maprotiline (Rx)

Brand and Other Names:
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 25mg
  • 50mg
  • 75mg

Depression

Outpatient (Mild to Moderate Depression)

  • Initial 75 mg PO qDay for 2 weeks
  • Increase by 25 mg increments to effective dosage; not to exceed 150 mg/day
  • Maintenance: Decrease dose to 75-150 mg PO qDay once symptoms are controlled
  • Geriatric: 50-75 mg PO qDay

Inpatient (Severe Depression)

  • Initial 100-150 mg PO qDay for 2 weeks
  • Increase cautiously to effective dosage; not to exceed 225 mg/day
  • Geriatric: 50-75 mg PO qDay

Other Indications & Uses

Off-label: anxiety associated with depression

Safety and effecay not established

Initial dose: 25 mg PO at bedtime, if tolerated increase by 25 mg every 3 days for inpatients and weekly for outpatients.

Maintenance dose: 50-75 mg/day, may increase dose for nonresponders.

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Interactions

Interaction Checker

and maprotiline

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            Contraindicated (14)

            • disopyramide

              maprotiline and disopyramide both increase QTc interval. Contraindicated.

            • ibutilide

              maprotiline and ibutilide both increase QTc interval. Contraindicated.

            • indapamide

              maprotiline and indapamide both increase QTc interval. Contraindicated.

            • iobenguane I 123

              maprotiline decreases effects of iobenguane I 123 by pharmacodynamic antagonism. Contraindicated. If clinically appropriate, discontinue drugs that decrease uptake of NE for at least 5 half-lives; may cause false-negative imaging results.

            • isocarboxazid

              isocarboxazid and maprotiline both increase serotonin levels. Contraindicated.

            • pentamidine

              maprotiline and pentamidine both increase QTc interval. Contraindicated.

            • phenelzine

              phenelzine and maprotiline both increase serotonin levels. Contraindicated.

            • pimozide

              maprotiline and pimozide both increase QTc interval. Contraindicated.

            • procainamide

              maprotiline and procainamide both increase QTc interval. Contraindicated.

            • procarbazine

              procarbazine and maprotiline both increase serotonin levels. Contraindicated. Combination is contraindicated within 2 weeks of MAOI use.

            • quinidine

              quinidine and maprotiline both increase QTc interval. Contraindicated.

            • safinamide

              maprotiline, safinamide. Either increases toxicity of the other by serotonin levels. Contraindicated. Concomitant use could result in life-threatening serotonin syndrome.

            • sotalol

              maprotiline and sotalol both increase QTc interval. Contraindicated.

            • tranylcypromine

              tranylcypromine and maprotiline both increase serotonin levels. Contraindicated.

            Serious - Use Alternative (133)

            • albuterol

              maprotiline, albuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • amiodarone

              maprotiline and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.

            • amisulpride

              maprotiline and amisulpride both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.

            • amitriptyline

              amitriptyline and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

              amitriptyline and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.

            • amoxapine

              amoxapine and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

              amoxapine and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.

            • apomorphine

              apomorphine and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

            • arformoterol

              maprotiline, arformoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • aripiprazole

              aripiprazole and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

            • arsenic trioxide

              maprotiline and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.

            • artemether/lumefantrine

              maprotiline and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • benzphetamine

              maprotiline, benzphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • buspirone

              maprotiline and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.

            • calcium/magnesium/potassium/sodium oxybates

              maprotiline, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

            • ceritinib

              ceritinib and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

            • chlorpromazine

              chlorpromazine and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

            • citalopram

              citalopram and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

            • clarithromycin

              maprotiline and clarithromycin both increase QTc interval. Avoid or Use Alternate Drug.

            • clomipramine

              clomipramine and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

              clomipramine and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.

            • clonidine

              maprotiline decreases effects of clonidine by Other (see comment). Avoid or Use Alternate Drug. Comment: Inhibition of uptake by adrenergic neurons.

            • clozapine

              clozapine and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

            • dacomitinib

              dacomitinib will increase the level or effect of maprotiline by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid use with CYP2D6 substrates where minimal increases in concentration of the CYP2D6 substrate may lead to serious or life-threatening toxicities.

            • desflurane

              desflurane and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

            • desipramine

              desipramine and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

              desipramine and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.

            • desvenlafaxine

              maprotiline and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.

            • dexfenfluramine

              maprotiline, dexfenfluramine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • dexmethylphenidate

              maprotiline, dexmethylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • dextroamphetamine

              maprotiline, dextroamphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • dextromethorphan

              maprotiline and dextromethorphan both increase serotonin levels. Avoid or Use Alternate Drug.

            • diethylpropion

              maprotiline, diethylpropion. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • dobutamine

              maprotiline, dobutamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • dofetilide

              maprotiline and dofetilide both increase QTc interval. Avoid or Use Alternate Drug.

              dofetilide increases toxicity of maprotiline by QTc interval. Avoid or Use Alternate Drug.

            • dopamine

              maprotiline, dopamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • dopexamine

              maprotiline, dopexamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • doxepin

              doxepin and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

              doxepin and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.

            • dronedarone

              maprotiline and dronedarone both increase QTc interval. Avoid or Use Alternate Drug.

            • droperidol

              maprotiline and droperidol both increase QTc interval. Avoid or Use Alternate Drug.

            • duloxetine

              duloxetine and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.

            • encorafenib

              encorafenib and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

            • entrectinib

              entrectinib and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

            • ephedrine

              maprotiline, ephedrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • epinephrine

              epinephrine and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

              maprotiline, epinephrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • epinephrine racemic

              epinephrine racemic and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

              maprotiline, epinephrine racemic. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • eribulin

              eribulin and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

            • erythromycin base

              maprotiline and erythromycin base both increase QTc interval. Avoid or Use Alternate Drug.

            • erythromycin ethylsuccinate

              maprotiline and erythromycin ethylsuccinate both increase QTc interval. Avoid or Use Alternate Drug.

            • erythromycin lactobionate

              maprotiline and erythromycin lactobionate both increase QTc interval. Avoid or Use Alternate Drug.

            • erythromycin stearate

              maprotiline and erythromycin stearate both increase QTc interval. Avoid or Use Alternate Drug.

            • escitalopram

              escitalopram and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.

            • fenfluramine

              maprotiline, fenfluramine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • fluconazole

              maprotiline and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.

            • fluoxetine

              fluoxetine and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.

            • fluphenazine

              fluphenazine and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

            • fluvoxamine

              fluvoxamine and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.

            • formoterol

              maprotiline and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

              maprotiline, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • fosamprenavir

              fosamprenavir increases levels of maprotiline by decreasing metabolism. Avoid or Use Alternate Drug.

            • givosiran

              givosiran will increase the level or effect of maprotiline by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP2D6 substrates with givosiran. If unavoidable, decrease the CYP2D6 substrate dosage in accordance with approved product labeling.

            • guanfacine

              maprotiline decreases effects of guanfacine by Other (see comment). Avoid or Use Alternate Drug. Comment: Inhibition of uptake by adrenergic neurons.

            • haloperidol

              maprotiline and haloperidol both increase QTc interval. Avoid or Use Alternate Drug.

            • hydroxychloroquine sulfate

              hydroxychloroquine sulfate and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

            • imipramine

              imipramine and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

              imipramine and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.

            • isoflurane

              isoflurane and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

            • isoproterenol

              maprotiline, isoproterenol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • itraconazole

              maprotiline and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.

            • ivosidenib

              ivosidenib and maprotiline both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of QTc prolonging drugs with ivosidenib or replace with alternate therapies. If coadministration of a QTc prolonging drug is unavoidable, monitor for increased risk of QTc interval prolongation.

            • ketoconazole

              maprotiline and ketoconazole both increase QTc interval. Avoid or Use Alternate Drug.

            • levalbuterol

              maprotiline, levalbuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • levoketoconazole

              maprotiline and levoketoconazole both increase QTc interval. Avoid or Use Alternate Drug.

            • levomilnacipran

              levomilnacipran and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.

            • linezolid

              linezolid and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • lisdexamfetamine

              maprotiline, lisdexamfetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • lithium

              lithium and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

            • lofepramine

              lofepramine and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

              lofepramine and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.

            • lumefantrine

              maprotiline and lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • macimorelin

              macimorelin and maprotiline both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.

            • mefloquine

              mefloquine increases toxicity of maprotiline by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.

            • meperidine

              maprotiline and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.

            • metaproterenol

              maprotiline, metaproterenol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • methamphetamine

              maprotiline, methamphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • methylene blue

              methylene blue and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug. Methylene blue may increase serotonin as a result of MAO-A inhibition. If methylene blue must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last methylene blue dose or after 2 weeks of monitoring, whichever comes first.

            • methylenedioxymethamphetamine

              maprotiline, methylenedioxymethamphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • methylphenidate

              maprotiline, methylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • metoclopramide intranasal

              maprotiline, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.

            • midodrine

              maprotiline, midodrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • milnacipran

              milnacipran and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.

            • mirtazapine

              mirtazapine and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

            • mobocertinib

              mobocertinib and maprotiline both increase QTc interval. Avoid or Use Alternate Drug. ]If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently.

            • moxifloxacin

              maprotiline and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • nefazodone

              nefazodone and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.

            • nilotinib

              maprotiline and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.

            • norepinephrine

              maprotiline, norepinephrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • nortriptyline

              maprotiline and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.

              maprotiline and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

            • octreotide

              maprotiline and octreotide both increase QTc interval. Avoid or Use Alternate Drug.

            • octreotide (Antidote)

              maprotiline and octreotide (Antidote) both increase QTc interval. Avoid or Use Alternate Drug.

            • olanzapine

              olanzapine and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

            • ondansetron

              maprotiline and ondansetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias.

            • oxaliplatin

              oxaliplatin and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

            • ozanimod

              ozanimod increases toxicity of maprotiline by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.

            • paroxetine

              paroxetine and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.

            • perphenazine

              perphenazine and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

            • phendimetrazine

              maprotiline, phendimetrazine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • phentermine

              maprotiline, phentermine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • phenylephrine

              maprotiline, phenylephrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • phenylephrine PO

              maprotiline, phenylephrine PO. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • pirbuterol

              maprotiline, pirbuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • promazine

              promazine and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

            • propylhexedrine

              maprotiline, propylhexedrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • protriptyline

              maprotiline and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.

              maprotiline and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

            • pseudoephedrine

              maprotiline, pseudoephedrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • rasagiline

              rasagiline and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.

            • ribociclib

              ribociclib increases toxicity of maprotiline by QTc interval. Avoid or Use Alternate Drug.

            • ropeginterferon alfa 2b

              ropeginterferon alfa 2b and maprotiline both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.

            • salmeterol

              maprotiline, salmeterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • selegiline

              selegiline and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.

            • selegiline transdermal

              selegiline transdermal and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.

            • serdexmethylphenidate/dexmethylphenidate

              maprotiline, serdexmethylphenidate/dexmethylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • sertraline

              sertraline and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.

            • sevoflurane

              sevoflurane and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

            • sodium oxybate

              maprotiline, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

            • St John's Wort

              maprotiline and St John's Wort both increase serotonin levels. Avoid or Use Alternate Drug.

            • terbutaline

              maprotiline, terbutaline. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • thioridazine

              thioridazine and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

            • trazodone

              maprotiline and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

              trazodone and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.

            • trifluoperazine

              trifluoperazine and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

            • trimipramine

              maprotiline and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.

              maprotiline and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug.

            • umeclidinium bromide/vilanterol inhaled

              maprotiline increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.

            • vandetanib

              maprotiline, vandetanib. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. Avoid coadministration with drugs known to prolong QT interval; if a drug known to prolong QT interval must be used, more frequent ECG monitoring is recommended.

            • vemurafenib

              vemurafenib and maprotiline both increase QTc interval. Avoid or Use Alternate Drug. Concomitant use of vemurafenib with drugs that prolong QT interval is not recommended.

            • venlafaxine

              venlafaxine and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.

            • vilanterol/fluticasone furoate inhaled

              maprotiline increases toxicity of vilanterol/fluticasone furoate inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.

            • xylometazoline

              maprotiline, xylometazoline. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • yohimbe

              yohimbe, maprotiline. Mechanism: unspecified interaction mechanism. Contraindicated. May cause increase or decrease in blood pressure.

            • yohimbine

              maprotiline, yohimbine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • ziprasidone

              maprotiline and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.

            Monitor Closely (319)

            • 5-HTP

              maprotiline and 5-HTP both increase serotonin levels. Modify Therapy/Monitor Closely.

            • abiraterone

              abiraterone increases levels of maprotiline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Avoid coadministration of abiraterone with substrates of CYP2D6. If alternative therapy cannot be used, exercise caution and consider a dose reduction of the CYP2D6 substrate.

            • abobotulinumtoxinA

              abobotulinumtoxinA increases effects of maprotiline by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects. .

            • aclidinium

              aclidinium and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • albuterol

              maprotiline increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              albuterol and maprotiline both increase QTc interval. Use Caution/Monitor.

            • alfentanil

              alfentanil and maprotiline both increase sedation. Use Caution/Monitor.

            • alfuzosin

              maprotiline and alfuzosin both increase QTc interval. Use Caution/Monitor.

              alfuzosin and maprotiline both increase QTc interval. Use Caution/Monitor.

            • almotriptan

              almotriptan and maprotiline both increase serotonin levels. Modify Therapy/Monitor Closely.

            • alprazolam

              alprazolam and maprotiline both increase sedation. Use Caution/Monitor.

            • amitriptyline

              amitriptyline and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              amitriptyline and maprotiline both increase sedation. Use Caution/Monitor.

            • amobarbital

              amobarbital and maprotiline both increase sedation. Use Caution/Monitor.

            • amoxapine

              amoxapine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              amoxapine and maprotiline both increase sedation. Use Caution/Monitor.

            • anticholinergic/sedative combos

              anticholinergic/sedative combos and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • apomorphine

              maprotiline and apomorphine both increase sedation. Use Caution/Monitor.

            • arformoterol

              maprotiline increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              arformoterol and maprotiline both increase QTc interval. Use Caution/Monitor.

            • aripiprazole

              aripiprazole and maprotiline both increase sedation. Use Caution/Monitor.

            • armodafinil

              maprotiline increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • artemether

              artemether and maprotiline both increase QTc interval. Use Caution/Monitor.

            • atazanavir

              atazanavir increases levels of maprotiline by unspecified interaction mechanism. Use Caution/Monitor.

            • atomoxetine

              atomoxetine and maprotiline both increase QTc interval. Use Caution/Monitor.

            • atracurium

              atracurium and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • atropine

              atropine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • atropine IV/IM

              atropine IV/IM and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • azelastine

              azelastine and maprotiline both increase sedation. Use Caution/Monitor.

            • azithromycin

              maprotiline and azithromycin both increase QTc interval. Use Caution/Monitor.

            • baclofen

              baclofen and maprotiline both increase sedation. Use Caution/Monitor.

            • bedaquiline

              maprotiline and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closely

            • belladonna alkaloids

              belladonna alkaloids and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • belladonna and opium

              belladonna and opium and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              belladonna and opium and maprotiline both increase sedation. Use Caution/Monitor.

            • benperidol

              benperidol and maprotiline both increase sedation. Use Caution/Monitor.

            • benzhydrocodone/acetaminophen

              benzhydrocodone/acetaminophen, maprotiline. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.

            • benzphetamine

              maprotiline increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • benztropine

              benztropine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

            • bethanechol

              bethanechol increases and maprotiline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • brexanolone

              brexanolone, maprotiline. Either increases toxicity of the other by sedation. Use Caution/Monitor.

            • brompheniramine

              brompheniramine and maprotiline both increase sedation. Use Caution/Monitor.

            • buprenorphine

              buprenorphine and maprotiline both increase sedation. Use Caution/Monitor.

            • buprenorphine buccal

              buprenorphine buccal and maprotiline both increase sedation. Use Caution/Monitor.

            • buprenorphine subdermal implant

              maprotiline, buprenorphine subdermal implant. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.

            • buprenorphine, long-acting injection

              maprotiline, buprenorphine, long-acting injection. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.

            • bupropion

              maprotiline increases toxicity of bupropion by unspecified interaction mechanism. Use Caution/Monitor. May lower seizure threshold; keep bupropion dose as low as possible.

              bupropion will increase the level or effect of maprotiline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • butabarbital

              butabarbital and maprotiline both increase sedation. Use Caution/Monitor.

            • butalbital

              butalbital and maprotiline both increase sedation. Use Caution/Monitor.

            • butorphanol

              butorphanol and maprotiline both increase sedation. Use Caution/Monitor.

            • caffeine

              maprotiline increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • carbachol

              carbachol increases and maprotiline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • carbinoxamine

              carbinoxamine and maprotiline both increase sedation. Use Caution/Monitor.

            • carisoprodol

              carisoprodol and maprotiline both increase sedation. Use Caution/Monitor.

            • cevimeline

              cevimeline increases and maprotiline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • chloral hydrate

              chloral hydrate and maprotiline both increase sedation. Use Caution/Monitor.

            • chlordiazepoxide

              chlordiazepoxide and maprotiline both increase sedation. Use Caution/Monitor.

            • chlorpheniramine

              chlorpheniramine and maprotiline both increase sedation. Use Caution/Monitor.

            • chlorpromazine

              chlorpromazine and maprotiline both increase sedation. Use Caution/Monitor.

            • chlorzoxazone

              chlorzoxazone and maprotiline both increase sedation. Use Caution/Monitor.

            • cinnarizine

              cinnarizine and maprotiline both increase sedation. Use Caution/Monitor.

            • cisatracurium

              cisatracurium and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • citalopram

              citalopram and maprotiline both increase serotonin levels. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.

            • clemastine

              clemastine and maprotiline both increase sedation. Use Caution/Monitor.

            • clobazam

              clobazam will increase the level or effect of maprotiline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Lower doses of drugs metabolized by CYP2D6 may be required when used concomitantly.

              maprotiline, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).

            • clomipramine

              clomipramine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              clomipramine and maprotiline both increase sedation. Use Caution/Monitor.

            • clonazepam

              clonazepam and maprotiline both increase sedation. Use Caution/Monitor.

            • clorazepate

              clorazepate and maprotiline both increase sedation. Use Caution/Monitor.

            • clozapine

              clozapine and maprotiline both increase sedation. Use Caution/Monitor.

            • cocaine

              maprotiline and cocaine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • codeine

              codeine and maprotiline both increase sedation. Use Caution/Monitor.

            • crizotinib

              crizotinib and maprotiline both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.

            • cyclizine

              cyclizine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              cyclizine and maprotiline both increase sedation. Use Caution/Monitor.

            • cyclobenzaprine

              cyclobenzaprine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              cyclobenzaprine and maprotiline both increase sedation. Use Caution/Monitor.

            • cyproheptadine

              cyproheptadine and maprotiline both increase sedation. Use Caution/Monitor.

            • dantrolene

              dantrolene and maprotiline both increase sedation. Use Caution/Monitor.

            • daridorexant

              maprotiline and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

            • darifenacin

              darifenacin and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • dasatinib

              maprotiline and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.

            • debrisoquine

              maprotiline decreases effects of debrisoquine by Other (see comment). Use Caution/Monitor. Comment: Inhibition of uptake by adrenergic neurons.

            • degarelix

              degarelix and maprotiline both increase QTc interval. Use Caution/Monitor.

            • desflurane

              desflurane and maprotiline both increase sedation. Use Caution/Monitor.

            • desipramine

              desipramine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              desipramine and maprotiline both increase sedation. Use Caution/Monitor.

            • deutetrabenazine

              deutetrabenazine and maprotiline both increase QTc interval. Use Caution/Monitor.

            • dexchlorpheniramine

              dexchlorpheniramine and maprotiline both increase sedation. Use Caution/Monitor.

            • dexfenfluramine

              maprotiline increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              maprotiline and dexfenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • dexmedetomidine

              dexmedetomidine and maprotiline both increase sedation. Use Caution/Monitor.

            • dexmethylphenidate

              maprotiline increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dextroamphetamine

              maprotiline increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              maprotiline and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.

              maprotiline increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor.

            • dextroamphetamine transdermal

              maprotiline, dextroamphetamine transdermal. Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue dextroamphetamine transdermal and concomitant serotonergic drug(s).

            • dextromoramide

              dextromoramide and maprotiline both increase sedation. Use Caution/Monitor.

            • diamorphine

              diamorphine and maprotiline both increase sedation. Use Caution/Monitor.

            • diazepam

              diazepam and maprotiline both increase sedation. Use Caution/Monitor.

            • diazepam intranasal

              diazepam intranasal, maprotiline. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.

            • dicyclomine

              dicyclomine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • diethylpropion

              maprotiline increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • difelikefalin

              difelikefalin and maprotiline both increase sedation. Use Caution/Monitor.

            • difenoxin hcl

              difenoxin hcl and maprotiline both increase sedation. Use Caution/Monitor.

            • dihydroergotamine

              maprotiline and dihydroergotamine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • dihydroergotamine intranasal

              maprotiline and dihydroergotamine intranasal both increase serotonin levels. Modify Therapy/Monitor Closely.

            • dimenhydrinate

              dimenhydrinate and maprotiline both increase sedation. Use Caution/Monitor.

            • diphenhydramine

              diphenhydramine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              diphenhydramine and maprotiline both increase sedation. Use Caution/Monitor.

            • diphenoxylate hcl

              diphenoxylate hcl and maprotiline both increase sedation. Use Caution/Monitor.

            • dipipanone

              dipipanone and maprotiline both increase sedation. Use Caution/Monitor.

            • dobutamine

              maprotiline increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dolasetron

              maprotiline and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.

            • donepezil

              donepezil increases and maprotiline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              donepezil and maprotiline both increase QTc interval. Use Caution/Monitor.

            • dopamine

              maprotiline increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dopexamine

              maprotiline increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • doxepin

              doxepin and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              doxepin and maprotiline both increase sedation. Use Caution/Monitor.

            • doxylamine

              doxylamine and maprotiline both increase sedation. Use Caution/Monitor.

            • droperidol

              droperidol and maprotiline both increase sedation. Use Caution/Monitor.

            • echothiophate iodide

              echothiophate iodide increases and maprotiline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • efavirenz

              efavirenz and maprotiline both increase QTc interval. Use Caution/Monitor.

            • eletriptan

              eletriptan and maprotiline both increase serotonin levels. Modify Therapy/Monitor Closely.

            • eliglustat

              eliglustat increases levels of maprotiline by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the concomitant drug and titrate to clinical effect.

            • elvitegravir/cobicistat/emtricitabine/tenofovir DF

              elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of maprotiline by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP2D6 inhibitor; caution with CYP2D6 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.

            • ephedrine

              maprotiline increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              maprotiline increases effects of ephedrine by unknown mechanism. Use Caution/Monitor.

            • epinephrine

              maprotiline increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              maprotiline increases effects of epinephrine by unknown mechanism. Use Caution/Monitor.

            • epinephrine racemic

              maprotiline increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              maprotiline increases effects of epinephrine racemic by unknown mechanism. Use Caution/Monitor.

            • ergotamine

              maprotiline and ergotamine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • escitalopram

              escitalopram increases toxicity of maprotiline by QTc interval. Use Caution/Monitor.

            • esketamine intranasal

              esketamine intranasal, maprotiline. Either increases toxicity of the other by sedation. Use Caution/Monitor.

            • estazolam

              estazolam and maprotiline both increase sedation. Use Caution/Monitor.

            • ethanol

              maprotiline and ethanol both increase sedation. Use Caution/Monitor.

            • etomidate

              etomidate and maprotiline both increase sedation. Use Caution/Monitor.

            • ezogabine

              ezogabine, maprotiline. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Slight and transient QT-prolongation observed with ezogabine, particularly when dose titrated to 1200 mg/day. QT interval should be monitored when ezogabine is prescribed with agents known to increase QT interval.

            • fedratinib

              fedratinib will increase the level or effect of maprotiline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP2D6 substrates as necessary.

            • fenfluramine

              maprotiline increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              maprotiline and fenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely.

              fenfluramine, maprotiline. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration with drugs that increase serotoninergic effects may increase the risk of serotonin syndrome.

            • fesoterodine

              fesoterodine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • fingolimod

              fingolimod and maprotiline both increase QTc interval. Use Caution/Monitor.

            • flavoxate

              flavoxate and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • flecainide

              maprotiline and flecainide both increase QTc interval. Modify Therapy/Monitor Closely.

            • fluoxetine

              maprotiline and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely.

            • fluphenazine

              fluphenazine and maprotiline both increase sedation. Use Caution/Monitor.

            • flurazepam

              flurazepam and maprotiline both increase sedation. Use Caution/Monitor.

            • fluvoxamine

              fluvoxamine and maprotiline both increase QTc interval. Modify Therapy/Monitor Closely.

            • formoterol

              maprotiline increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • foscarnet

              maprotiline and foscarnet both increase QTc interval. Modify Therapy/Monitor Closely.

            • frovatriptan

              frovatriptan and maprotiline both increase serotonin levels. Modify Therapy/Monitor Closely.

            • gabapentin

              gabapentin, maprotiline. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

            • gabapentin enacarbil

              gabapentin enacarbil, maprotiline. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

            • galantamine

              galantamine increases and maprotiline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ganaxolone

              maprotiline and ganaxolone both increase sedation. Use Caution/Monitor.

            • gemifloxacin

              gemifloxacin and maprotiline both increase QTc interval. Use Caution/Monitor.

            • gilteritinib

              gilteritinib and maprotiline both increase QTc interval. Use Caution/Monitor.

            • glycopyrrolate

              glycopyrrolate and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              maprotiline increases levels of glycopyrrolate by unknown mechanism. Use Caution/Monitor.

            • glycopyrrolate inhaled

              glycopyrrolate inhaled and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              maprotiline increases levels of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.

            • granisetron

              granisetron and maprotiline both increase QTc interval. Use Caution/Monitor.

            • haloperidol

              haloperidol and maprotiline both increase sedation. Use Caution/Monitor.

            • henbane

              henbane and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • homatropine

              homatropine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • huperzine A

              huperzine A increases and maprotiline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • hydrocodone

              hydrocodone, maprotiline. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.

            • hydromorphone

              hydromorphone and maprotiline both increase sedation. Use Caution/Monitor.

            • hydroxyzine

              hydroxyzine and maprotiline both increase sedation. Use Caution/Monitor.

              hydroxyzine and maprotiline both increase QTc interval. Use Caution/Monitor.

            • hyoscyamine

              hyoscyamine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • hyoscyamine spray

              hyoscyamine spray and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • iloperidone

              maprotiline and iloperidone both increase QTc interval. Modify Therapy/Monitor Closely.

              iloperidone and maprotiline both increase sedation. Use Caution/Monitor.

            • imipramine

              imipramine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              imipramine and maprotiline both increase sedation. Use Caution/Monitor.

            • indacaterol, inhaled

              indacaterol, inhaled, maprotiline. QTc interval. Use Caution/Monitor. Drugs that are known to prolong the QTc interval may have an increased the risk of ventricular arrhythmias.

            • ipratropium

              ipratropium and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.

            • isoniazid

              maprotiline and isoniazid both increase serotonin levels. Modify Therapy/Monitor Closely.

            • isoproterenol

              maprotiline increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ketamine

              ketamine and maprotiline both increase sedation. Use Caution/Monitor.

            • ketotifen, ophthalmic

              maprotiline and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.

            • L-tryptophan

              maprotiline and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.

            • lapatinib

              maprotiline and lapatinib both increase QTc interval. Modify Therapy/Monitor Closely.

            • lasmiditan

              lasmiditan, maprotiline. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.

            • lemborexant

              lemborexant, maprotiline. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.

            • levalbuterol

              maprotiline increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • levofloxacin

              maprotiline and levofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

            • levorphanol

              levorphanol and maprotiline both increase sedation. Use Caution/Monitor.

            • lisdexamfetamine

              maprotiline increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • lithium

              maprotiline and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.

            • lofepramine

              lofepramine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              lofepramine and maprotiline both increase sedation. Use Caution/Monitor.

            • lofexidine

              maprotiline and lofexidine both increase sedation. Use Caution/Monitor.

              maprotiline decreases effects of lofexidine by unspecified interaction mechanism. Use Caution/Monitor.

            • loprazolam

              loprazolam and maprotiline both increase sedation. Use Caution/Monitor.

            • lorazepam

              lorazepam and maprotiline both increase sedation. Use Caution/Monitor.

            • lorcaserin

              lorcaserin will increase the level or effect of maprotiline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • lormetazepam

              lormetazepam and maprotiline both increase sedation. Use Caution/Monitor.

            • loxapine

              loxapine and maprotiline both increase sedation. Use Caution/Monitor.

            • loxapine inhaled

              loxapine inhaled and maprotiline both increase sedation. Use Caution/Monitor.

            • lsd

              maprotiline and lsd both increase serotonin levels. Modify Therapy/Monitor Closely.

            • lurasidone

              lurasidone increases effects of maprotiline by Other (see comment). Use Caution/Monitor. Comment: Potential for additive CNS effects .

            • marijuana

              maprotiline and marijuana both increase sedation. Use Caution/Monitor.

            • meclizine

              meclizine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • melatonin

              maprotiline and melatonin both increase sedation. Use Caution/Monitor.

            • meperidine

              meperidine and maprotiline both increase sedation. Use Caution/Monitor.

            • meprobamate

              maprotiline and meprobamate both increase sedation. Use Caution/Monitor.

            • metaproterenol

              maprotiline increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • metaxalone

              metaxalone and maprotiline both increase sedation. Use Caution/Monitor.

            • methadone

              maprotiline and methadone both increase QTc interval. Modify Therapy/Monitor Closely.

              methadone and maprotiline both increase sedation. Use Caution/Monitor.

            • methamphetamine

              maprotiline increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • methocarbamol

              methocarbamol and maprotiline both increase sedation. Use Caution/Monitor.

            • methscopolamine

              methscopolamine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • methylenedioxymethamphetamine

              maprotiline increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • midazolam

              midazolam and maprotiline both increase sedation. Use Caution/Monitor.

            • midazolam intranasal

              midazolam intranasal, maprotiline. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.

            • midodrine

              maprotiline increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • mifepristone

              mifepristone, maprotiline. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.

            • mirabegron

              mirabegron will increase the level or effect of maprotiline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • mirtazapine

              maprotiline and mirtazapine both increase sedation. Use Caution/Monitor.

              maprotiline and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • modafinil

              maprotiline increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • morphine

              morphine and maprotiline both increase sedation. Use Caution/Monitor.

              maprotiline and morphine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • motherwort

              maprotiline and motherwort both increase sedation. Use Caution/Monitor.

            • moxonidine

              maprotiline and moxonidine both increase sedation. Use Caution/Monitor.

            • nabilone

              maprotiline and nabilone both increase sedation. Use Caution/Monitor.

            • nalbuphine

              nalbuphine and maprotiline both increase sedation. Use Caution/Monitor.

            • naratriptan

              naratriptan and maprotiline both increase serotonin levels. Modify Therapy/Monitor Closely.

            • nefopam

              nefopam, maprotiline. Mechanism: unspecified interaction mechanism. Use Caution/Monitor. Use combination with caution.

            • neostigmine

              neostigmine increases and maprotiline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • norepinephrine

              maprotiline increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              maprotiline increases effects of norepinephrine by unknown mechanism. Use Caution/Monitor.

            • nortriptyline

              maprotiline and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              maprotiline and nortriptyline both increase sedation. Use Caution/Monitor.

            • ofloxacin

              maprotiline and ofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

            • olanzapine

              olanzapine and maprotiline both increase sedation. Use Caution/Monitor.

            • oliceridine

              maprotiline, oliceridine. Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely.

            • olodaterol inhaled

              maprotiline and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmias

            • onabotulinumtoxinA

              onabotulinumtoxinA and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • opium tincture

              opium tincture and maprotiline both increase sedation. Use Caution/Monitor.

            • orphenadrine

              maprotiline and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              orphenadrine and maprotiline both increase sedation. Use Caution/Monitor.

            • osimertinib

              osimertinib and maprotiline both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.

            • oxazepam

              oxazepam and maprotiline both increase sedation. Use Caution/Monitor.

            • oxybutynin

              oxybutynin and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • oxybutynin topical

              oxybutynin topical and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • oxybutynin transdermal

              oxybutynin transdermal and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • oxycodone

              oxycodone and maprotiline both increase sedation. Use Caution/Monitor.

            • oxymorphone

              oxymorphone and maprotiline both increase sedation. Use Caution/Monitor.

            • ozanimod

              ozanimod and maprotiline both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.

            • paliperidone

              maprotiline and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.

              paliperidone and maprotiline both increase sedation. Use Caution/Monitor.

            • pancuronium

              pancuronium and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • papaveretum

              papaveretum and maprotiline both increase sedation. Use Caution/Monitor.

            • papaverine

              maprotiline and papaverine both increase sedation. Use Caution/Monitor.

            • paroxetine

              maprotiline and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.

            • pasireotide

              maprotiline and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.

            • pazopanib

              maprotiline and pazopanib both increase QTc interval. Use Caution/Monitor.

            • peginterferon alfa 2b

              peginterferon alfa 2b, maprotiline. Other (see comment). Use Caution/Monitor. Comment: When patients are administered peginterferon alpha-2b with CYP2D6 substrates, the therapeutic effect of these drugs may be altered. Peginterferon alpha-2b may increase or decrease levels of CYP2D6 substrate.

            • pentazocine

              pentazocine and maprotiline both increase sedation. Use Caution/Monitor.

              maprotiline and pentazocine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • pentobarbital

              pentobarbital and maprotiline both increase sedation. Use Caution/Monitor.

            • perphenazine

              perphenazine and maprotiline both increase sedation. Use Caution/Monitor.

            • phendimetrazine

              maprotiline increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • phenobarbital

              phenobarbital and maprotiline both increase sedation. Use Caution/Monitor.

            • phentermine

              maprotiline increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • phenylephrine

              maprotiline increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • phenylephrine ophthalmic

              maprotiline, phenylephrine ophthalmic. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • phenylephrine PO

              maprotiline increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

            • pholcodine

              maprotiline and pholcodine both increase sedation. Use Caution/Monitor.

            • physostigmine

              physostigmine increases and maprotiline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pilocarpine

              pilocarpine increases and maprotiline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pimozide

              pimozide and maprotiline both increase sedation. Use Caution/Monitor.

            • pirbuterol

              maprotiline increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • posaconazole

              maprotiline and posaconazole both increase QTc interval. Modify Therapy/Monitor Closely.

            • pralidoxime

              pralidoxime and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • pregabalin

              pregabalin, maprotiline. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

            • primaquine

              primaquine and maprotiline both increase QTc interval. Use Caution/Monitor.

            • primidone

              primidone and maprotiline both increase sedation. Use Caution/Monitor.

            • prochlorperazine

              prochlorperazine and maprotiline both increase QTc interval. Use Caution/Monitor.

              prochlorperazine and maprotiline both increase sedation. Use Caution/Monitor.

            • promethazine

              promethazine and maprotiline both increase QTc interval. Use Caution/Monitor.

              promethazine and maprotiline both increase sedation. Use Caution/Monitor.

            • propantheline

              propantheline and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • propofol

              propofol and maprotiline both increase sedation. Use Caution/Monitor.

            • propylhexedrine

              maprotiline increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • protriptyline

              maprotiline and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              maprotiline and protriptyline both increase sedation. Use Caution/Monitor.

            • pyridostigmine

              pyridostigmine increases and maprotiline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • quazepam

              quazepam and maprotiline both increase sedation. Use Caution/Monitor.

            • quetiapine

              quetiapine and maprotiline both increase sedation. Use Caution/Monitor.

              quetiapine, maprotiline. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Avoid use with drugs that prolong QT and in patients with risk factors for prolonged QT interval. Postmarketing cases show QT prolongation with overdose in patients with concomitant illness or with drugs known to cause electrolyte imbalance or prolong QT.

            • quinine

              maprotiline and quinine both increase QTc interval. Use Caution/Monitor.

            • ramelteon

              maprotiline and ramelteon both increase sedation. Use Caution/Monitor.

            • ranolazine

              maprotiline and ranolazine both increase QTc interval. Modify Therapy/Monitor Closely.

            • rapacuronium

              rapacuronium and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • remimazolam

              remimazolam, maprotiline. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.

            • rifabutin

              rifabutin decreases levels of maprotiline by increasing metabolism. Use Caution/Monitor.

            • rilpivirine

              rilpivirine increases toxicity of maprotiline by QTc interval. Use Caution/Monitor. Rilpivirine should be used with caution when co-administered with a drug with a known risk of Torsade de Pointes.

            • risperidone

              maprotiline and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.

              risperidone and maprotiline both increase sedation. Use Caution/Monitor.

            • rivastigmine

              rivastigmine increases and maprotiline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • rizatriptan

              rizatriptan and maprotiline both increase serotonin levels. Modify Therapy/Monitor Closely.

            • rocuronium

              rocuronium and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • rolapitant

              rolapitant will increase the level or effect of maprotiline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Rolapitant may increase plasma concentrations of CYP2D6 substrates for at least 28 days following rolapitant administration.

            • romidepsin

              maprotiline and romidepsin both increase QTc interval. Modify Therapy/Monitor Closely.

            • salmeterol

              maprotiline increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • SAMe

              maprotiline and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

            • scopolamine

              scopolamine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • scullcap

              maprotiline and scullcap both increase sedation. Use Caution/Monitor.

            • secobarbital

              secobarbital and maprotiline both increase sedation. Use Caution/Monitor.

            • selpercatinib

              selpercatinib increases toxicity of maprotiline by QTc interval. Use Caution/Monitor.

            • sevoflurane

              sevoflurane and maprotiline both increase sedation. Use Caution/Monitor.

            • shepherd's purse

              maprotiline and shepherd's purse both increase sedation. Use Caution/Monitor.

            • solifenacin

              solifenacin and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • sorafenib

              sorafenib and maprotiline both increase QTc interval. Use Caution/Monitor.

            • stiripentol

              stiripentol, maprotiline. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.

            • succinylcholine

              succinylcholine increases and maprotiline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • sufentanil

              sufentanil and maprotiline both increase sedation. Use Caution/Monitor.

            • sufentanil SL

              sufentanil SL, maprotiline. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.

            • sulfamethoxazole

              maprotiline and sulfamethoxazole both increase QTc interval. Modify Therapy/Monitor Closely.

            • sumatriptan

              sumatriptan and maprotiline both increase serotonin levels. Modify Therapy/Monitor Closely.

            • sumatriptan intranasal

              sumatriptan intranasal and maprotiline both increase serotonin levels. Modify Therapy/Monitor Closely.

            • tapentadol

              tapentadol and maprotiline both increase sedation. Use Caution/Monitor.

            • telavancin

              maprotiline and telavancin both increase QTc interval. Modify Therapy/Monitor Closely.

            • temazepam

              temazepam and maprotiline both increase sedation. Use Caution/Monitor.

            • terbinafine

              terbinafine will increase the level or effect of maprotiline by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Assess need to reduce dose of CYP2D6-metabolized drug.

            • terbutaline

              maprotiline increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • thioridazine

              thioridazine and maprotiline both increase sedation. Use Caution/Monitor.

            • thiothixene

              thiothixene and maprotiline both increase sedation. Use Caution/Monitor.

            • tiotropium

              tiotropium and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • tolterodine

              tolterodine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • topiramate

              maprotiline and topiramate both increase sedation. Modify Therapy/Monitor Closely.

            • tramadol

              tramadol and maprotiline both increase sedation. Use Caution/Monitor.

              maprotiline and tramadol both increase serotonin levels. Modify Therapy/Monitor Closely.

            • trazodone

              maprotiline and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

              maprotiline and trazodone both increase sedation. Use Caution/Monitor.

            • triazolam

              triazolam and maprotiline both increase sedation. Use Caution/Monitor.

            • triclofos

              triclofos and maprotiline both increase sedation. Use Caution/Monitor.

            • trifluoperazine

              trifluoperazine and maprotiline both increase sedation. Use Caution/Monitor.

            • trihexyphenidyl

              trihexyphenidyl and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • trimethoprim

              maprotiline and trimethoprim both increase QTc interval. Modify Therapy/Monitor Closely.

            • trimipramine

              maprotiline and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              maprotiline and trimipramine both increase sedation. Use Caution/Monitor.

            • triprolidine

              triprolidine and maprotiline both increase sedation. Use Caution/Monitor.

            • tropisetron

              maprotiline and tropisetron both increase QTc interval. Modify Therapy/Monitor Closely.

            • trospium chloride

              trospium chloride and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • vecuronium

              vecuronium and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • venlafaxine

              maprotiline and venlafaxine both increase QTc interval. Modify Therapy/Monitor Closely.

            • voclosporin

              voclosporin, maprotiline. Either increases effects of the other by QTc interval. Use Caution/Monitor.

            • voriconazole

              maprotiline and voriconazole both increase QTc interval. Modify Therapy/Monitor Closely.

            • xylometazoline

              maprotiline increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • yohimbine

              maprotiline increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ziconotide

              maprotiline and ziconotide both increase sedation. Use Caution/Monitor.

            • ziprasidone

              ziprasidone and maprotiline both increase sedation. Use Caution/Monitor.

            • zolmitriptan

              zolmitriptan and maprotiline both increase serotonin levels. Modify Therapy/Monitor Closely.

            Minor (70)

            • acarbose

              maprotiline increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

            • amobarbital

              amobarbital, maprotiline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

            • atropine

              maprotiline increases levels of atropine by unknown mechanism. Minor/Significance Unknown.

            • atropine IV/IM

              maprotiline increases levels of atropine IV/IM by unknown mechanism. Minor/Significance Unknown.

            • bazedoxifene/conjugated estrogens

              bazedoxifene/conjugated estrogens, maprotiline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

            • brimonidine

              maprotiline decreases effects of brimonidine by pharmacodynamic antagonism. Minor/Significance Unknown.

            • butabarbital

              butabarbital, maprotiline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

            • butalbital

              butalbital, maprotiline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

            • carbamazepine

              carbamazepine decreases levels of maprotiline by increasing metabolism. Minor/Significance Unknown.

            • chloroquine

              chloroquine increases toxicity of maprotiline by QTc interval. Minor/Significance Unknown.

            • chlorpromazine

              maprotiline, chlorpromazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

              maprotiline, chlorpromazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • chlorpropamide

              maprotiline increases effects of chlorpropamide by pharmacodynamic synergism. Minor/Significance Unknown.

            • conjugated estrogens

              conjugated estrogens, maprotiline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

            • conjugated estrogens, vaginal

              conjugated estrogens, vaginal, maprotiline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

            • desflurane

              desflurane, maprotiline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

            • dexmethylphenidate

              dexmethylphenidate increases effects of maprotiline by decreasing metabolism. Minor/Significance Unknown.

            • estradiol

              estradiol, maprotiline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

            • estrogens conjugated synthetic

              estrogens conjugated synthetic, maprotiline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

            • estrogens esterified

              estrogens esterified, maprotiline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

            • estropipate

              estropipate, maprotiline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

            • etomidate

              etomidate, maprotiline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

            • eucalyptus

              maprotiline and eucalyptus both increase sedation. Minor/Significance Unknown.

            • fluphenazine

              maprotiline, fluphenazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

              maprotiline, fluphenazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • glimepiride

              maprotiline increases effects of glimepiride by pharmacodynamic synergism. Minor/Significance Unknown.

            • glipizide

              maprotiline increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

            • glyburide

              maprotiline increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • hydroxyprogesterone caproate

              hydroxyprogesterone caproate, maprotiline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

            • insulin aspart

              maprotiline increases effects of insulin aspart by pharmacodynamic synergism. Minor/Significance Unknown.

            • insulin detemir

              maprotiline increases effects of insulin detemir by pharmacodynamic synergism. Minor/Significance Unknown.

            • insulin glargine

              maprotiline increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

            • insulin glulisine

              maprotiline increases effects of insulin glulisine by pharmacodynamic synergism. Minor/Significance Unknown.

            • insulin lispro

              maprotiline increases effects of insulin lispro by pharmacodynamic synergism. Minor/Significance Unknown.

            • insulin NPH

              maprotiline increases effects of insulin NPH by pharmacodynamic synergism. Minor/Significance Unknown.

            • insulin regular human

              maprotiline increases effects of insulin regular human by pharmacodynamic synergism. Minor/Significance Unknown.

            • isoproterenol

              isoproterenol, maprotiline. Mechanism: unknown. Minor/Significance Unknown. Risk of cardiac arrhythmias.

            • ketamine

              ketamine, maprotiline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

            • lithium

              lithium, maprotiline. Other (see comment). Minor/Significance Unknown. Comment: Risk of neurotoxicity in geriatric pts. Multiple mechanisms involved.

            • mestranol

              mestranol, maprotiline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

            • metformin

              maprotiline increases effects of metformin by pharmacodynamic synergism. Minor/Significance Unknown.

            • miglitol

              maprotiline increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

            • nateglinide

              maprotiline increases effects of nateglinide by pharmacodynamic synergism. Minor/Significance Unknown.

            • panax ginseng

              panax ginseng increases effects of maprotiline by pharmacodynamic synergism. Minor/Significance Unknown.

            • pentobarbital

              pentobarbital, maprotiline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

            • perphenazine

              maprotiline, perphenazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

              maprotiline, perphenazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • phenobarbital

              phenobarbital, maprotiline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

            • pioglitazone

              maprotiline increases effects of pioglitazone by pharmacodynamic synergism. Minor/Significance Unknown.

            • pleurisy root

              pleurisy root decreases effects of maprotiline by unspecified interaction mechanism. Minor/Significance Unknown. Theoretical interaction.

            • primidone

              primidone, maprotiline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

            • prochlorperazine

              maprotiline, prochlorperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

              maprotiline, prochlorperazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • progesterone micronized

              progesterone micronized, maprotiline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

            • promazine

              maprotiline, promazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

              maprotiline, promazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • promethazine

              maprotiline, promethazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

              maprotiline, promethazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • propofol

              propofol, maprotiline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

            • repaglinide

              maprotiline increases effects of repaglinide by pharmacodynamic synergism. Minor/Significance Unknown.

            • rosiglitazone

              maprotiline increases effects of rosiglitazone by pharmacodynamic synergism. Minor/Significance Unknown.

            • sage

              maprotiline and sage both increase sedation. Minor/Significance Unknown.

            • saxagliptin

              maprotiline increases effects of saxagliptin by pharmacodynamic synergism. Minor/Significance Unknown.

            • secobarbital

              secobarbital, maprotiline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

            • serdexmethylphenidate/dexmethylphenidate

              serdexmethylphenidate/dexmethylphenidate increases effects of maprotiline by decreasing metabolism. Minor/Significance Unknown.

            • sevoflurane

              sevoflurane, maprotiline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

            • sitagliptin

              maprotiline increases effects of sitagliptin by pharmacodynamic synergism. Minor/Significance Unknown.

            • sulfamethoxazole

              sulfamethoxazole decreases levels of maprotiline by unspecified interaction mechanism. Minor/Significance Unknown.

            • thioridazine

              maprotiline, thioridazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

              maprotiline, thioridazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • tolazamide

              maprotiline increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.

            • tolbutamide

              maprotiline increases effects of tolbutamide by pharmacodynamic synergism. Minor/Significance Unknown.

            • trifluoperazine

              maprotiline, trifluoperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

              maprotiline, trifluoperazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • vasopressin

              maprotiline increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.

            • verapamil

              verapamil increases levels of maprotiline by decreasing metabolism. Minor/Significance Unknown.

            • vildagliptin

              maprotiline increases effects of vildagliptin by pharmacodynamic synergism. Minor/Significance Unknown.

            • zolpidem

              zolpidem, maprotiline. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

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            Adverse Effects

            Frequency Not Defined

            Common

            • Fatigue
            • Sedation
            • Lethargy
            • Weakness
            • Constipation
            • Dry mouth
            • Blurred vision

            Less Common

            • Agitation
            • Anxiety
            • Headache
            • Insomnia
            • Nausea
            • Vomiting
            • Sweating

            Infrequent

            • Orthostatic hypotension, ECG changes, tachycardia
            • Confusion, EPS, dizziness, paresthesia, tinnitus
            • Rash
            • Incr LFTs
            • Sexual dysfunction

            Rare

            • Seizure
            • Agranulocytosis
            • Thrombocytopenia
            • Eosinophilia
            • Leukopenia
            • SIADH
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            Warnings

            Black Box Warnings

            In short-term studies, antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults (<24 yr of age) taking antidepressants for major depressive disorders and other psychiatric illnesses

            This increase was not seen in patients aged >24 years; a slight decrease in suicidal thinking was seen in adults >65 years

            In children and young adults, risks must be weighed against the benefits of taking antidepressants

            Patients should be monitored closely for changes in behavior, clinical worsening, and suicidal tendencies; this should be done during initial 1-2 months of therapy and dosage adjustments

            The patient’s family should communicate any abrupt changes in behavior to the healthcare provider

            Worsening behavior and suicidal tendencies that are not part of the presenting symptoms may require discontinuation of therapy

            This drug is not approved for use in pediatric patients

            Contraindications

            Hypersensitivity

            Severe cardiovascular disorders

            Narrow angle glaucoma

            Within 14 days of MAO inhibitors may cause serotonin syndrome

            Any drugs or conditions that prolong QT interval

            Acute recovery post-MI

            Cautions

            Caution in BPH, urinary/GI retention, increased IOP, hyperthyroidism, open-angle glaucoma, seizure disorder, brain tumor, respiratory impairment

            Clinical worsening & suicide ideation may occur despite medication in adolescents & young adults (18-24 years)

            Risk of anticholinergic side-effects

            May cause sedation (may impair physical and mental abilities), orthostatic hypotension, and anticholinergic effects

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            Pregnancy & Lactation

            Pregnancy Category: B

            Lactation: avoid during breastfeeding

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

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            Pharmacology

            Mechanism of Action

            Tetracyclic; may increase norepinephrine synaptic concentrations in the central nervous system by blocking NE reuptake by the presynaptic neuronal membrane; may also down regulate serotonin receptors and beta-adrenergic receptors and desensitize adenyl cyclase

            Pharmacokinetics

            Half-life elimination: 27-58 hr

            Peak Plasma Time: within 12 hr (8-24 hr)

            Bioavailability: Completely absorbed

            Protein Bound: 88%

            Metabolism: Liver

            Metabolites: Desmethylmaprotiline

            Excretion: Urine (70%); feces (30%)

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            Images

            BRAND FORM. UNIT PRICE PILL IMAGE
            maprotiline oral
            -
            75 mg tablet
            maprotiline oral
            -
            50 mg tablet
            maprotiline oral
            -
            25 mg tablet

            Copyright © 2010 First DataBank, Inc.

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            Patient Handout

            Patient Education
            maprotiline oral

            MAPROTILINE - ORAL

            (map-ROW-till-een)

            COMMON BRAND NAME(S): Ludiomil

            WARNING: Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, studies have shown that a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. It is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition. Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.

            USES: This medication is used to treat various types of depression and related anxiety. It may help improve mood and feelings of well-being. This medication belongs to a class of medications called tetracyclic antidepressants. It works by affecting the balance of certain natural chemicals (neurotransmitters) in the brain.

            HOW TO USE: Read the Medication Guide provided by your pharmacist before you start taking maprotiline and each time you get a refill. If you have any questions, consult your doctor or pharmacist.Take this medication by mouth, usually 1 to 3 times daily or as directed by your doctor. If you take it only once a day, take it at bedtime to reduce daytime sleepiness. The dosage is based on your medical condition and response to treatment.To reduce your risk of side effects (such as drowsiness, dry mouth, dizziness), your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully.Take this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time(s) each day. Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase.Keep taking this medication even if you feel well. Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Also, you may experience symptoms such as mood swings, headache, and tiredness. To prevent these symptoms while you are stopping treatment with this drug, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details. Report any new or worsening symptoms right away.This medication may not work right away. You may see some benefit within a week. However, it may take up to 3 weeks before you feel the full effect.Tell your doctor if your condition lasts or gets worse (such as your feelings of sadness get worse, or you have thoughts of suicide).

            SIDE EFFECTS: See also Warning section.Drowsiness, dizziness, dry mouth, blurred vision, constipation, or trouble urinating may occur. If any of these effects last or get worse, notify your doctor or pharmacist promptly.To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.To relieve dry mouth, suck on (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water, or use a saliva substitute.To prevent constipation, eat dietary fiber, drink enough water, and exercise. You may also need to take a laxative. Ask your pharmacist which type of laxative is right for you.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if any of these rare but serious side effects occur: heartburn that doesn't go away, mental/mood changes (such as anxiety, agitation, confusion), shaking, severe stomach/abdominal pain.Get medical help right away if you have any very serious side effects, including: severe dizziness, fast/irregular heartbeat, fainting, seizures, eye pain/swelling/redness, widened pupils, vision changes (such as seeing rainbows around lights at night).A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

            PRECAUTIONS: See also Warning section.Before taking maprotiline, tell your doctor or pharmacist if you are allergic to it; or to tricyclic antidepressants (such as nortriptyline); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: bleeding problems, breathing problems, kidney problems, liver problems, recent heart attack, problems urinating (such as due to enlarged prostate), overactive thyroid (hyperthyroidism), personal or family history of glaucoma (angle-closure type), personal or family history of mental/mood conditions (such as bipolar disorder, psychosis), family history of suicide, seizures, conditions that may increase your risk of seizures (such as other brain disease, alcohol/sedative withdrawal).Maprotiline may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using maprotiline, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using maprotiline safely.This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.If you have diabetes, this drug may make it harder to control your blood sugar levels. Monitor your blood sugar levels regularly and tell your doctor of the results. Your doctor may need to adjust your diabetes medication, exercise program, or diet.Older adults may be more sensitive to the side effects of this drug, especially dizziness (more likely when standing up), drowsiness, dry mouth, confusion, constipation, difficulty urinating, and QT prolongation (see above). Dizziness, drowsiness, and confusion can increase the risk of falling.During pregnancy, this medication should be used only when clearly needed. Since untreated mental/mood problems (such as depression) can be a serious condition, do not stop using this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss with your doctor the benefits and risks of using this medication during pregnancy.This medication passes into breast milk and the effect on a nursing infant is unknown. Consult your doctor before breast-feeding.

            DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: arbutamine, thyroid supplements, anticholinergic drugs (such as belladonna alkaloids), central-acting drugs to treat high blood pressure (such as clonidine, guanabenz, guanadrel, methyldopa).Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication. Ask your doctor when to start or stop taking this medication.Other medications can affect the removal of maprotiline from your body, thereby affecting how maprotiline works. These drugs include cimetidine, terbinafine, drugs to treat irregular heart rate (such as quinidine/propafenone/flecainide), antidepressants (such as SSRIs including paroxetine/fluoxetine/fluvoxamine). This is not a complete list.Many drugs besides maprotiline may affect the heart rhythm (QT prolongation in the EKG), including amiodarone, dofetilide, pimozide, procainamide, quinidine, sotalol, macrolide antibiotics (such as erythromycin), among others. Before using maprotiline, report all medications you are currently using to your doctor or pharmacist.Tell your doctor or pharmacist if you are taking other products that cause drowsiness, including alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain relievers (such as codeine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain decongestants or ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

            OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: extreme drowsiness, hallucinations, fast/irregular heartbeat, fainting, slow/shallow breathing, seizures.

            NOTES: Do not share this medication with others.Laboratory and/or medical tests (such as blood counts, blood pressure, EKG, liver tests) may be performed from time to time to monitor your progress or check for side effects. Keep all medical appointments. Consult your doctor for more details.

            MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

            STORAGE: Store at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

            Information last revised May 2022. Copyright(c) 2022 First Databank, Inc.

            IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.