MAPROTILINE

Brand & Generic Names

Ludiomil

Basic Information

• Habit forming? No
• Prescription needed? Yes
• Available as generic? Yes
• Drug class: Antidepressant

Uses

• Treatment for depression or anxiety associated with depression.
• Used to treat some types of chronic pain.

Dosage & Usage Information

How to take:
Tablet--Swallow with liquid.

When to take:
At the same time each day, usually bedtime.

If you forget a dose:
Bedtime dose--If you forget your once-a- day bedtime dose, don't take it more than 3 hours late. If more than 3 hours, wait for next scheduled dose. Don't double this dose.

What drug does:
Probably affects part of brain that controls messages between nerve cells.

Time lapse before drug works:
Begins in 1 to 2 weeks. May require 4 to 6 weeks for maximum benefit.

Don't take with:
Non-prescription drugs without consulting doctor.
See Interaction Section and consult doctor.

Overdose

SYMPTOMS:
Respiratory failure, fever, cardiac arrhythmia, muscle stiffness, drowsiness, hallucinations, convulsions, coma.

WHAT TO DO:

• Dial 911 (emergency) or O (operator) for an ambulance or medical help. Then give first aid immediately.
• If patient is unconscious and not breathing, give mouth-to- mouth breathing. If there is no heartbeat, use cardiac massage and mouth-to-mouth breathing (CPR). Don't try to make patient vomit. If you can't get help quickly, take patient to nearest emergency facility.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

Seizures. Seek emergency treatment immediately.

Common:

• Tremor.
• Headache, dry mouth or unpleasant taste, constipation or diarrhea, nausea, indigestion, fatigue, weakness, drowsiness, nervousness, anxiety, excessive sweating.
• Insomnia, craving sweets.

Infrequent:

• Convulsions.
• Hallucinations, shakiness, dizziness, fainting, blurred vision, eye pain, vomiting, irregular heartbeat or slow pulse, inflamed tongue, abdominal pain, jaundice, hair loss, rash, chills, joint pain, palpitations, hiccups, vision changes.
• Painful or difficult urination; fatigue; decreased sex drive; abnormal dreams; nasal congestion; back pain; muscle aches; frequent urination; painful, absent or irregular menstruation.

Rare:

Itchy skin; sore throat; jaundice; fever; involuntary movements of jaw, lips and tongue; nightmares; confusion; swollen breasts in men.

Warnings & Precautions

Don't take if:

• You are allergic to any tricyclic antidepressant.
• You drink alcohol.
• You have had a heart attack within 6 weeks.
• You have glaucoma.
• You have taken MAO inhibitors within 2 weeks.
• Patient is younger than 12.

Before you start, consult your doctor:

• If you will have surgery within 2 months, including dental surgery, requiring general or spinal anesthesia.
• If you have an enlarged prostate, heart disease or high blood pressure, stomach or intestinal problems, overactive thyroid, asthma, liver disease, schizophrenia, urinary retention.

Over age 60:
More likely to develop urination difficulty and side effects such as hallucinations, shakiness, dizziness, fainting, headache or insomnia.

Pregnancy:
Studies inconclusive on harm to unborn child. Animal studies show fetal abnormalities. Decide with your doctor whether drug benefits justify risk to unborn child.

Breast-feeding:
Drug passes into milk. Avoid drug or discontinue nursing until you finish medicine. Consult doctor for advice on maintaining milk supply.

Infants & children:
Don't give to children younger than 12.

Prolonged use:
Request blood cell counts, liver-function studies, monitor blood pressure closely.

Skin & sunlight:
May cause rash or intensify sunburn in areas exposed to sun or sunlamp.

Driving, piloting or hazardous work:
Don't drive or pilot aircraft until you learn how medicine affects you. Don't work around dangerous machinery. Don't climb ladders or work in high places. Danger increases if you drink alcohol or take medicine affecting alertness and reflexes.

Discontinuing:
Don't discontinue without consulting doctor. Dose may require gradual reduction if you have taken drug for a long time. Doses of other drugs may also require adjustment.

Others:
No problems expected.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Anticoagulants*	Increased anticoagulant effect.
Anticholinergics*	Increased sedation.
Antihistamines*	Increased antihistamine effect.
Barbiturates*	Decreased antidepressant effect.
Benzodiazepine	Increased sedation.
Central nervous system	Increased sedation.
Cimetidine	Possible increased antidepressant
	effect and toxicity.
Clonidine	Decreased clonidine effect.
Clozapine	Toxic effect on the central nervous
	system.
Disulfiram	Delirium.
Diuretics, thiazide*	Increased maprotiline effect.
Ethchlorvynol	Delirium.
Ethinamate	Dangerous increased effects of
	ethinamate. Avoid combining.
Fluoxetine	Increased depressant effects of
	both drugs.
Guanabenz	Possible decreased clonidine
	effect.
Guanethidine	Decreased guanethidine effect.
Guanfacine	May increase depressant effects of
	either drug.
Leucovorin	High alcohol content of leucovorin
	may cause adverse effects.
Levodopa	May increase blood pressure.
Lithium	Possible decreased seizure
	threshold.
MAO inhibitors*	Fever, delirium, convulsions.
Methyldopa	Decreased methyldopa effect.
Methylphenidate	Possible increased antidepressant
	effect and toxicity.
Methyprylon	Increased sedative effect, perhaps
	to dangerous level. Avoid.
Molindone	Increased tranquilizer effect.
Nabilone	Greater depression of central
	nervous system.
Narcotics*	Dangerous oversedation.
Phenothiazine	Possible increased antidepressant
	effect and toxicity.
Phenytoin	Decreased phenytoin effect.
Procainamide	Possible irregular heartbeat.
Quinidine	Irregular heartbeat.
Sedatives*	Dangerous oversedation.
Sertraline	Increased depressive effects
	of both drugs.
Sympathomimetics*	Increased sympathomimetic effect.
Thyroid hormones*	Irregular heartbeat.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Beverages or medicines	Excessive
with alcohol.	intoxication. Avoid.
Beverages:	None expected.
Cocaine:	Excessive intoxication. Avoid.
Foods:	None expected.
Marijuana:	Excessive drowsiness. Avoid.
Tobacco:	May decrease absorption of
	maprotiline. Avoid.