Drug interactions
Citalopram + Maprotiline
Severity: Major
Citalopram and Maprotiline: major interaction.
Last updated Sources: US FDA label
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
Citalopram causes dose-dependent QT prolongation, and maprotiline can add to this effect, increasing the risk of torsades de pointes. Both drugs also increase serotonergic activity and may lower the seizure threshold.
What this interaction means in plain words
Citalopram 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.
Citalopram belongs to Central Nervous System; Maprotiline belongs to Central Nervous System.
Why it happens
Additive QT prolongation and additive serotonergic effects; citalopram may modestly inhibit CYP2D6.
What to do
Avoid combining if possible. If used, keep citalopram at or below labeled maximum doses, check ECG and electrolytes, and watch for serotonin toxicity.
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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References
Other interactions of Maprotiline
- Arsenic trioxide + Maprotiline Contraindicated
- Disopyramide + Maprotiline Contraindicated
- Dofetilide + Maprotiline Contraindicated
- Ibutilide + Maprotiline Contraindicated
- Isocarboxazid + Maprotiline Contraindicated
- Maprotiline + Methylene blue Contraindicated
Other interactions of Citalopram
- Cisapride + Citalopram Contraindicated
- Citalopram + Dronedarone Contraindicated
- Citalopram + Escitalopram Contraindicated
- Citalopram + Isocarboxazid Contraindicated
- Citalopram + Methylene blue Contraindicated
- Citalopram + Phenelzine Contraindicated
Frequently asked questions
Can I take Citalopram with Maprotiline?
MediHelp rates the interaction as major. Citalopram 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. Citalopram causes dose-dependent QT prolongation, and maprotiline can add to this effect, increasing the risk of torsades de pointes. Both drugs also increase serotonergic activity and may lower the seizure threshold.
How serious is the interaction between Citalopram 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 combining if possible. If used, keep citalopram at or below labeled maximum doses, check ECG and electrolytes, and watch for serotonin toxicity.
What other medicines interact with Maprotiline?
MediHelp also lists interactions of Maprotiline with, for example, Arsenic trioxide, Disopyramide, Dofetilide. The full list is on the Maprotiline page.
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