Disulfiram Desipramine

Drugs that might be affected by lopinavir/ritonavir include ergot derivatives, oral contraceptives, antiarrhythmics, HMG-CoA reductase inhibitors, HIV protease inhibitors, atovaquone, calcium channel blockers, ketoconazole, itraconazole, pimozide, cisapride, clarithromycin, disulfiram, metronidazole, immunosuppressants, midazolam, triazolam, narcotic analgesics, rifabutin and rifabutin metabolite, sildenafil, warfarin, bupropion, clozapine, desipramine, piroxicam, quinidine, theophylline, and zolpidem. 

It has been noted that amitriptyline increases the effects of both disulflram and citrated calcium carbimide without any increase in adverse effeets. However, there is also some evidence that an adverse interaction can occur. A study in two men found that disulfiram 500 mg daily increased the AUC of imipramine (12.5 mg given intravenously after an overnight fast) by about 30%, and of desipramine 12.5 mg given intravenously in one subject by a similar amount. Peak plasma levels were also increased. The suggest reason is that the disulfiram inhibits the metabolism of the antidepressants by the liver. There is also a report of a man taking disulfiram who, when given amitriptyline, complained of dizziness, visual and auditory hallucinations, and who became disorientated to person, plaee and time. A similar reaction was seen in another patient. Concurrent use should therefore be well monitored for any evidence of toxicity. 

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