Drug & supplement interaction

Rauvolfia Vomitoria + Desipramine

Desipramine brand names: Norpramin, Desipramine, Pertofrane.

Moderate Interaction
The bottom line Moderate

Desipramine falls into 3 drug categories that Rauvolfia Vomitoria can interact with; the most serious is rated moderate. Theoretically, taking Rauvolfia vomitoria might cause additive sedative effects.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Rauvolfia Vomitoria and Desipramine

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Rauvolfia Vomitoria interacts with whole categories of medication. Desipramine falls into 3 of those categories, so it can interact with Rauvolfia Vomitoria in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CNS DEPRESSANTS

1 of 3

Why this applies to Desipramine

Desipramine falls under CNS DEPRESSANTS — the group Rauvolfia Vomitoria interacts with.

Theoretically, taking Rauvolfia vomitoria might cause additive sedative effects.
Rauvolfia vomitoria has sedative effects in animal research.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist of pairing Rauvolfia vomitoria with desipramine (Norpramin). Desipramine is an active tricyclic antidepressant, not a prodrug, so we don't have to worry about it needing the supplement to switch it on. The concern here is simpler: both can have a calming, sedating effect, and stacking them may add up. You could feel extra drowsy, foggy, or lightheaded, especially when standing up.

I'll be honest, this is a theoretical caution based mostly on the sedative effects seen in animal studies, so it isn't a proven, dramatic clash. Still, rauvolfia also strongly affects blood pressure and mood, which makes it a poor casual mix with an antidepressant. Please loop in your doctor or pharmacist before combining the two.

References
  1. Ekong MB, Peter AI, Edagha IA, et al. Rauwolfia vomitoria inhibits olfaction and modifies olfactory bulb cells. Brain Res Bull 2016;124:206-13. PubMed
  2. Amole OO, Yemitan OK, Oshikoya KA. Anticonvulsant activity of Rauvol?a Vomitoria (Afzel). Afr J Pharmacy Pharmacol 2009;3:319-322.
  3. Campbell JI, Mortensen A, Mølgaard P. Tissue lipid lowering-effect of a traditional Nigerian anti-diabetic infusion of Rauwolfia vomitoria foilage and Citrus aurantium fruit. J Ethnopharmacol 2006;104:379-86. PubMed
Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

2 of 3

Desipramine also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.

Theoretically, Rauvolfia vomitoria might increase the levels and clinical effects of CYP2D6 substrates.
Rauvolfia vomitoria contains small amounts of the drug yohimbine. In vitro research shows that yohimbine inhibits CYP2D6 enzyme activity.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist: your body relies on a liver enzyme called CYP2D6 to clear desipramine out of your system. Rauvolfia vomitoria contains a small amount of yohimbine, and in lab studies yohimbine slowed that same enzyme down. If that happens in real life, desipramine could build up more than expected, which may amplify its typical side effects (dry mouth, constipation, drowsiness, dizziness, a racing or irregular heartbeat).

Two things to keep in mind. First, this is theoretical, based only on test-tube research, so we don't know how strong it is in people. Second, desipramine is a drug where blood levels matter, so even modest changes are worth watching. Please check with your pharmacist or doctor before pairing these.

References
  1. VandenBrink, B. M., Foti, R. S., Rock, D. A., Wienkers, L. C., and Wahlstrom, J. L. Prediction of CYP2D6 drug interactions from in vitro data: evidence for substrate-dependent inhibition. Drug Metab Dispos. 2012;40(1):47-53. PubMed
Moderate

TRICYCLIC ANTIDEPRESSANTS (TCAs)

3 of 3

Desipramine also falls under TRICYCLIC ANTIDEPRESSANTS (TCAs).

Theoretically, concomitant use might alter the effects of Rauvolfia vomitoria and increase the risk for adverse effects.
A small clinical study in patients taking TCAs for at least 4 weeks shows that receiving doses of intravenous yohimbine, a constituent of Rauvolfia vomitoria, 2.5-20 mg daily for up to 7 days precipitates severe anxiety, agitation, and tremor. Also, concomitant use of TCAs with Rauvolfia vomitoria may decrease the effects of rauwolfia alkaloids.
Severity Moderate Likelihood Probable Evidence D

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing to know if you take desipramine (Norpramin) for depression and are thinking about Rauvolfia vomitoria. This root contains some active alkaloids, including a yohimbine-like compound. In a small study, people on tricyclic antidepressants who were given yohimbine ran into severe anxiety, agitation, and tremor. So combining the two could ramp up those jittery, nervous-system effects on top of desipramine's own potential for restlessness and a racing heart.

There's also a flip side: the blood-pressure-lowering reserpine in this plant may have its effect blunted by your TCA, so it may not work as expected. This is mostly theoretical, based on how the compounds behave, not strong human proof. Still, please don't start this on your own. Have a quick chat with your pharmacist or doctor first.

References
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
  2. Schmauss M, Laakmann G, Dieterle D. Effects of alpha 2-receptor blockade in addition to tricyclic antidepressants in therapy-resistant depression. J Clin Psychopharmacol. 1988;8(2):108-11.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Rauvolfia Vomitoria Also Interacts With Other Medications

Rauvolfia Vomitoria has 230 major, 522 moderate, 87 minor known drug interactions in our database — the Desipramine one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Rauvolfia Vomitoria

Covers the 2,830 medications we’ve checked against Rauvolfia Vomitoria. Pick one to open its full report.

From our Q&A

Questions About Rauvolfia Vomitoria or Desipramine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Rauvolfia Vomitoria or Desipramine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Desipramine

This page covers Rauvolfia Vomitoria only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Desipramine page lists 253 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), American Hellebore (major), Arsenic (major) and Beer (major).

By severity: 16 major · 198 moderate · 39 minor.

Open the Desipramine interaction page

One more smart check

Taking Rauvolfia Vomitoria as Part of a Dietary Supplement Product? Check It for Interactions

We hold 17 real supplement products containing Rauvolfia Vomitoria, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Rauvolfia Vomitoria. Your product may carry other ingredients that interact with Desipramine too, on top of Rauvolfia Vomitoria — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Rauvolfia Vomitoria and Desipramine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Rauvolfia Vomitoria
Steady interest

#1,013 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Desipramine
Top half

#948 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Rauvolfia Vomitoria

What is Rauvolfia Vomitoria?

  • High blood pressure
  • Anxiety and agitation
  • Sleep problems
  • Mental health symptoms (traditional use)
  • Fever and general ailments

Rauvolfia vomitoria is an African shrub whose root contains powerful alkaloids, including reserpine, that have historically been used for high blood pressure and agitation. Because these compounds can strongly affect blood pressure, mood, and the nervous system, the plant can cause serious side effects and is not a casual supplement. Always talk to a doctor or pharmacist before using it.

Read the full Rauvolfia Vomitoria monograph & all interactions
Medication

About Desipramine

What Is Desipramine Used For?

Brand names: Norpramin, Desipramine, Pertofrane

Desipramine hydrochloride tablets — sold under the brand names Norpramin, Desipramine HCL, and Desipramine Hydrochloride — are FDA-approved for the treatment of depression in adults. Norpramin tablets and the generic formulations share this same approved indication.

Desipramine tablets are not approved for use in children. Adolescents and elderly patients may be prescribed it in certain circumstances, but at lower doses and under close supervision.

See full Desipramine drug information
Keep checking

Other Drugs & Rauvolfia Vomitoria

Browse every other medication we’ve checked against Rauvolfia Vomitoria — both the ones with a known interaction and the ones without. Select any drug for the full detail.

230Major
522Moderate
87Minor
1,990No known interaction
Major

230 interactions

Showing 60 of 230 major interactions — see all 230 on the Rauvolfia Vomitoria page.

Moderate

522 interactions

Showing 60 of 522 moderate interactions — see all 522 on the Rauvolfia Vomitoria page.

Minor

87 interactions

Showing 60 of 87 minor interactions — see all 87 on the Rauvolfia Vomitoria page.

No interaction 1,990 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Rauvolfia Vomitoria and Desipramine Together: Common Questions

Can you take Rauvolfia Vomitoria with Desipramine?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 3 interactions listed for Rauvolfia Vomitoria and Desipramine?
Desipramine belongs to more than one drug category, and Rauvolfia Vomitoria interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Rauvolfia Vomitoria and Desipramine interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.