Milnacipran Hydrochloride interactions

Checked as Milnacipran in this data source.

Full monograph for Milnacipran Hydrochloride Check it against another medicine

Medicines

243 documented

Severity

Medicines documented to interact with Milnacipran Hydrochloride, worst severity first.
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…	102 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…	102 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…	102 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
Citalopram Hydrobromide	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
Clomipramine 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
Cyclobenzaprine 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
Desvenlafaxine Succinate	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
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…	102 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…	102 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…	102 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…	102 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…	102 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…	102 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	108 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…	102 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…	102 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
Lasmiditan Hemisuccinate	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
Leflunomide	Major	Synergy	The recent, concomitant, or subsequent use (without the recommended leflunomide washout period or procedure) of other agents known to induce hepatotoxicity may…	3 sources — open the full entry
Levomilnacipran 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
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
Maprotiline 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…	102 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…	102 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 and SNRIs may potentiate the risk of serotonin…	28 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…	102 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…	102 sources — open the full entry
Pethidine 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
Rasagiline	Major	Synergy	By inhibiting serotonin metabolism, monoamine oxidase inhibitors (MAOIs) may potentiate the pharmacologic activity of serotonergic agents such as serotonin…	74 sources — open the full entry
Remifentanil 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
Rizatriptan Benzoate	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
Safinamide Mesylate	Major	Synergy	By inhibiting serotonin metabolism, monoamine oxidase inhibitors (MAOIs), including safinamide, may potentiate the pharmacologic activity of serotonergic…	93 sources — open the full entry
Sertraline 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
Sumatriptan	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
Tapentadol 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
Tramadol Hydrochloride	Major	Synergy	Due to its serotonergic activity, coadministration of tramadol with serotonin-enhancing drugs such as SSRIs and SNRIs may potentiate the risk of serotonin…	28 sources — open the full entry

Food & lifestyle

alcohol
Moderate
Synergy
Use of milnacipran in conjunction with chronic alcohol consumption may potentiate the risk of liver injury. Milnacipran alone can increase serum transaminase levels.
What to do: Due to the risk of liver injury, patients prescribed milnacipran should be counseled to avoid excessive use of alcohol. Milnacipran should generally not be prescribed to patients with substantial alcohol use.
1 source
1. "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):

Conditions

Conditions in which Milnacipran Hydrochloride needs care, as documented in this source.

Depressive Disorder
Major
Adult 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
1. "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
2. "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
3. "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
4. "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
5. "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
Kidney Diseases
Major
The 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
1. "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
2. "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
3. "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
4. "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
Liver Diseases
Major
Postmarketing studies have reported that duloxetine and some other SNRIs like milnacipran may aggravate preexisting liver disease. The use of duloxetine delayed-release and milnacipran should be avoided in patients with chronic liver disease or cirrhosis.
2 sources
1. "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
2. "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
Glaucoma
Moderate
SNRI antidepressants cause pupillary dilation that may trigger an angle closure attack in patients with anatomically narrow angle without iridectomy.
5 sources
1. "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
2. "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
3. "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
4. "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
5. "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
Hypertension
Moderate
Selective 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
1. "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
2. "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
3. "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
4. "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
5. "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
Hyponatremia
Moderate
Treatment 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
1. "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
2. "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
3. "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
4. "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
5. "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
Mania
Moderate
Therapy 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
1. "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
2. "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
3. "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
4. "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
5. "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
Seizures
Moderate
SNRI antidepressants may trigger seizures and should be administered with caution in patients with a seizure disorder.
5 sources
1. "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
2. "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
3. "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
4. "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
5. "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
Urethral Obstruction
Moderate
SNRI 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
1. "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
2. "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
3. "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
4. "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
5. "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):

Therapeutic duplication

Drug classes that overlap with Milnacipran 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

Medicines

Food & lifestyle

alcohol

Conditions

Depressive Disorder

Kidney Diseases

Liver Diseases

Glaucoma

Hypertension

Hyponatremia

Mania

Seizures

Urethral Obstruction

Therapeutic duplication

antidepressants

antidepressants

antidepressants

antidepressants

antidepressants