Levomilnacipran Hydrochloride interactions
Checked as Levomilnacipran in this data source.
Full monograph for Levomilnacipran HydrochlorideCheck it against another medicine
Medicines
240 documented
Mechanism
| Medicine | Severity | Mechanism | Effect | Sources |
|---|---|---|---|---|
| Almotriptan | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Amitriptyline Hydrochloride | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Amitriptyline Hydrochloride + Chlordiazepoxide | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Bupropion Hydrochloride | Major | Synergy | The use of bupropion is associated with a dose-related risk of seizures. The risk may be further increased when coadministered with selective serotonin… | 19 sources — open the full entry |
| Ceritinib | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may increase the plasma concentrations of levomilnacipran, which is primarily metabolized by the… | 6 sources — open the full entry |
| Citalopram Hydrobromide | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Clarithromycin | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may increase the plasma concentrations of levomilnacipran, which is primarily metabolized by the… | 6 sources — open the full entry |
| Clomipramine Hydrochloride | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Cyclobenzaprine Hydrochloride | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Desvenlafaxine Succinate | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Dextromethorphan + Bupropion | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1…2 documented mechanisms | 153 sources — open the full entry |
| Dextromethorphan + Phenylephrine + Triprolidine | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1…2 documented mechanisms | 146 sources — open the full entry |
| Dextromethorphan + Pseudoephedrine + Triprolidine | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1…2 documented mechanisms | 146 sources — open the full entry |
| Dextromethorphan Hydrobromide | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 134 sources — open the full entry |
| Dextromethorphan Hydrobromide + Guaifenesin | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 134 sources — open the full entry |
| Dextromethorphan Polistirex | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 134 sources — open the full entry |
| Diphenhydramine + Dextromethorphan + Levomenthol | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 134 sources — open the full entry |
| Doxepin (Oral) | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Doxepin (Topical) | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Duloxetine Hydrochloride | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Escitalopram Oxalate | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Esomeprazole + Amoxicillin + Clarithromycin | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may increase the plasma concentrations of levomilnacipran, which is primarily metabolized by the… | 6 sources — open the full entry |
| Fentanyl Citrate | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Fluoxetine Hydrochloride | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Fluphenazine + Nortriptyline | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1…2 documented mechanisms | 106 sources — open the full entry |
| Fluvoxamine Maleate | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Granisetron | Major | Synergy | Concomitant use of 5-HT3 receptor antagonists with agents that possess or enhance serotonergic activity such as selective serotonin reuptake inhibitors… | 7 sources — open the full entry |
| Guaifenesin + Dextromethorphan + Menthol | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 134 sources — open the full entry |
| Imipramine Hydrochloride | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Iohexol | Major | Synergy | Intrathecal administration of iodinated contrast media may induce seizures. Although clinical data are generally lacking, there may be a theoretical risk of… | 5 sources — open the full entry |
| Iopamidol | Major | Synergy | Intrathecal administration of iodinated contrast media may induce seizures. Although clinical data are generally lacking, there may be a theoretical risk of… | 5 sources — open the full entry |
| Itraconazole | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may increase the plasma concentrations of levomilnacipran, which is primarily metabolized by the… | 6 sources — open the full entry |
| Ketoconazole | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may increase the plasma concentrations of levomilnacipran, which is primarily metabolized by the… | 6 sources — open the full entry |
| Ketoconazole + Zinc Pyrithione + Aleovera | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may increase the plasma concentrations of levomilnacipran, which is primarily metabolized by the… | 6 sources — open the full entry |
| Lansoprazole + Amoxicillin + Clarithromycin | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may increase the plasma concentrations of levomilnacipran, which is primarily metabolized by the… | 6 sources — open the full entry |
| Lasmiditan Hemisuccinate | Major | Synergy | Coadministration of lasmiditan and serotonergic agents may increase the risk of serotonin syndrome. Lasmiditan binds to the 5-HT(1F) receptor, where it… | 5 sources — open the full entry |
| Linezolid | Major | Synergy | Coadministration of linezolid with serotonergic agents may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal… | 52 sources — open the full entry |
| Lithium Carbonate | Major | Synergy | Lithium may enhance the pharmacologic effects of serotonin reuptake inhibitors (e.g., SSRIs, SNRIs, nefazodone, trazodone) and potentiate the risk of serotonin… | 22 sources — open the full entry |
| Lopinavir + Ritonavir | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may increase the plasma concentrations of levomilnacipran, which is primarily metabolized by the… | 6 sources — open the full entry |
| Maprotiline Hydrochloride | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Milnacipran Hydrochloride | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 102 sources — open the full entry |
| Mirtazapine | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Nelfinavir | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may increase the plasma concentrations of levomilnacipran, which is primarily metabolized by the… | 6 sources — open the full entry |
| Nirmatrelvir + Ritonavir | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may increase the plasma concentrations of levomilnacipran, which is primarily metabolized by the… | 6 sources — open the full entry |
| Nortriptyline | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Ondansetron | Major | Synergy | Concomitant use of 5-HT3 receptor antagonists with agents that possess or enhance serotonergic activity such as selective serotonin reuptake inhibitors… | 7 sources — open the full entry |
| Palonosetron | Major | Synergy | Concomitant use of 5-HT3 receptor antagonists with agents that possess or enhance serotonergic activity such as selective serotonin reuptake inhibitors… | 7 sources — open the full entry |
| Paracetamol + Tramadol Hydrochloride | Major | Synergy | Due to its serotonergic activity, coadministration of tramadol with serotonin-enhancing drugs such as SSRIs, SNRIs, nefazodone, trazodone, and mirtazapine may… | 33 sources — open the full entry |
| Paroxetine Hydrochloride | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Pentazocine | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
Food & lifestyle
alcohol
ModerateSynergy
Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.
What to do: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
4 sources
- Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7
- Gilman AG, eds., Nies AS, Rall TW, Taylor P "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc. (1990):
- "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
- "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):
Conditions
Conditions in which Levomilnacipran Hydrochloride needs care, as documented in this source.
Depressive Disorder
MajorAdult and pediatric patients with depression and other psychiatric disorders may experience worsening of their symptoms and may have the emergence of suicidal thoughts and behavior. Patients should be monitored appropriately and observed closely for worsening of their symptoms, suicidality or changes in their behavior, especially during the first few months of treatment, and at times of dose changes. Discontinuing the medication should be considered if symptoms are persistently worse, or abrupt in onset. It may be prudent to refrain from dispensing large quantities of medication to these patients.
5 sources
- "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
- "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
- "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
- "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
- "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
Kidney Diseases
MajorThe clearance of SNRI antidepressants is decreased in subjects with renal impairment. SNRIs should be used with caution in this group of patients and a dose adjustment is recommended in those with moderate and severe renal impairment. The use of SNRIs is not recommended in patients with end-stage renal disease.
4 sources
- "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
- "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
- "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
- "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
Glaucoma
ModerateSNRI antidepressants cause pupillary dilation that may trigger an angle closure attack in patients with anatomically narrow angle without iridectomy.
5 sources
- "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
- "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
- "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
- "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
- "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
Hypertension
ModerateSelective serotonin and norepinephrine reuptake inhibitor antidepressants (SNRIs) have been associated with sustained increases in blood pressure. Therapy with SNRI antidepressants should be administered cautiously in patients with preexisting hypertension. Blood pressure should be assessed prior to initiating treatment and monitored regularly. The dose should be reduced or discontinued if necessary.
5 sources
- "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
- "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
- "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
- "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
- "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
Hyponatremia
ModerateTreatment with SNRI antidepressants can cause hyponatremia. Caution should be used when treating patients with hyponatremia or at greater risk of hyponatremia such as the elderly, patients taking diuretics or who are volume depleted.
5 sources
- "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
- "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
- "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
- "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
- "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
Mania
ModerateTherapy with SNRI antidepressants can cause activation of mania and hypomania and should be used with caution in patients with personal or family history of mania, hypomania, bipolar disorder, and other mood disorders.
5 sources
- "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
- "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
- "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
- "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
- "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
Seizures
ModerateSNRI antidepressants may trigger seizures and should be administered with caution in patients with a seizure disorder.
5 sources
- "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
- "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
- "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
- "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
- "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
Urethral Obstruction
ModerateSNRI antidepressants have a noradrenergic effect and can affect urethral resistance. Caution should be used in patients with a history of dysuria, prostatic hypertrophy, prostatitis, and other lower urinary tract obstructive disorders.
5 sources
- "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
- "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
- "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
- "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
- "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
Therapeutic duplication
Drug classes that overlap with Levomilnacipran Hydrochloride, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.
antidepressants
The recommended maximum number of medicines in the 'antidepressants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antidepressants' category.
Example product in the source data (US market): Bupropion/dextromethorphan
antidepressants
The recommended maximum number of medicines in the 'antidepressants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antidepressants' category.
Example product in the source data (US market): Fluoxetine/olanzapine
antidepressants
The recommended maximum number of medicines in the 'antidepressants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antidepressants' category.
Example product in the source data (US market): Limbitrol ds
antidepressants
The recommended maximum number of medicines in the 'antidepressants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antidepressants' category.
Example product in the source data (US market): Amitriptyline/perphenazine
antidepressants
The recommended maximum number of medicines in the 'antidepressants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antidepressants' category.
Example product in the source data (US market): Bupropion/naltrexone