Drug interactions
Fentanyl intranasal + Maprotiline
Severity: Major
Fentanyl intranasal 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
Combining an opioid with a sedating tricyclic-type antidepressant increases the risk of profound sedation, respiratory depression, coma and death. Serotonergic effects of fentanyl may also add to risk.
What this interaction means in plain words
Fentanyl intranasal 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, with possible additive serotonergic activity.
What to do
Reserve the combination for patients with no adequate alternatives, using the lowest effective doses and shortest duration. Monitor closely for sedation and respiratory depression.
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
Frequently asked questions
Can I take Fentanyl intranasal with Maprotiline?
MediHelp rates the interaction as major. Fentanyl intranasal 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 an opioid with a sedating tricyclic-type antidepressant increases the risk of profound sedation, respiratory depression, coma and death. Serotonergic effects of fentanyl may also add to risk.
How serious is the interaction between Fentanyl intranasal 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: Reserve the combination for patients with no adequate alternatives, using the lowest effective doses and shortest duration. Monitor closely for sedation and respiratory depression.
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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