Drug interactions
Buprenorphine long-acting + Milnacipran
Severity: Moderate
Buprenorphine long-acting and Milnacipran: 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
Serotonin syndrome has been reported with buprenorphine and serotonergic antidepressants. Long-acting injection formulations remain active for weeks, so toxicity could be prolonged.
What this interaction means in plain words
Buprenorphine long-acting and Milnacipran 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.
Why it happens
Additive serotonergic effects of milnacipran reuptake inhibition and buprenorphine.
What to do
Monitor for agitation, tremor, clonus, hyperthermia and autonomic instability, especially at initiation and after milnacipran dose changes. Stop milnacipran and treat symptomatically if serotonin syndrome 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 Milnacipran
- Isocarboxazid + Milnacipran Contraindicated
- Methylene blue + Milnacipran Contraindicated
- Milnacipran + Phenelzine Contraindicated
- Milnacipran + Procarbazine Contraindicated
- Milnacipran + Rasagiline Contraindicated
- Milnacipran + Safinamide Contraindicated
Frequently asked questions
Can I take Buprenorphine long-acting with Milnacipran?
MediHelp rates the interaction as moderate. Buprenorphine long-acting and Milnacipran 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. Serotonin syndrome has been reported with buprenorphine and serotonergic antidepressants. Long-acting injection formulations remain active for weeks, so toxicity could be prolonged.
How serious is the interaction between Buprenorphine long-acting and Milnacipran?
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 agitation, tremor, clonus, hyperthermia and autonomic instability, especially at initiation and after milnacipran dose changes. Stop milnacipran and treat symptomatically if serotonin syndrome is suspected.
What other medicines interact with Milnacipran?
MediHelp also lists interactions of Milnacipran with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Milnacipran page.
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