Drug interactions
Carbidopa-entacapone-levodopa + Levomilnacipran
Severity: Minor
Carbidopa-entacapone-levodopa and Levomilnacipran: minor 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
Levomilnacipran raises synaptic serotonin and norepinephrine, and levodopa may add to monoaminergic activity. Serotonin syndrome is possible but rarely reported, and levodopa combinations are generally tolerated. Blood pressure and heart rate increases from levomilnacipran may also be relevant in Parkinson's disease.
What this interaction means in plain words
Carbidopa-entacapone-levodopa and Levomilnacipran have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Carbidopa-entacapone-levodopa belongs to Central Nervous System; Levomilnacipran belongs to Central Nervous System.
Why it happens
Additive monoaminergic effects; levodopa is converted to dopamine, with a minor theoretical serotonergic contribution.
What to do
Monitor for agitation, tremor, hyperreflexia, sweating, and changes in blood pressure and heart rate when starting or titrating. Reassess therapy if serotonin toxicity features appear.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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Other interactions of Carbidopa-entacapone-levodopa
- Carbidopa-entacapone-levodopa + Isocarboxazid Contraindicated
- Carbidopa-entacapone-levodopa + Phenelzine Contraindicated
- Carbidopa-entacapone-levodopa + Selegiline transdermal Contraindicated
- Carbidopa-entacapone-levodopa + Tranylcypromine Contraindicated
- Amisulpride + Carbidopa-entacapone-levodopa Major
- Asenapine transdermal + Carbidopa-entacapone-levodopa 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 Carbidopa-entacapone-levodopa with Levomilnacipran?
MediHelp rates the interaction as minor. Carbidopa-entacapone-levodopa and Levomilnacipran have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Levomilnacipran raises synaptic serotonin and norepinephrine, and levodopa may add to monoaminergic activity. Serotonin syndrome is possible but rarely reported, and levodopa combinations are generally tolerated. Blood pressure and heart rate increases from levomilnacipran may also be relevant in Parkinson's disease.
How serious is the interaction between Carbidopa-entacapone-levodopa and Levomilnacipran?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for agitation, tremor, hyperreflexia, sweating, and changes in blood pressure and heart rate when starting or titrating. Reassess therapy if serotonin toxicity features appear.
What other medicines interact with Carbidopa-entacapone-levodopa?
MediHelp also lists interactions of Carbidopa-entacapone-levodopa with, for example, Isocarboxazid, Phenelzine, Selegiline transdermal. The full list is on the Carbidopa-entacapone-levodopa page.
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