Drug interactions
Cyproheptadine + Milnacipran
Severity: Moderate
Cyproheptadine 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
Cyproheptadine blocks serotonin 5-HT2 receptors and may reduce the antidepressant or serotonergic effect of milnacipran. Loss of therapeutic response is possible, particularly with regular use.
What this interaction means in plain words
Cyproheptadine 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.
Cyproheptadine belongs to Respiratory; Milnacipran belongs to Central Nervous System.
Why it happens
Pharmacodynamic antagonism at 5-HT2 receptors by cyproheptadine.
What to do
Monitor for reduced antidepressant or analgesic effect and consider an alternative antihistamine if response worsens. Review the need for cyproheptadine.
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 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 Cyproheptadine with Milnacipran?
MediHelp rates the interaction as moderate. Cyproheptadine 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. Cyproheptadine blocks serotonin 5-HT2 receptors and may reduce the antidepressant or serotonergic effect of milnacipran. Loss of therapeutic response is possible, particularly with regular use.
How serious is the interaction between Cyproheptadine 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 reduced antidepressant or analgesic effect and consider an alternative antihistamine if response worsens. Review the need for cyproheptadine.
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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