Indications 

Norpramin is a prescribed medication utilized for treating depression. It can enhance mood, sleep, appetite, and energy levels, thereby assisting in the restoration of interest in daily activities. 

Classified as a tricyclic antidepressant, Norpramin functions by reestablishing the equilibrium of certain natural substances in the brain that promotes mental stability. 

Uses and Dosage 

Before taking Norpramin and with each prescription refill, carefully review its medication guide and patient information leaflet. Ask your doctor or pharmacist if you have any queries or clarifications. 

Norpramin dosage may vary per individual based on their medical condition and response to the treatment.  

Healthcare professionals typically initiate treatment with Norpramin at a low dose and gradually adjust it as needed. It is usually taken 1 to 3 times a day without regard to food intake. 

For optimal results, take this medication around the same times daily, exactly as directed. Do not alter the prescribed dosage or frequency of intake, as it may not improve the condition and may lead to side effects. 

Continue taking Norpramin even if you feel better. Consult your doctor before discontinuing this medication, as abrupt cessation may worsen certain conditions. Gradual reduction of dosage might be necessary. 

Side Effects 

Listed below are the potential adverse effects of Norpramin. If any of them last or worsen, promptly notify your physician. 

Common Side Effects 

• Dizziness, sleepiness, tiredness, or weakness 
• Constipation, diarrhea, stomach pain, upset stomach, vomiting, or decreased appetite 
• Dry mouth 
• Headache 
• Hair loss 
• Altered sense of taste 
• Stomach cramps 
• Mouth irritation or mouth sores 
• Weight gain or weight loss 
• Excessive sweating 
• Flushing 

Serious Side Effects 

• Symptoms of high or low blood pressure: 
  • Severe headache 
  • Dizziness 
  • Fainting 
  • Changes in eyesight 
• Confusion 
• Hallucinations  
• Difficulty sleeping 
• Nightmares 
• Difficulty urinating or increased urination frequency 
• Fever, chills, sore throat, unexplained bruising or bleeding, or extreme fatigue or weakness 
• Chest pain or pressure 
• Rapid or irregular heartbeat 
• Weakness on one side of the body, speech or thinking difficulties, balance changes, facial drooping, or blurred vision 
• Abnormal burning, numbness, or tingling sensations 
• Tremors, difficulty in movement, or stiffness 
• Ringing in the ears 
• Seizures 
• Enlarged breasts 
• Nipple discharge 
• Sexual problems such as reduced interest in sex or ejaculation problems 

Call your doctor right away and ask for medical help if any of the severe side effects listed above occur. 

The use of Norpramin can elevate serotonin levels and potentially lead to serotonin syndrome toxicity, especially when combined with other serotonin-boosting medications. Seek immediate medical attention if experiencing symptoms such as: 

• Rapid heartbeat 
• Hallucinations 
• Loss of coordination 
• Severe dizziness 
• Nausea 
• Vomiting 
• Diarrhea 
• Muscle twitching 
• Unexplained fever 
• Unusual agitation 

Allergic Reactions 

Although rare, a severe allergic reaction to Norpramin may occur. Seek prompt medical assistance if you observe any of these symptoms: 

• Hives 
• Itching 
• Red, swollen, blistered, or peeling skin with or without fever 
• Wheezing 
• Tightness in the chest or throat 
• Difficulty breathing, swallowing, or speaking 
• Unusual hoarseness 
• Mouth, face, lips, tongue, or throat swelling 

Not all side effects of Norpramin are included in this list. In case any unlisted effects are observed, inform your physician promptly.   

Cautions 

Before starting treatment with Norpramin, inform your doctor and pharmacist of any known allergies, particularly to: 

• Desipramine 
• Other tricyclic antidepressants (e.g., imipramine, amitriptyline) 
• Other drugs 
• Any of the components of Norpramin tablet 

To ensure Norpramin is safe for you, disclose to your physician your medical background, especially if you have a history of: 

• Breathing problems (e.g., asthma, chronic bronchitis) 
• Personal or family history of glaucoma (angle-closure type) 
• Diabetes 
• Eating disorders (e.g., bulimia) 
• Heart problems (e.g., arrhythmias, coronary artery disease, heart attack) 
• Liver problems 
• Kidney problems 
• Personal or family history of other mental/mood conditions (e.g., bipolar disorder, schizophrenia) 
• Seizures 
• Overactive thyroid (hyperthyroidism) 
• Difficulty urinating (e.g., due to enlarged prostate) 
• Conditions that may increase the risk of seizures: 
  • Alcohol/sedative dependency 
  • Use of electroconvulsive therapy 
  • Brain injury/disease such as stroke 
• Certain types of tumors (e.g., pheochromocytoma, neuroblastoma) 

Inform your doctor and pharmacist about all prescription and non-prescription medications, vitamins, and herbal supplements you are currently taking or planning to take to lower the risk of drug interaction with Norpramin. 

Some of the products that may interact with Norpramin include: 

• Disopyramide 
• Certain medications for high blood pressure (e.g., clonidine, guanadrel, guanethidine) 
• Digoxin 
• Thyroid supplements 
• Valproic acid 

Taking Norpramin with MAO inhibitors can lead to a severe (potentially fatal) drug interaction. Avoid using the following MAO inhibitors while on Norpramin treatment: 

• Isocarboxazid 

• Linezolid 
• Metaxalone 
• Methylene blue 
• Moclobemide 
• Phenelzine 
• Procarbazine  
• Rasagiline 
• Safinamide 
• Selegiline 
• Tranylcypromine 

Moreover, most MAO inhibitors should be discontinued two weeks before and after using Norpramin. Consult your doctor for guidance on when to initiate or discontinue this medication. 

The efficacy of Norpramin may be affected by other medications that impact its removal from the body. These medications include: 

• Barbiturates (e.g., phenobarbital) 
• Cimetidine 
• Haloperidol 
• Specific drugs for heart rhythm (e.g., flecainide, propafenone) 
• Halofantrine 
• HIV protease inhibitors (e.g., fosamprenavir) 
• Phenothiazines (e.g., thioridazine) 
• Pimozide 

• Certain anti-seizure drugs (e.g., phenytoin) 
• Antidepressants (e.g., trazodone) 

Desipramine and imipramine are closely related. Avoid taking medications that contain imipramine while using Norpramin. 

Inform your doctor and pharmacist if you are using other products that induce drowsiness, including: 

• Alcohol 
• Marijuana (cannabis) 
• Antihistamines (e.g., cetirizine, diphenhydramine) 
• Sleep or anxiety medications (e.g., alprazolam, diazepam, zolpidem)  
• Muscle relaxants (e.g., carisoprodol, cyclobenzaprine) 
• Opioid pain relievers (e.g., codeine, hydrocodone) 

Ensure to review the labels of all your medications, including cough-and-cold products, as they may contain ingredients that cause drowsiness or decongestants that can elevate heart rate or blood pressure. Consult your pharmacist for guidance on the proper and safe use of these products. 

Norpramin may increase the risk of eye problems for certain individuals. Your physician may recommend an eye examination to assess your susceptibility to these issues. Contact your doctor immediately if you experience eye discomfort, altered vision, swelling, or redness in or around the eye. 

Norpramin can potentially cause QT prolongation, a condition that affects the heart rhythm. In rare cases, QT prolongation can lead to severe symptoms such as fast/irregular heartbeat, fainting, or severe dizziness, requiring immediate medical attention. 

Norpramin can increase sun sensitivity. Minimize sun exposure, avoid tanning booths and sunlamps, and use sunscreen with protective clothing when outside. Notify your doctor immediately if you experience sunburn or skin blisters and redness. 

For individuals with diabetes, taking Norpramin may hinder blood sugar management. Follow the directed schedule for monitoring blood sugar levels and report results to your physician.  

Inform your physician if you are expecting, intending to conceive, or currently nursing. A discussion regarding the advantages and disadvantages for both you and the infant will be necessary before using Norpramin.