What the FDA labels say about taking them together
Desipramine and fentanyl
Desipramine's FDA label of July 9, 2025 names fentanyl in its warnings section; fentanyl's label does not name desipramine itself but warns about its class (Tricyclic antidepressants). The desipramine label: “Serotonin Syndrome: The development of a potentially life-threatening serotonin syndrome has been reported with serotonin norepinephrine re-uptake inhibitors (SNRIs) and SSRIs, including desipramine hydrochloride …”
Check it at the source: the desipramine FDA label on DailyMed (effective July 9, 2025, Alembic Pharmaceuticals Inc.); the fentanyl FDA label on DailyMed (effective March 6, 2026, Hikma Pharmaceuticals USA Inc.).
What does the desipramine label say about fentanyl?
Desipramine label, warningsSerotonin Syndrome: The development of a potentially life-threatening serotonin syndrome has been reported with serotonin norepinephrine re-uptake inhibitors (SNRIs) and SSRIs, including desipramine hydrochloride tablets, alone but particularly with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, and St. John’s Wort) and with drugs that impair metabolism of serotonin (in particular, MAOIs both those intended to treat psychiatric disorders and also others, such as linezolid and intravenous methylene blue).
Source: FDA drug label (DESIPRAMINE HYDROCHLORIDE), Alembic Pharmaceuticals Inc., effective July 9, 2025 (SPL set cad14805-64d8-4257-b5f1-d56e0063f0e2), via openFDA; the full label on DailyMed
What does the fentanyl label say about desipramine?
Fentanyl's label does not name desipramine itself; it warns about its class (Tricyclic antidepressants):
Fentanyl label, warnings and precautionsIf a patient is suspected to be experiencing OIH, carefully consider appropriately decreasing the dose of the current opioid analgesic or opioid rotation (safely switching the patient to a different opioid moiety) [see Dosage and Administration (2), Warnings and Precautions (5.7) ] . 5.8 Serotonin Syndrome with Concomitant Use of Serotonergic Drugs Cases of serotonin syndrome, a potentially life-threatening condition, have been reported during concomitant use of fentanyl with serotonergic drugs. …
Fentanyl label, warnings and precautionsSyndrome with Concomitant Use of Serotonergic Drugs Cases of serotonin syndrome, a potentially life-threatening condition, have been reported during concomitant use of fentanyl with serotonergic drugs. Serotonergic drugs include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), triptans, 5-HT3 receptor antagonists, drugs that affect the serotonergic neurotransmitter system (e.g., mirtazapine, trazadone, tramadol), certain …
Source: FDA drug label (Fentanyl Citrate), Hikma Pharmaceuticals USA Inc., effective March 6, 2026 (SPL set ce5db1c2-feb1-4ad2-847a-d02e865bd47e), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Desipramine | Fentanyl | |
|---|---|---|
| Labeled for | Depression | Pain |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | $0.276 per tablet 75 mg tablet | $1.79 per mL 100 mcg/2 mL vial |
| Shortage now | No current entry | In shortage |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once