Drug interactions
Maprotiline + Perphenazine
Severity: Major
Maprotiline and Perphenazine: 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
Perphenazine can prolong the QT interval and is a CYP2D6 substrate and inhibitor, while maprotiline is metabolized by CYP2D6 and also prolongs QT. Combined use can raise antidepressant levels and increase arrhythmia, sedation and anticholinergic effects.
What this interaction means in plain words
Maprotiline and Perphenazine 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; Perphenazine belongs to Central Nervous System.
Why it happens
Additive QT prolongation plus mutual CYP2D6-related metabolic competition that may raise maprotiline exposure.
What to do
Obtain a baseline ECG and monitor the QTc after starting or changing doses, and correct electrolyte disturbances. Use lower doses and consider alternatives in patients with cardiac disease or other QT-prolonging drugs.
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
Other interactions of Perphenazine
- Ibutilide + Perphenazine Contraindicated
- Perphenazine + Pimozide Contraindicated
- Perphenazine + Thioridazine Contraindicated
- Adagrasib + Perphenazine Major
- Alfentanil + Perphenazine Major
- Amiodarone + Perphenazine Major
Frequently asked questions
Can I take Maprotiline with Perphenazine?
MediHelp rates the interaction as major. Maprotiline and Perphenazine 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. Perphenazine can prolong the QT interval and is a CYP2D6 substrate and inhibitor, while maprotiline is metabolized by CYP2D6 and also prolongs QT. Combined use can raise antidepressant levels and increase arrhythmia, sedation and anticholinergic effects.
How serious is the interaction between Maprotiline and Perphenazine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain a baseline ECG and monitor the QTc after starting or changing doses, and correct electrolyte disturbances. Use lower doses and consider alternatives in patients with cardiac disease or other QT-prolonging drugs.
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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