Drug interactions
Epinephrine + Maprotiline
Severity: Major
Epinephrine 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
Maprotiline blocks norepinephrine reuptake, which can amplify the pressor and arrhythmic effects of systemically administered epinephrine. This can cause severe hypertension and ventricular arrhythmias, particularly with intravenous doses or with local anesthetic injections.
What this interaction means in plain words
Epinephrine 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.
Epinephrine belongs to Endocrine; Maprotiline belongs to Central Nervous System.
Why it happens
Blockade of catecholamine reuptake potentiates adrenergic effects, with possible additive arrhythmogenic effects.
What to do
Avoid systemic epinephrine where alternatives exist, and use the smallest effective dose when it is essential, as in anaphylaxis. Monitor blood pressure and ECG and limit epinephrine in local anesthetics.
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 Epinephrine
- Epinephrine + Isocarboxazid Contraindicated
- Epinephrine + Phenelzine Contraindicated
- Epinephrine + Tranylcypromine Contraindicated
- Acebutolol + Epinephrine Major
- Amitriptyline + Epinephrine Major
- Amoxapine + Epinephrine Major
Frequently asked questions
Can I take Epinephrine with Maprotiline?
MediHelp rates the interaction as major. Epinephrine 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. Maprotiline blocks norepinephrine reuptake, which can amplify the pressor and arrhythmic effects of systemically administered epinephrine. This can cause severe hypertension and ventricular arrhythmias, particularly with intravenous doses or with local anesthetic injections.
How serious is the interaction between Epinephrine 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 systemic epinephrine where alternatives exist, and use the smallest effective dose when it is essential, as in anaphylaxis. Monitor blood pressure and ECG and limit epinephrine in local anesthetics.
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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