Drug interactions
Donepezil + Maprotiline
Severity: Moderate
Donepezil and Maprotiline: moderate 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 has anticholinergic properties that oppose the cholinesterase inhibition of donepezil, which may blunt its benefit in dementia. Both drugs can also prolong the QT interval, and donepezil can cause bradycardia, so arrhythmia risk may rise.
What this interaction means in plain words
Donepezil and Maprotiline can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Donepezil belongs to Central Nervous System; Maprotiline belongs to Central Nervous System.
Why it happens
Pharmacodynamic antagonism between antimuscarinic and cholinesterase inhibiting effects, plus additive QT prolongation.
What to do
Where possible choose an antidepressant with low anticholinergic activity such as an SSRI with lower QT risk. If combined, monitor cognition, heart rate and ECG, and correct electrolyte abnormalities.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Donepezil
- Donepezil + Dronedarone Contraindicated
- Donepezil + Pimozide Contraindicated
- Donepezil + Thioridazine Contraindicated
- Donepezil + Vandetanib Contraindicated
- Amiodarone + Donepezil Major
- Amisulpride + Donepezil Major
Frequently asked questions
Can I take Donepezil with Maprotiline?
MediHelp rates the interaction as moderate. Donepezil and Maprotiline can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Maprotiline has anticholinergic properties that oppose the cholinesterase inhibition of donepezil, which may blunt its benefit in dementia. Both drugs can also prolong the QT interval, and donepezil can cause bradycardia, so arrhythmia risk may rise.
How serious is the interaction between Donepezil and Maprotiline?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Where possible choose an antidepressant with low anticholinergic activity such as an SSRI with lower QT risk. If combined, monitor cognition, heart rate and ECG, and correct electrolyte abnormalities.
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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