Dosing & Uses
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.
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

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 (145)
- adagrasib
adagrasib, maprotiline. Either increases effects of the other by QTc interval. Avoid or Use Alternate Drug. Each drug prolongs the QTc interval, which may increased the risk of Torsade de pointes, other serious arryhthmias, and sudden death. If coadministration unavoidable, more frequent monitoring is recommended for such patients.
- 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. - anagrelide
anagrelide and maprotiline both increase QTc interval. 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.
- asenapine
asenapine and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.
- asenapine transdermal
asenapine transdermal and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.
- benzhydrocodone/acetaminophen
benzhydrocodone/acetaminophen and maprotiline both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- 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.
- buprenorphine subdermal implant
buprenorphine subdermal implant and maprotiline both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- 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.
- eliglustat
eliglustat and maprotiline both increase QTc interval. 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.
- olopatadine intranasal
maprotiline and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- 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.
- siponimod
siponimod 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.
- solifenacin
solifenacin and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.
- 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.
- tetrabenazine
tetrabenazine and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.
- 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.
- vorinostat
vorinostat and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.
- 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 (331)
- 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.
- acrivastine
acrivastine and maprotiline both increase sedation. 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.
- asenapine
asenapine and maprotiline both increase sedation. Use Caution/Monitor.
- asenapine transdermal
asenapine transdermal and maprotiline both increase sedation. 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.
- avapritinib
avapritinib and maprotiline both increase sedation. 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.
- brexpiprazole
brexpiprazole and maprotiline both increase sedation. Use Caution/Monitor.
- brimonidine
brimonidine and maprotiline both increase sedation. Use Caution/Monitor.
- brivaracetam
brivaracetam and maprotiline both increase 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 and maprotiline both increase QTc interval. Use Caution/Monitor. - buprenorphine buccal
buprenorphine buccal and maprotiline both increase sedation. Use Caution/Monitor.
buprenorphine buccal and maprotiline both increase QTc interval. 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 subdermal implant and maprotiline both increase QTc interval. Use Caution/Monitor. - buprenorphine transdermal
buprenorphine transdermal and maprotiline both increase QTc interval. Use Caution/Monitor.
- 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.
buprenorphine, long-acting injection and maprotiline both increase QTc interval. Use Caution/Monitor. - 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 topical
maprotiline and cocaine topical 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. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).
- 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.
- sertraline
sertraline and maprotiline both increase 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.
- sunitinib
sunitinib and maprotiline both increase QTc interval. Use Caution/Monitor.
- tacrolimus
tacrolimus and maprotiline both increase QTc interval. Use Caution/Monitor.
- 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.
- valbenazine
valbenazine and maprotiline both increase QTc interval. 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 (DSC)
hydroxyprogesterone caproate (DSC), 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.
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
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
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.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%)
Images
Formulary
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- View the formulary and any restrictions for each plan.
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