Drug interactions
Clomipramine + Maprotiline
Severity: Major
Clomipramine 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
Combining two tricyclic or tetracyclic antidepressants adds QT prolongation, seizure risk, anticholinergic burden and serotonergic effects. Maprotiline in particular carries a notable seizure risk, which is further increased by clomipramine.
What this interaction means in plain words
Clomipramine 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.
Clomipramine belongs to Central Nervous System; Maprotiline belongs to Central Nervous System.
Why it happens
Additive QT prolongation, lowered seizure threshold and monoamine reuptake inhibition.
What to do
Avoid using two such antidepressants together; choose a single agent and, if switching, taper and allow for washout. If unavoidable, monitor ECG and for seizures and 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 Clomipramine
- Arsenic trioxide + Clomipramine Contraindicated
- Clomipramine + Dofetilide Contraindicated
- Clomipramine + Droperidol Contraindicated
- Clomipramine + Isocarboxazid Contraindicated
- Clomipramine + Methylene blue Contraindicated
- Clomipramine + Pentamidine 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 Clomipramine with Maprotiline?
MediHelp rates the interaction as major. Clomipramine 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. Combining two tricyclic or tetracyclic antidepressants adds QT prolongation, seizure risk, anticholinergic burden and serotonergic effects. Maprotiline in particular carries a notable seizure risk, which is further increased by clomipramine.
How serious is the interaction between Clomipramine 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 using two such antidepressants together; choose a single agent and, if switching, taper and allow for washout. If unavoidable, monitor ECG and for seizures and serotonin toxicity.
What other medicines interact with Clomipramine?
MediHelp also lists interactions of Clomipramine with, for example, Arsenic trioxide, Dofetilide, Droperidol. The full list is on the Clomipramine page.
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