Drug interactions
Clopidogrel + Milnacipran
Severity: Moderate
Clopidogrel 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
Milnacipran, like other serotonin-norepinephrine reuptake inhibitors, impairs platelet function. Combined with clopidogrel, this can raise the risk of bruising and gastrointestinal or other bleeding.
What this interaction means in plain words
Clopidogrel 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.
Clopidogrel belongs to Cardiovascular; Milnacipran belongs to Central Nervous System.
Why it happens
Additive pharmacodynamic effect: SNRIs deplete platelet serotonin and impair aggregation, adding to P2Y12 inhibition.
What to do
Monitor for signs of bleeding, especially in patients with prior GI bleeding or taking other antithrombotics. Consider gastroprotection with a proton pump inhibitor that has little CYP2C19 inhibition, such as pantoprazole, in higher-risk patients.
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 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 Clopidogrel with Milnacipran?
MediHelp rates the interaction as moderate. Clopidogrel 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. Milnacipran, like other serotonin-norepinephrine reuptake inhibitors, impairs platelet function. Combined with clopidogrel, this can raise the risk of bruising and gastrointestinal or other bleeding.
How serious is the interaction between Clopidogrel 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 signs of bleeding, especially in patients with prior GI bleeding or taking other antithrombotics. Consider gastroprotection with a proton pump inhibitor that has little CYP2C19 inhibition, such as pantoprazole, in higher-risk patients.
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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