to breastfeed. They will know or recommend what is best for you.