Disulfiram and Desipramine: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Desipramine
Disulfiram
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased bioavailability of desipramine
Interaction Deep Dive
Increased elimination half-life, higher peak plasma levels, and decreased total body clearance of imipramine when administered during disulfiram therapy have been demonstrated1. The clinical significance of this finding is unknown.
Why it happens (mechanism)
Disulfiram-induced inhibition of desipramine hepatic metabolism
Literature reports
1 report — tap to read
a) Two healthy men who had been detoxified for 14 days participated in a study to determine the effect of disulfiram on the pharmacokinetics of imipramine and desipramine. Doses of imipramine 12.5 mg were administered intravenously both prior to disulfiram 500 mg daily therapy and after 14 days of therapy with disulfiram. The protocol for desipramine was also the same but was performed only in one subject. For imipramine, the area under the concentration-time curve (AUC) increased by 32.5% and 26.8% after disulfiram administration in patient 1 and patient 2, respectively. The elimination half-lives were also increased by 18.3% and 13.6%, respectively, while the total body imipramine clearance decreased 24.5% and 21.3%, respectively. Desipramine showed a 32.3% increase in the AUC when administered with disulfiram. The elimination half-life also increased by 19.8% and the total body clearance decreased 24.3% 1.
Common questions
Can I take Disulfiram and Desipramine together?
Increased bioavailability of desipramine Always confirm with your pharmacist or prescriber before making any change.
How serious is the Disulfiram and Desipramine interaction?
It is rated minor. Usually limited clinical impact.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Disulfiram or Desipramine need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (1)
- Ciraulo DA, Barnhill J, & Boxenbaum H: Pharmacokinetic interaction of disulfiram and antidepressants. Am J Psychiatry 1985; 142:1373-1374. PubMed
Keep reading about Desipramine
Keep reading about Disulfiram
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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