Drug interactions
Cyproheptadine + Levomilnacipran
Severity: Moderate
Cyproheptadine 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
Cyproheptadine blocks serotonin 5-HT2 receptors and may reduce the serotonergic effect of antidepressants such as levomilnacipran. This could lessen antidepressant efficacy, although it is also used deliberately to treat serotonin toxicity.
What this interaction means in plain words
Cyproheptadine 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.
Cyproheptadine belongs to Respiratory; Levomilnacipran belongs to Central Nervous System.
Why it happens
Pharmacodynamic antagonism through 5-HT2A receptor blockade.
What to do
Monitor for loss of antidepressant effect or worsening depression, especially with sustained cyproheptadine use. Reassess the need for cyproheptadine if depressive symptoms recur.
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 Cyproheptadine
- Cyproheptadine + Isocarboxazid Contraindicated
- Cyproheptadine + Phenelzine Contraindicated
- Cyproheptadine + Tranylcypromine Contraindicated
- Alfentanil + Cyproheptadine Major
- Belladonna and opium + Cyproheptadine Major
- Benzhydrocodone / acetaminophen + Cyproheptadine 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 Cyproheptadine with Levomilnacipran?
MediHelp rates the interaction as moderate. Cyproheptadine 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. Cyproheptadine blocks serotonin 5-HT2 receptors and may reduce the serotonergic effect of antidepressants such as levomilnacipran. This could lessen antidepressant efficacy, although it is also used deliberately to treat serotonin toxicity.
How serious is the interaction between Cyproheptadine 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 loss of antidepressant effect or worsening depression, especially with sustained cyproheptadine use. Reassess the need for cyproheptadine if depressive symptoms recur.
What other medicines interact with Cyproheptadine?
MediHelp also lists interactions of Cyproheptadine with, for example, Isocarboxazid, Phenelzine, Tranylcypromine. The full list is on the Cyproheptadine page.
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