Drug interactions
Flecainide + Maprotiline
Severity: Major
Flecainide and Maprotiline: major interaction.
Last updated Sources: UK SmPC
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 tricyclic-like effects on cardiac conduction and QT, and combined with flecainide it raises the risk of ventricular arrhythmias and seizures. Both drugs are metabolized in part via CYP2D6.
What this interaction means in plain words
Flecainide 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.
Flecainide belongs to Cardiovascular; Maprotiline belongs to Central Nervous System.
Why it happens
Additive conduction slowing and QT prolongation, with possible CYP2D6 competition.
What to do
Avoid the combination if possible; otherwise monitor ECG and electrolytes and choose a safer antidepressant.
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 Flecainide
- Flecainide + Nirmatrelvir Contraindicated
- Flecainide + Nirmatrelvir / ritonavir Contraindicated
- Flecainide + Pimozide Contraindicated
- Flecainide + Ritonavir Contraindicated
- Flecainide + Thioridazine Contraindicated
- Flecainide + Tipranavir Contraindicated
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 Flecainide with Maprotiline?
MediHelp rates the interaction as major. Flecainide 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 has tricyclic-like effects on cardiac conduction and QT, and combined with flecainide it raises the risk of ventricular arrhythmias and seizures. Both drugs are metabolized in part via CYP2D6.
How serious is the interaction between Flecainide 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 the combination if possible; otherwise monitor ECG and electrolytes and choose a safer antidepressant.
What other medicines interact with Flecainide?
MediHelp also lists interactions of Flecainide with, for example, Nirmatrelvir, Nirmatrelvir / ritonavir, Pimozide. The full list is on the Flecainide page.
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