Maprotiline, Oral

What are other names for this medicine?

Type of medicine: antidepressant

Generic and brand names: maprotiline, oral

What is this medicine used for?

This medicine is taken by mouth to treat depression and anxiety.

It may be used for other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• bleeding problems or blood disorders
• breathing problems
• chronic constipation or bowel obstruction
• diabetes
• glaucoma
• heart disease or a heart attack
• high or low blood pressure
• liver or kidney disease
• mental illness such as bipolar disorder, paranoia, or schizophrenia
• porphyria (nerve pain or sensitivity to sunlight)
• problems with drug or alcohol abuse
• seizures
• thoughts of suicide
• thyroid problems
• trouble urinating or an enlarged prostate.
• trouble swallowing.

Females of childbearing age: Tell your health care provider if you are pregnant or plan to become pregnant. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I take it?

Take this medicine exactly as your healthcare provider prescribes. Do not take more of it or take it longer than prescribed. Do not stop taking this medicine without your healthcare provider's approval. You may have to reduce your dosage gradually. Stopping too quickly may cause withdrawal symptoms such as seizures.

You may take this medicine with or without food. Take it with a full glass of water.

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider. Do not stop taking this medicine without your healthcare provider's approval. You may need to reduce your dose slowly to avoid withdrawal symptoms.

What should I watch out for?

Behavior changes may be caused by the medicine or by depression or another mental illness. Contact your provider right away if you or your family notice any disturbing changes in your thoughts or behavior, such as:

• more outgoing or aggressive behavior than normal
• confusion
• hallucinations
• worsening of depression
• suicidal thoughts.

Children and teens who take antidepressants are more likely to think about harming or killing themselves or try to do so than children who do not take antidepressants. Talk with your provider about this.

It may take several weeks before you start to feel better. Do not stop taking this medicine unless your healthcare provider tells you to do so. You may have withdrawal symptoms if you stop this medicine abruptly.

This medicine increases the effects of alcohol and other drugs that slow down your nervous system. Do not drink alcohol or take other medicines unless your healthcare provider approves.

This medicine may make you dizzy or drowsy or cause blurred vision. Do not drive or operate machinery unless you are fully alert.

You may feel dizzy or faint when you get up quickly after sitting or lying down. Getting up slowly may help.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

You may need regular blood tests to find out how this medicine affects you. Keep all appointments for these tests.

Adults over the age of 65 may be at greater risk for side effects. Talk with your healthcare provider about this.

This medicine may cause dry mouth. Sucking hard candy, taking sips of water, or chewing sugarless gum may help.

Diabetics: This medicine may affect your blood sugar level and change the amount of insulin or other diabetes medicines you may need. Talk to your healthcare provider about this.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you are unable to reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat)

Serious (report these to your healthcare provider right away): Chest pain, chills, dark urine, fast or irregular heartbeat, hallucinations, high fever with rash or heavy sweating, lightheadedness and fainting, loss of bladder control, muscle or joint pain, numbness or tingling in the hands or feet, prolonged erection, seizures, severe confusion, severe drowsiness, severe muscle stiffness, thoughts of suicide, trouble urinating, twitching or involuntary movement of your body or face, unusual excitement, yellowing of your eyes or skin, unexplained sore throat.

Other: Abnormal dreams, vision problems, constipation, diarrhea, dizziness, drowsiness, dry mouth, increased appetite, increased or decreased interest in sex, lightheadedness, nausea, trouble sleeping, weight gain or loss, headache, change in sense of taste, bloating.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• antiarrhythmics (medicine to treat irregular heartbeat) such as amiodarone (Cordarone, Pacerone), flecainide (Tambocor), procainamide (Pronestyl), propafenone (Rythmol), and quinidine (Quinora, Quinaglute, Quinidex)
• antibiotics such as clarithromycin (Biaxin) and erythromycin (Erythrocin, EES, E-Mycin, EryPed), ciprofloxacin (Cipro), levofloxacin (Levaquin), norfloxacin (Noroxin), ofloxacin (Floxin), trovafloxacin (Trovan), metronidazole (Flagyl), rifampin (Rifampin, Rimactane), and rifabutin (Mycobutin)
• anticholinergic medicines such as amantadine (Symmetrel), procyclidine (Kemadrin), trihexyphenidyl (Artane) dicyclomine (Bentyl), atropine sulfate, belladonna, propantheline (Pro-Banthine), methscopolamine (Pamine), benztropine (Cogentin), hyoscyamine (Levsin), ipratropium (Atrovent), scopolamine (Isopto Hyoscine, Transderm Scop), and tolterodine (Detrol)
• anticonvulsants such as carbamazepine (Tegretol), primidone (Mysoline), gabapentin (Neurontin), felbamate (Felbatol), lamotrigine (Lamictal), levetiracetam (Keppra), topiramate (Topamax), oxcarbazepine (Trileptal), tiagabine (Gabitril), phenytoin (Dilantin), and valproic acid (Depakote, Depakene)
• antifungals such as fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral)
• antihistamines such as diphenhydramine (Benadryl), hydroxyzine (Atarax, Vistaril), chlorpheniramine (Chlor-Trimeton) and clemastine (Tavist)
• antinausea medicines such as prochlorperazine (Compazine) and promethazine (Phenergan)
• antipsychotic medicines such as chlorpromazine (Thorazine), fluphenazine (Permitil, Prolixin), loxapine (Loxitane), perphenazine, trifluoperazine (Stelazine), thioridazine, haloperidol (Haldol), clozapine (Clozaril), risperidone (Risperdal), and olanzapine (Zyprexa)
• antiretroviral (AIDS) drugs such as saquinavir (Invirase, Fortovase), ritonavir (Norvir, Kaletra), indinavir (Crixivan), nelfinavir (Viracept), and amprenavir (Agenerase)
• barbiturates such as phenobarbital, butabarbital (Butisol), and pentobarbital (Nembutal)
• benzodiazepines such as alprazolam (Xanax), diazepam (Valium), triazolam (Halcion), and lorazepam (Ativan)
• beta blockers such as metoprolol (Lopressor), atenolol (Tenormin), acebutolol (Sectral), betaxolol (Kerlone), carteolol, bisoprolol (Zebeta), pindolol, timolol, sotalol (Betapace), nadolol (Corgard), labetalol (Normodyne, Trandate), carvedilol (Coreg), and propranolol (Inderal)
• birth control pills and estrogen products such as estradiol (Estrace, Estratab), conjugated estrogens (Premarin), norethindrone (Aygestin, Micronor), norgestrel (Ovrette), megestrol (Megace), and medroxyprogesterone (Provera, Curretab, Cycrin)
• cold and flu medicines, especially antihistamines and decongestants
• diabetes medicines such as insulin, chlorpropamide (Diabinese), tolazamide (Tolinase), glyburide (DiaBeta, Micronase), glipizide (Glucotrol), repaglinide (Prandin), metformin (Glucophage), rosiglitazone (Avandia), and pioglitazone (Actos)
• digoxin (Lanoxin)
• disulfiram (Antabuse)
• epinephrine
• ergotamine tartrate (Ergomar)
• heartburn medicines such as famotidine (Pepcid, Pepcid AC, Pepcid Complete), nizatidine (Axid), and ranitidine (Zantac, Zantac 75), and cimetidine (Tagamet)
• herbal remedies such as St. John's wort, kava, gotu kola, valerian root, and SAMe
• linezolid (Zyvox)
• lithium (Eskalith, Eskalith CR, Lithobid)
• MAO inhibitor antidepressants such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl), and tranylcypromine (Parnate) (Do not take an MAO inhibitor and this medicine within 14 days of each other)
• medicines to relax your intestines such as atropine sulfate (Atropair), clidinium bromide (Quarzan), glycopyrrolate (Robinul), mepenzolate bromide (Cantil), and propantheline bromide (Pro-Banthine)
• medicines to treat Parkinson's disease such as bromocriptine (Parlodel), carbidopa/levodopa (Sinemet), pergolide (Permax), pramipexole (Mirapex), ropinirole (Requip), cabergoline (Dostinex), and entacapone (Comtan)
• medicines used to treat high blood pressure such as guanethidine (Ismelin), guanadrel (Hylorel), and clonidine (Catapres)
• methylphenidate (Concerta, Metadate CD, Methylin, Ritalin, Ritalin LA, Ritalin SR)
• metoclopramide (Reglan)
• muscle relaxants such as cyclobenzaprine (Flexeril), carisoprodol (Soma), tizanidine (Zanaflex), methocarbamol (Robaxin), and baclofen (Lioresal)
• narcotics such as codeine, morphine, oxycodone (OxyContin), hydromorphone (Dilaudid), propoxyphene (Darvon, Darvon-N, Darvocet, Wygesic), and combination products such as Vicodin, Tylox, Percocet, Percodan, Tylenol #3
• omeprazole (Prilosec)
• probenecid (Benemid)
• procarbazine (Matulane)
• sedatives such as zolpidem (Ambien), eszopiclone (Lunesta), and zaleplon (Sonata)
• antidepressants such as duloxetine (Cymbalta), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), nefazodone, citalopram (Celexa), escitalopram (Lexapro) and bupropion (Wellbutrin, Zyban), and sertraline (Zoloft)
• thyroid medicines such as Thyroid USP, levothyroxine (Synthroid, Levothroid), liothyronine (Cytomel), and liotrix (Thyrolar)
• tricyclic antidepressants such as amitriptyline, amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Tofranil), nortriptyline (Aventyl), protriptyline (Vivactil), and trimipramine (Surmontil)
• warfarin (Coumadin).

Do not drink alcohol while you are taking this medicine.

Keep a list of all your medicines (prescription, nonprescription, supplements, natural remedies, and vitamins) with you. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.