Drug interactions
Clopidogrel + Levomilnacipran
Severity: Moderate
Clopidogrel 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
Serotonin-norepinephrine reuptake inhibitors deplete platelet serotonin, which impairs platelet aggregation. Combined with clopidogrel, this increases the risk of bleeding, especially gastrointestinal bleeding.
What this interaction means in plain words
Clopidogrel 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.
Clopidogrel belongs to Cardiovascular; Levomilnacipran belongs to Central Nervous System.
Why it happens
Additive impairment of platelet function via reduced platelet serotonin uptake and P2Y12 receptor inhibition.
What to do
Monitor for bleeding and consider gastroprotection in patients at higher risk of gastrointestinal bleeding. Avoid adding NSAIDs where possible.
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 Clopidogrel
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 Clopidogrel with Levomilnacipran?
MediHelp rates the interaction as moderate. Clopidogrel 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. Serotonin-norepinephrine reuptake inhibitors deplete platelet serotonin, which impairs platelet aggregation. Combined with clopidogrel, this increases the risk of bleeding, especially gastrointestinal bleeding.
How serious is the interaction between Clopidogrel 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 bleeding and consider gastroprotection in patients at higher risk of gastrointestinal bleeding. Avoid adding NSAIDs where possible.
What other medicines interact with Clopidogrel?
MediHelp also lists interactions of Clopidogrel with, for example, Ombitasvir / paritaprevir / ritonavir and dasabuvir, Abrocitinib, Acetylsalicylic acid. The full list is on the Clopidogrel page.
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