Maprotiline and Fluvoxamine: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Fluvoxamine
No brand names on recordMaprotiline
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Maprotiline toxicity (dry mouth, urinary retention, sedation)
Interaction Deep Dive
An interaction of fluvoxamine with tricyclic antidepressants (TCAs) was reported1. Plasma concentrations of TCAs were increased when combined with fluvoxamine. This effect was less prominent with maprotiline compared with imipramine, clomipramine, or amitriptyline. In addition, TCAs appeared to increase fluvoxamine levels.
Why it happens (mechanism)
Decreased maprotiline metabolism
Literature reports
1 report — tap to read
a) Metabolism of tricyclic antidepressants coadministered with fluvoxamine was studied in eight depressed patients (one patient received maprotiline) 1. Fluvoxamine was found to interfere with N-demethylation of maprotiline. The combination of fluvoxamine and maprotiline led to increased plasma levels of maprotiline and decreased concentrations of maprotiline's N-demethylated metabolite, desmethylmaprotiline. Also, plasma levels of fluvoxamine were increased.
Common questions
Can I take Maprotiline and Fluvoxamine together?
Maprotiline toxicity (dry mouth, urinary retention, sedation) Always confirm with your pharmacist or prescriber before making any change.
How serious is the Maprotiline and Fluvoxamine interaction?
It is rated minor. Usually limited clinical impact.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Maprotiline or Fluvoxamine need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (1)
- Hartter S, Wetzel H, Hammes E, et al: Inhibition of antidepressant demethylation and hydroxylation by fluvoxamine in depressed patients. Psychopharmacology 1993; 110:302-308. PubMed
Keep reading about Fluvoxamine
Keep reading about Maprotiline
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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