Drug interactions
Maprotiline + Neostigmine
Severity: Moderate
Maprotiline and Neostigmine: moderate 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
Maprotiline has anticholinergic properties that can oppose the cholinergic effects of neostigmine. This may reduce the intended effect of neostigmine, for example on reversal of neuromuscular blockade or on myasthenic symptoms. The size of the effect is variable and usually modest.
What this interaction means in plain words
Maprotiline and Neostigmine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Maprotiline belongs to Central Nervous System; Neostigmine belongs to Central Nervous System.
Why it happens
Pharmacodynamic antagonism between the anticholinergic activity of maprotiline and the cholinesterase inhibition of neostigmine.
What to do
Monitor clinical response to neostigmine, such as muscle strength or reversal of blockade, and titrate the dose accordingly. Consider a less anticholinergic antidepressant if response is inadequate.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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
Other interactions of Neostigmine
Frequently asked questions
Can I take Maprotiline with Neostigmine?
MediHelp rates the interaction as moderate. Maprotiline and Neostigmine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Maprotiline has anticholinergic properties that can oppose the cholinergic effects of neostigmine. This may reduce the intended effect of neostigmine, for example on reversal of neuromuscular blockade or on myasthenic symptoms. The size of the effect is variable and usually modest.
How serious is the interaction between Maprotiline and Neostigmine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor clinical response to neostigmine, such as muscle strength or reversal of blockade, and titrate the dose accordingly. Consider a less anticholinergic antidepressant if response is inadequate.
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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