Drug interactions
Maprotiline + Nortriptyline
Severity: Major
Maprotiline and Nortriptyline: 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
Combining two tricyclic-type antidepressants adds anticholinergic, sedative and cardiac conduction effects and lowers the seizure threshold. Maprotiline is notable for seizure risk, and QT prolongation and arrhythmia are also more likely.
What this interaction means in plain words
Maprotiline and Nortriptyline 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; Nortriptyline belongs to Central Nervous System.
Why it happens
Duplicate pharmacology with additive QT prolongation, anticholinergic effects, seizure threshold lowering and noradrenergic and serotonergic reuptake inhibition.
What to do
Avoid using both; choose one antidepressant. If a switch is needed, taper one before starting the other and check an ECG.
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 Nortriptyline
- Disopyramide + Nortriptyline Contraindicated
- Dofetilide + Nortriptyline Contraindicated
- Dronedarone + Nortriptyline Contraindicated
- Ibutilide + Nortriptyline Contraindicated
- Isocarboxazid + Nortriptyline Contraindicated
- Methylene blue + Nortriptyline 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 Nortriptyline?
MediHelp rates the interaction as major. Maprotiline and Nortriptyline 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. Combining two tricyclic-type antidepressants adds anticholinergic, sedative and cardiac conduction effects and lowers the seizure threshold. Maprotiline is notable for seizure risk, and QT prolongation and arrhythmia are also more likely.
How serious is the interaction between Maprotiline and Nortriptyline?
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 using both; choose one antidepressant. If a switch is needed, taper one before starting the other and check an ECG.
What other medicines interact with Nortriptyline?
MediHelp also lists interactions of Nortriptyline with, for example, Disopyramide, Dofetilide, Dronedarone. The full list is on the Nortriptyline page.
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