Drug interactions
Cocaine + Maprotiline
Severity: Major
Cocaine 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
Cocaine blocks reuptake of norepinephrine, dopamine and serotonin, and tricyclic-type antidepressants can potentiate its sympathomimetic effects. Systemic exposure from topical medical use is limited, but illicit use can cause hypertension, arrhythmias and seizures, which maprotiline may also worsen.
What this interaction means in plain words
Cocaine 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.
Cocaine belongs to Central Nervous System; Maprotiline belongs to Central Nervous System.
Why it happens
Additive monoamine reuptake inhibition and sympathomimetic effects, with additive seizure-threshold lowering and proarrhythmic effects.
What to do
Avoid concomitant use, especially of non-topical cocaine. If topical cocaine is required, use minimal doses and monitor blood pressure and 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 Maprotiline
- Arsenic trioxide + Maprotiline Contraindicated
- Disopyramide + Maprotiline Contraindicated
- Dofetilide + Maprotiline Contraindicated
- Ibutilide + Maprotiline Contraindicated
- Isocarboxazid + Maprotiline Contraindicated
- Maprotiline + Methylene blue Contraindicated
Other interactions of Cocaine
- Cocaine + Isocarboxazid Contraindicated
- Cocaine + Phenelzine Contraindicated
- Cocaine + Procarbazine Contraindicated
- Amitriptyline + Cocaine Major
- Bisoprolol + Cocaine Major
- Citalopram + Cocaine Major
Frequently asked questions
Can I take Cocaine with Maprotiline?
MediHelp rates the interaction as major. Cocaine 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. Cocaine blocks reuptake of norepinephrine, dopamine and serotonin, and tricyclic-type antidepressants can potentiate its sympathomimetic effects. Systemic exposure from topical medical use is limited, but illicit use can cause hypertension, arrhythmias and seizures, which maprotiline may also worsen.
How serious is the interaction between Cocaine 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 concomitant use, especially of non-topical cocaine. If topical cocaine is required, use minimal doses and monitor blood pressure and ECG.
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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