Drug interactions
Maprotiline + Protriptyline
Severity: Major
Maprotiline and Protriptyline: 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 duplicates therapy and raises the risk of QT prolongation, anticholinergic toxicity, seizures and serotonergic effects. Protriptyline is also a CYP2D6 substrate, so overlapping metabolism can raise levels.
What this interaction means in plain words
Maprotiline and Protriptyline 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 noradrenergic and serotonergic reuptake inhibition, QT prolongation and anticholinergic effects, with competition for CYP2D6 metabolism.
What to do
Avoid concurrent use and use a single antidepressant. If a switch is needed, taper one drug before starting the other and monitor ECG and symptoms of toxicity.
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 Protriptyline?
MediHelp rates the interaction as major. Maprotiline and Protriptyline 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 duplicates therapy and raises the risk of QT prolongation, anticholinergic toxicity, seizures and serotonergic effects. Protriptyline is also a CYP2D6 substrate, so overlapping metabolism can raise levels.
How serious is the interaction between Maprotiline and Protriptyline?
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 concurrent use and use a single antidepressant. If a switch is needed, taper one drug before starting the other and monitor ECG and symptoms of toxicity.
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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