Drug interactions
Maprotiline + Nefazodone
Severity: Major
Maprotiline and Nefazodone: 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
Nefazodone inhibits serotonin reuptake and is a potent CYP3A4 inhibitor, and maprotiline also affects monoamine reuptake. The combination may raise maprotiline exposure and add to serotonergic activity, increasing the risk of serotonin syndrome, seizures and cardiac toxicity.
What this interaction means in plain words
Maprotiline and Nefazodone 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 serotonergic and noradrenergic effects, with possible pharmacokinetic increase in maprotiline levels through CYP inhibition by nefazodone.
What to do
Avoid the combination when possible. If used together, start with low maprotiline doses and monitor for serotonin toxicity, seizures and ECG changes.
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 Maprotiline with Nefazodone?
MediHelp rates the interaction as major. Maprotiline and Nefazodone 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. Nefazodone inhibits serotonin reuptake and is a potent CYP3A4 inhibitor, and maprotiline also affects monoamine reuptake. The combination may raise maprotiline exposure and add to serotonergic activity, increasing the risk of serotonin syndrome, seizures and cardiac toxicity.
How serious is the interaction between Maprotiline and Nefazodone?
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 when possible. If used together, start with low maprotiline doses and monitor for serotonin toxicity, seizures and ECG changes.
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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