Drug interactions
Ketoconazole + Maprotiline
Severity: Major
Ketoconazole 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
Both drugs can prolong the QT interval, and ketoconazole may increase maprotiline levels. This raises the risk of ventricular arrhythmia and also of seizures, which are a known concern with maprotiline.
What this interaction means in plain words
Ketoconazole 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.
Ketoconazole belongs to Anti Fungals; Maprotiline belongs to Central Nervous System.
Why it happens
Additive QT prolongation with possible metabolic inhibition by ketoconazole.
What to do
Avoid the combination if possible and consider another antidepressant or antifungal. If both are required, check an ECG and electrolytes and monitor for toxicity.
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 Ketoconazole
- Alfuzosin + Ketoconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Avanafil + Ketoconazole Contraindicated
- Conivaptan + Ketoconazole Contraindicated
- Dihydroergotamine intranasal + Ketoconazole Contraindicated
- Dihydroergotamine + Ketoconazole 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 Ketoconazole with Maprotiline?
MediHelp rates the interaction as major. Ketoconazole 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. Both drugs can prolong the QT interval, and ketoconazole may increase maprotiline levels. This raises the risk of ventricular arrhythmia and also of seizures, which are a known concern with maprotiline.
How serious is the interaction between Ketoconazole 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 and consider another antidepressant or antifungal. If both are required, check an ECG and electrolytes and monitor for toxicity.
What other medicines interact with Ketoconazole?
MediHelp also lists interactions of Ketoconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Ketoconazole page.
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