Drug interactions
Asenapine + Levomilnacipran
Severity: Moderate
Asenapine and Levomilnacipran: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Combining an antipsychotic with a serotonin-norepinephrine reuptake inhibitor may increase the risk of serotonin syndrome, and dopamine blockade with serotonergic agents can contribute to neuroleptic malignant syndrome. The risk is low but the outcomes are serious.
What this interaction means in plain words
Asenapine and Levomilnacipran can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Asenapine belongs to Central Nervous System; Levomilnacipran belongs to Central Nervous System.
Why it happens
Additive serotonergic activity (reuptake inhibition plus 5-HT receptor effects of asenapine) combined with dopamine antagonism.
What to do
Monitor for mental status change, hyperthermia, rigidity, clonus and autonomic instability, especially after dose changes. Stop the agents and give supportive care if serotonin syndrome or NMS is suspected.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Asenapine
- Asenapine + Pimozide Contraindicated
- Asenapine + Thioridazine Contraindicated
- Asenapine + Vandetanib Contraindicated
- Adagrasib + Asenapine Major
- Alfentanil + Asenapine Major
- Alfuzosin + Asenapine Major
Other interactions of Levomilnacipran
- Isocarboxazid + Levomilnacipran Contraindicated
- Levomilnacipran + Linezolid Contraindicated
- Levomilnacipran + Methylthioninium chloride Contraindicated
- Levomilnacipran + Phenelzine Contraindicated
- Levomilnacipran + Procarbazine Contraindicated
- Levomilnacipran + Rasagiline Contraindicated
Frequently asked questions
Can I take Asenapine with Levomilnacipran?
MediHelp rates the interaction as moderate. Asenapine and Levomilnacipran can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Combining an antipsychotic with a serotonin-norepinephrine reuptake inhibitor may increase the risk of serotonin syndrome, and dopamine blockade with serotonergic agents can contribute to neuroleptic malignant syndrome. The risk is low but the outcomes are serious.
How serious is the interaction between Asenapine and Levomilnacipran?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for mental status change, hyperthermia, rigidity, clonus and autonomic instability, especially after dose changes. Stop the agents and give supportive care if serotonin syndrome or NMS is suspected.
What other medicines interact with Asenapine?
MediHelp also lists interactions of Asenapine with, for example, Pimozide, Thioridazine, Vandetanib. The full list is on the Asenapine page.
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