Pricing
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Ludiomil is indicated for:
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Adults may take the full dose once a day instead of splitting it into smaller doses through the day. Some people notice benefit within 3 to 7 days, though it usually takes 2 to 3 weeks for the full effect to appear. Initial Adult Dosage: Outpatients with mild to moderate depression usually start on 75 mg a day. Some patients, particularly the elderly, may instead start on 25 mg a day. Because maprotiline stays in the body a long time, this starting dose should be kept unchanged for 2 weeks before any adjustment. After that, the dose can be raised gradually in steps of 25 mg, as needed and as tolerated. Most outpatients respond well to a maximum of 150 mg a day, and this should not be exceeded except in the most severely depressed patients, who may have their dose raised gradually to a maximum of 225 mg. Patients with more severe depression who are hospitalized should start on 100 mg to 150 mg a day, which may be raised gradually as needed and tolerated. Most hospitalized patients with moderate to severe depression respond to a daily dose of 150 mg, though some may need as much as 225 mg. The daily dose should never go above 225 mg. Elderly Patients: Lower doses are generally recommended for patients over 60 years of age. A maintenance dose of 50 mg to 75 mg a day is usually enough for elderly patients who cannot tolerate higher amounts.
Side Effects
Cardiovascular side effects reported with maprotiline include rare cases of low or high blood pressure, fast heartbeat, palpitations, irregular heartbeat, heart block, and fainting. Psychiatric effects include nervousness (6%), anxiety (3%), insomnia (2%), and agitation (2%), and rarely confusion (especially in the elderly), hallucinations, disorientation, delusions, restlessness, nightmares, hypomania, mania, worsening of psychosis, memory decline, and a sense of unreality. Neurological effects include drowsiness (16%), dizziness (8%), tremor (3%), and rarely numbness, tingling, excess motor activity, akathisia, seizures, EEG changes, ringing in the ears, extrapyramidal symptoms, loss of coordination, and slurred speech. Anticholinergic effects include dry mouth (22%), constipation (6%), and blurred vision (4%), and rarely eye focusing problems, dilated pupils, urinary retention, and delayed urination. Allergic reactions include rare skin rash, small red or purple spots, itching, sun sensitivity, swelling, and drug fever. Gastrointestinal effects include nausea (2%) and rarely vomiting, upper stomach discomfort, diarrhea, bitter taste, abdominal cramps, and difficulty swallowing. Endocrine effects include rare cases of increased or decreased sex drive, impotence, and raised or lowered blood sugar levels.
Cautions & Contraindications
Warnings & Precautions
Patients with serious depression may remain at risk of suicide until their illness shows real improvement, since this danger is part of the underlying condition. For this reason, anyone taking maprotiline should be closely monitored throughout treatment, and doctors should prescribe only as many tablets at a time as good care allows. Some patients on tricyclic antidepressants have developed hypomanic or manic episodes, especially those with cyclic mood disorders, and this has occasionally been seen with maprotiline as well. Before any planned surgery, maprotiline should be stopped as early as is practically possible, since its interaction with general anaesthetics is not well understood. Because Ludiomil has anticholinergic effects, it should be used carefully in patients who have a history of urinary retention or narrow angle glaucoma.
Contraindications
Maprotiline hydrochloride tablets should not be used in patients who are hypersensitive to maprotiline or who have a known or suspected seizure disorder. It must not be given together with monoamine oxidase (MAO) inhibitors, and treatment should not begin until at least 14 days after an MAO inhibitor has been stopped. Once started, the patient's response should be monitored closely as the dose is increased gradually to the optimum level. Use during the acute phase of a heart attack (myocardial infarction) is not recommended.