What the FDA labels say about taking them together
Desipramine and methylene blue
Desipramine's FDA label of July 9, 2025 names methylene blue in its contraindications section; the methylene blue label PlainMeds reads does not name desipramine. The desipramine label: “Starting NORPRAMIN in a patient who is being treated with MAOIs such as linezolid or intravenous methylene blue is also contraindicated because of an increased risk of serotonin syndrome.”
Check it at the source: the desipramine FDA label on DailyMed (effective July 9, 2025, Alembic Pharmaceuticals Inc.); the methylene blue FDA label on DailyMed (effective May 28, 2025, American Regent, Inc.).
What does the desipramine label say about methylene blue?
Desipramine label, contraindicationsStarting desipramine hydrochloride tablets in a patient who is being treated with MAOIs such as linezolid or intravenous methylene blue is also contraindicated because of an increased risk of serotonin syndrome (see WARNINGS and DOSAGE AND ADMINISTRATION).
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 (Norpramin, NDA014399), Validus Pharmaceuticals LLC, effective July 3, 2025 (SPL set 70b562ea-9f21-4e4a-b3ed-0590b2892f6a), via openFDA
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 methylene blue label say about desipramine?
Methylene blue's label (effective May 28, 2025) does not name desipramine in these sections. A label lists what its studies and reports found; it is not a complete list.
Source: FDA drug label (PROVAYBLUE), NDA204630 (Provepharm Sas), as published by American Regent, Inc., effective May 28, 2025 (SPL set 4f6848e5-35ed-4046-b13c-3032b5ba3232), 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 | Methylene blue | |
|---|---|---|
| Labeled for | Depression | n/a |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | $0.276 per tablet 75 mg tablet | n/a |
| Shortage now | No current entry | No current entry |
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