maprotiline (Ludiomil)
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Introduction
Tradename: Ludiomil.
Indications
- treatment of depression
Dosage
Start 25-75 mg PO QHS, max 225 mg/day
Tabs: 25, 50, 75 mg.
Pharmacokinetics
- metabolized in the liver by cyt P450 2D6
- active metabolite desmethylmaprotiline
- secreted into breast milk at approximately same concentration as in maternal blood
elimination via liver
1/2life = 28 hours
protein binding = 88 %
elimination by hemodialysis = -
elimination by peritoneal dialysis = -
Adverse effects
(increased at > 300 ng/mL)
- tinnitus
- skin rash
- constipation
- nausea/vomiting
- trembling
- weight loss
- unusual excitement
- higher incidence of seizures than other antidepressants
- overdose results in prolongation of the QT interval
- drug adverse effects of tricyclic antidepressants
- drug adverse effects of antidepressants
- drug adverse effects of psychotropic agents
Drug interactions
- coadmistration may decrease maprotiline levels
- coadmistration may increase maprotiline levels
- coadministration of anticonvulsants
- decreased seizure threshold
- decreased effects of anticonvulsants
- any pharmaceutical agent that inhibits cyt P450 2D6 may increase levels of maprotiline[2]
- drug interaction(s) of tricyclic antidepressants with physostigmine
- drug interaction(s) of benzodiazepines with antidepressants
- drug interaction(s) of antidepressants with benzodiazepines
- drug interaction(s) of NSAIDs with antidepressants
Laboratory
- specimen: serum
- methods: GC, GC-MS, HPLC
- interferences: protriptyline may interfere with HPLC assay
Notes
Maprotiline is a secondary amine
More general terms
Additional terms
References
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- ↑ 2.0 2.1 Clinical Guide to Laboratory Tests, 3rd ed. Teitz ed., W.B. Saunders, 1995
- ↑ Prescriber's Letter 13(3): 2006 Cytochrome P450 drug interactions Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=220233&pb=PRL (subscription needed) http://www.prescribersletter.com