Drug interactions
Maprotiline + Ranolazine
Severity: Major
Maprotiline and Ranolazine: 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
Maprotiline and ranolazine both prolong the QT interval and the combination may raise the risk of torsades de pointes. Ranolazine's CYP2D6 inhibition may also raise maprotiline concentrations, and maprotiline lowers seizure threshold and is dangerous in overdose.
What this interaction means in plain words
Maprotiline and Ranolazine 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; Ranolazine belongs to Cardiovascular.
Why it happens
Additive QT prolongation, with possible increased maprotiline exposure from CYP2D6 inhibition by ranolazine.
What to do
Avoid the combination where possible and consider an antidepressant with less cardiac effect; if used, monitor ECG, correct potassium and magnesium, and use a low maprotiline dose.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Maprotiline and Ranolazine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Ranolazine
- Adagrasib + Ranolazine Contraindicated
- Amobarbital + Ranolazine Contraindicated
- Apalutamide + Ranolazine Contraindicated
- Butabarbital + Ranolazine Contraindicated
- Carbamazepine + Ranolazine Contraindicated
- Clarithromycin + Ranolazine 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 Ranolazine?
MediHelp rates the interaction as major. Maprotiline and Ranolazine 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 and ranolazine both prolong the QT interval and the combination may raise the risk of torsades de pointes. Ranolazine's CYP2D6 inhibition may also raise maprotiline concentrations, and maprotiline lowers seizure threshold and is dangerous in overdose.
How serious is the interaction between Maprotiline and Ranolazine?
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 where possible and consider an antidepressant with less cardiac effect; if used, monitor ECG, correct potassium and magnesium, and use a low maprotiline dose.
What other medicines interact with Ranolazine?
MediHelp also lists interactions of Ranolazine with, for example, Adagrasib, Amobarbital, Apalutamide. The full list is on the Ranolazine page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
