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Take this medicine only as directed by your doctor to benefit your condition as much as possible. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

Sometimes this medicine must be taken for up to two or three weeks before you begin to feel better. Your doctor should check your progress at regular visits.

Dosing

The dose of maprotiline will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of maprotiline. If your dose is different, do not change it unless your doctor tells you to do so.

The number of tablets that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking maprotiline.

• For oral dosage form (tablets):
  • For depression:
    • Adults At first, 25 milligrams (mg) taken one to three times a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 150 mg a day, unless you are in the hospital. Some hospitalized patients may need higher doses.
    • Children Use and dose must be determined by your doctor.

Missed dose

If you miss a dose of this medicine and your dosing schedule is:

• One dose a day at bedtime Do not take the missed dose in the morning since it may cause disturbing side effects during waking hours. Instead, check with your doctor.
• More than one dose a day Take the missed dose as soon as possible. Then go back to your regular dosing schedule. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. If you have any questions about this, check with your doctor.

Storage

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For maprotiline, the following should be considered:

Allergies Tell your doctor if you have ever had any unusual or allergic reaction to maprotiline or tricyclic antidepressants. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy Maprotiline has not been studied in pregnant women. However, this medicine has not been shown to cause birth defects or other problems in animal studies.

Breast-feeding Maprotiline passes into the breast milk. However, this medicine has not been reported to cause problems in nursing babies.

Children Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of maprotiline in children with use in other age groups.

Older adults Drowsiness, dizziness or lightheadedness; confusion; vision problems; dryness of mouth; constipation; and difficulty in urinating may be especially likely to occur in elderly patients, who are usually more sensitive than younger adults to the effects of maprotiline.

Other medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking maprotiline, it is especially important that your health care professional know if you are taking any of the following:

• Amphetamines or
• Appetite suppressants (diet pills) or
• Medicine for asthma or other breathing problems or
• Medicine for colds, sinus problems, or hay fever or other allergies (including nose drops or sprays) Using these medicines with maprotiline may cause serious unwanted effects on your heart and blood pressure

• Central nervous system (CNS) depressants (medicines that cause drowsiness) Taking these medicines with maprotiline may increase the CNS depressant effects

• Monoamine oxidase (MAO) inhibitor activity (isocarboxazid [e.g., Marplan], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], selegiline [e.g., Eldepryl], tranylcypromine [e.g., Parnate]) Taking maprotiline while you are taking or within 2 weeks of taking monoamine oxidase (MAO) inhibitors may cause very serious side effects, such as sudden high body temperature, extremely high blood pressure, and severe convulsions; at least 14 days should be allowed between stopping treatment with one medicine and starting treatment with the other

• Alcohol abuse or
• Seizure disorders (including epilepsy) The risk of seizures may be increased

• Asthma or
• Difficult urination or
• Enlarged prostate or
• Glaucoma or
• Mental illness (severe) or
• Stomach or intestinal problems Maprotiline may make the condition worse

• Heart or blood vessel disease or
• Overactive thyroid Serious effects on your heart may occur

• Liver disease Higher blood levels of maprotiline may occur, increasing the chance of side effects