Drug interactions
Maprotiline + Methylene blue
Severity: Contraindicated
Maprotiline and Methylene blue: contraindicated 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
Methylene blue inhibits monoamine oxidase A, so combining it with a serotonergic antidepressant can cause serotonin syndrome, with agitation, hyperthermia, clonus and autonomic instability. The reaction can be severe.
What this interaction means in plain words
Maprotiline and Methylene blue are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
MAO-A inhibition by methylene blue combined with maprotiline's norepinephrine reuptake blockade increases monoamine activity.
What to do
Avoid unless urgent treatment is essential; if needed, stop maprotiline and monitor for CNS toxicity. Serotonergic therapy can be resumed 24 hours after the last methylene blue dose, or sooner if toxicity is absent after 2 weeks of monitoring.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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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 + Phenelzine Contraindicated
Frequently asked questions
Can I take Maprotiline with Methylene blue?
MediHelp rates the interaction as contraindicated. Maprotiline and Methylene blue are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Methylene blue inhibits monoamine oxidase A, so combining it with a serotonergic antidepressant can cause serotonin syndrome, with agitation, hyperthermia, clonus and autonomic instability. The reaction can be severe.
How serious is the interaction between Maprotiline and Methylene blue?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid unless urgent treatment is essential; if needed, stop maprotiline and monitor for CNS toxicity. Serotonergic therapy can be resumed 24 hours after the last methylene blue dose, or sooner if toxicity is absent after 2 weeks of monitoring.
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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