Drug interactions
Amitriptyline + Maprotiline
Severity: Major
Amitriptyline and Maprotiline: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Maprotiline is a tetracyclic with tricyclic-like properties, so combining it with amitriptyline adds QT prolongation, anticholinergic burden, sedation and seizure risk. Both are metabolised by CYP2D6, so levels may rise.
What this interaction means in plain words
Amitriptyline and Maprotiline can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amitriptyline belongs to Central Nervous System; Maprotiline belongs to Central Nervous System.
Why it happens
Additive cardiac conduction, anticholinergic and seizure-threshold lowering effects, with CYP2D6 competition.
What to do
Avoid the combination and use a single antidepressant. If a switch is needed, taper gradually and monitor ECG.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Amitriptyline
- Amitriptyline + Isocarboxazid Contraindicated
- Amitriptyline + Methylene blue Contraindicated
- Amitriptyline + Phenelzine Contraindicated
- Amitriptyline + Pimozide Contraindicated
- Amitriptyline + Procarbazine Contraindicated
- Amitriptyline + Safinamide Contraindicated
Other interactions of Maprotiline
- Arsenic trioxide + Maprotiline Contraindicated
- Disopyramide + Maprotiline Contraindicated
- Dofetilide + Maprotiline Contraindicated
- Ibutilide + Maprotiline Contraindicated
- Isocarboxazid + Maprotiline Contraindicated
- Maprotiline + Methylene blue Contraindicated
Frequently asked questions
Can I take Amitriptyline with Maprotiline?
MediHelp rates the interaction as major. Amitriptyline and Maprotiline can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Maprotiline is a tetracyclic with tricyclic-like properties, so combining it with amitriptyline adds QT prolongation, anticholinergic burden, sedation and seizure risk. Both are metabolised by CYP2D6, so levels may rise.
How serious is the interaction between Amitriptyline and Maprotiline?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and use a single antidepressant. If a switch is needed, taper gradually and monitor ECG.
What other medicines interact with Amitriptyline?
MediHelp also lists interactions of Amitriptyline with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Amitriptyline page.
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