Drug interactions
Dextromoramide + Maprotiline
Severity: Major
Dextromoramide and Maprotiline: major interaction.
Last updated Sources: Base de donnees publique des medicaments (France)
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 a sedating antidepressant with a potent opioid increases the risk of profound sedation, respiratory depression and hypotension. Maprotiline may also add to anticholinergic effects such as constipation and urinary retention.
What this interaction means in plain words
Dextromoramide 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.
Why it happens
Additive CNS and respiratory depression from opioid agonism and the sedative antidepressant.
What to do
Use the lowest effective doses and monitor sedation and respiratory rate, especially at initiation and dose increases. Counsel the patient against driving and alcohol.
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
Frequently asked questions
Can I take Dextromoramide with Maprotiline?
MediHelp rates the interaction as major. Dextromoramide 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 a sedating antidepressant with a potent opioid increases the risk of profound sedation, respiratory depression and hypotension. Maprotiline may also add to anticholinergic effects such as constipation and urinary retention.
How serious is the interaction between Dextromoramide 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: Use the lowest effective doses and monitor sedation and respiratory rate, especially at initiation and dose increases. Counsel the patient against driving and alcohol.
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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