Drug interactions
Maprotiline + Meperidine
Severity: Major
Maprotiline and Meperidine: 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
Meperidine has serotonergic activity and maprotiline inhibits norepinephrine reuptake with some serotonergic effect. Together they may precipitate serotonin syndrome, with agitation, hyperthermia, tremor, clonus and autonomic instability. Maprotiline also lowers seizure threshold, as does meperidine's metabolite normeperidine.
What this interaction means in plain words
Maprotiline and Meperidine 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 belongs to Central Nervous System; Meperidine belongs to Musculoskeletal.
Why it happens
Additive serotonergic effects from meperidine's weak serotonin reuptake inhibition and maprotiline's monoaminergic reuptake inhibition.
What to do
Prefer a non-serotonergic opioid such as morphine or hydromorphone in patients taking maprotiline. If combined, monitor for neuromuscular excitability and mental status changes and stop both if serotonin syndrome develops.
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 Meperidine
- Alvimopan + Meperidine Contraindicated
- Isocarboxazid + Meperidine Contraindicated
- Meperidine + Methylene blue Contraindicated
- Meperidine + Olanzapine / samidorphan Contraindicated
- Meperidine + Phenelzine Contraindicated
- Meperidine + Procarbazine 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 Maprotiline with Meperidine?
MediHelp rates the interaction as major. Maprotiline and Meperidine 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. Meperidine has serotonergic activity and maprotiline inhibits norepinephrine reuptake with some serotonergic effect. Together they may precipitate serotonin syndrome, with agitation, hyperthermia, tremor, clonus and autonomic instability. Maprotiline also lowers seizure threshold, as does meperidine's metabolite normeperidine.
How serious is the interaction between Maprotiline and Meperidine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer a non-serotonergic opioid such as morphine or hydromorphone in patients taking maprotiline. If combined, monitor for neuromuscular excitability and mental status changes and stop both if serotonin syndrome develops.
What other medicines interact with Meperidine?
MediHelp also lists interactions of Meperidine with, for example, Alvimopan, Isocarboxazid, Methylene blue. The full list is on the Meperidine page.
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