Drug interactions
Maprotiline + Tramadol
Severity: Major
Maprotiline and Tramadol: 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 inhibits norepinephrine reuptake and has sedative properties, and both drugs substantially lower the seizure threshold. Combined use raises the risk of seizures, serotonin toxicity and CNS depression. Maprotiline is also metabolized by CYP2D6.
What this interaction means in plain words
Maprotiline and Tramadol 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; Tramadol belongs to Musculoskeletal.
Why it happens
Additive monoaminergic effects, CNS depression and seizure threshold lowering.
What to do
Avoid the combination where possible, or use low doses with close monitoring for seizures, serotonin syndrome and sedation. Choose a different analgesic in patients with a seizure history.
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 Tramadol
- Isocarboxazid + Tramadol Contraindicated
- Olanzapine / samidorphan + Tramadol Contraindicated
- Phenelzine + Tramadol Contraindicated
- Procarbazine + Tramadol Contraindicated
- Rasagiline + Tramadol Contraindicated
- Safinamide + Tramadol 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 Tramadol?
MediHelp rates the interaction as major. Maprotiline and Tramadol 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 inhibits norepinephrine reuptake and has sedative properties, and both drugs substantially lower the seizure threshold. Combined use raises the risk of seizures, serotonin toxicity and CNS depression. Maprotiline is also metabolized by CYP2D6.
How serious is the interaction between Maprotiline and Tramadol?
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, or use low doses with close monitoring for seizures, serotonin syndrome and sedation. Choose a different analgesic in patients with a seizure history.
What other medicines interact with Tramadol?
MediHelp also lists interactions of Tramadol with, for example, Isocarboxazid, Olanzapine / samidorphan, Phenelzine. The full list is on the Tramadol page.
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