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Pronunciation: ma-PRO-tih-leen HIGH-droe-KLOR-ide
Class: Tetracyclic compound
- Tablets 25 mg
- Tablets 50 mg
- Tablets 75 mg
Inhibits norepinephrine (but not serotonin) reuptake.
Mean T max is 12 h.
Maprotiline protein binding is 88% and apparent Vd is 13 to 24 L/kg.
Maprotiline is metabolized in the liver.
Maprotiline is excreted in urine and feces. The mean t ½ is 51 h.
Indications and Usage
Depression; anxiety associated with depression.
Relief of chronic neurogenic pain.
Hypersensitivity to tricyclic antidepressants; MI acute recovery period; seizure disorder; concomitant use with MAOIs.
Dosage and AdministrationAdults Initial dose
PO 25 to 75 mg/day as single dose or divided doses. May be increased to 150 mg/day (outpatient) or 225 mg/day (inpatient).
Store at controlled room temperature.
Drug InteractionsAlcohol, CNS depressants
Additive CNS effects possible.MAOIs
May precipitate hypertensive crisis and convulsions with possibly fatal results. Discontinue at least 14 days before starting maprotiline.
Laboratory Test Interactions
None well documented.
Syncope; tachycardia; palpitations; orthostatic hypotension; hypertension; MI; arrhythmias; heart block.
Drowsiness; dizziness; hallucinations; disorientation; mania; exacerbation of psychosis; nervousness; fatigue; headache; anxiety; tremor; insomnia; agitation; seizures.
Blurred vision; mydriasis.
Dry mouth; constipation; nausea; diarrhea.
Impotence; urinary retention.
Bone marrow depression, including agranulocytosis; eosinophilia; purpura; thrombocytopenia; leukopenia.
Increased bilirubin and alkaline phosphatase.
Altered blood glucose levels.
Hypersensitivity (eg, rash, itching, photosensitivity, petechiae, edema, drug fever).
Category B .
Excreted in breast milk.
Safety and efficacy not established.
Use lower doses.
Special Risk Patients
Use with caution in patients with history of seizures, urinary retention, urethral or ureteral spasm, angle-closure glaucoma or increased IOP, CV disorders, hyperthyroid patients or those receiving thyroid medication, hepatic or renal function impairment, schizophrenic or paranoid patients.
Do not allow patient to possess more than small quantities of drug.
May occur in therapeutic dose or overdose.
Hypotension, tachycardia, ventricular arrhythmias, CNS depression, seizures, respiratory depression, coma.
- Explain that full effectiveness of drug may not occur until after several doses.
- Instruct patient that if dose is missed, it should be taken as soon as possible unless close to time of next dose.
- Warn patient not to double up doses and to notify health care provider if more than one dose is missed.
- Explain that drug may cause dry mouth and constipation. Advise patient about measures to manage these adverse reactions.
- Advise diabetic patient that drug may alter blood glucose level.
- Instruct patient not to take OTC medications without consulting health care provider.
- Instruct patient to avoid intake of alcoholic beverages or other CNS depressants.
- Instruct patient to report these symptoms to health care provider: difficult or infrequent voiding, dizziness, chest pain, palpitations, anxiety, depression, blurred vision, excessive dry mouth, mouth sores, severe constipation.
- Advise patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness.
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