What the FDA labels say about taking them together
Desipramine and escitalopram
Escitalopram's FDA label of October 1, 2023 names desipramine in its drug interactions section; desipramine's label does not name escitalopram itself but warns about its class (serotonin reuptake inhibitors). The escitalopram label: “Coadministration of escitalopram (20 mg/day for 21 days) with the tricyclic antidepressant desipramine (single dose of 50 mg), a substrate for CYP2D6, resulted in a 40% increase in Cmax and a 100% increase in AUC of …”
Check it at the source: the desipramine FDA label on DailyMed (effective July 9, 2025, Alembic Pharmaceuticals Inc.); the escitalopram FDA label on DailyMed (effective October 1, 2023, Allergan, Inc.).
What does the desipramine label say about escitalopram?
Desipramine's label does not name escitalopram itself; it warns about its class (serotonin reuptake inhibitors):
Desipramine label, warningsThe 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. …
Desipramine label, drug interactionsWhile all the SSRIs, e.g., fluoxetine, sertraline, paroxetine, inhibit P450 2D6, they may vary in the extent of inhibition.
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 escitalopram label say about desipramine?
Escitalopram label, drug interactionsDrugs Metabolized by CYP2D6 Clinical Impact: Coadministration of escitalopram (20 mg/day for 21 days) with the tricyclic antidepressant desipramine (single dose of 50 mg), a substrate for CYP2D6, resulted in a 40% increase in Cmax and a 100% increase in AUC of desipramine. Intervention: The clinical significance of this finding is unknown. Exercise caution during coadministration of escitalopram and drugs metabolized by CYP2D6.
Escitalopram label (Almatica Pharma LLC, August 31, 2025), drug interactionsMechanism and Clinical Effect (s); Coadministration of escitalopram with the tricyclic antidepressant desipramine, a substrate for CYP2D6, resulted in a 40% increase in Cmax and a 100% increase in AUC of desipramine.
Source: FDA drug label (Escitalopram, NDA219130), Almatica Pharma LLC, effective August 31, 2025 (SPL set c0401570-a3b0-bef2-7365-c23dc952b8b6), via openFDA
Source: FDA drug label (Lexapro), NDA021323 (Abbvie), as published by Allergan, Inc., effective October 1, 2023 (SPL set 13bb8267-1cab-43e5-acae-55a4d957630a), 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 | Escitalopram | |
|---|---|---|
| Labeled for | Depression | Depression, Anxiety |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | $0.276 per tablet 75 mg tablet | $0.0632 per tablet 20 mg tablet |
| 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