Maprotiline and Perseris

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Using maprotiline together with risperiDONE may increase the effects of maprotiline. Contact your doctor if you experience a fast or irregular heartbeat, seizures, muscle stiffness, vomiting, fever, confusion, poor memory, dizziness, drowsiness, and large pupils. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

MONITOR: Coadministration with risperidone may increase the plasma concentrations of maprotiline. The exact mechanism is unknown but may involve competitive inhibition of maprotiline metabolism, possibly via CYP450 2D6. In a case report of 3 patients treated with maprotiline (150 to 175 mg/day), addition of risperidone led to increases in maprotiline plasma levels by 40% to 60% within 10 days to several weeks. One patient gradually developed anticholinergic adverse effects, including dry mouth, constipation, blurred vision, and urinary retention, all of which attenuated with lower dosages of both drugs. Excessive anticholinergic effects can also result in paralytic ileus, hyperthermia, heat stroke, and the anticholinergic intoxication syndrome. Peripheral symptoms of anticholinergic intoxication commonly include mydriasis, blurred vision, flushed face, fever, dry skin and mucous membranes, tachycardia, urinary retention, and constipation. Central symptoms may include memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures. Other adverse effects that may be increased with this combination include CNS depression and orthostatic hypotension.

MANAGEMENT: Pharmacologic response and maprotiline plasma levels should be monitored more closely whenever risperidone is added to or withdrawn from therapy, and the maprotiline dosage adjusted as necessary. Caution is advised when prescribing this combination, particularly in the elderly and those with underlying organic brain disease, who tend to be more sensitive to the central anticholinergic effects of these drugs and in whom toxicity symptoms may be easily overlooked. Patients should be advised to notify their physician promptly if they experience potential symptoms of anticholinergic intoxication such as abdominal pain, fever, heat intolerance, blurred vision, confusion, and/or hallucinations. Ambulatory patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them.

Maprotiline

Generic Name: maprotiline

Brand name: Ludiomil

Synonyms: n.a.

What is Maprotiline?

Perseris

Generic Name: risperidone

Brand name: Perseris, Risperdal Consta, Risperdal, Risperdal Consta, Risperdal M-Tab

Synonyms: Perseris (injection)

What is Perseris?