Drug interactions
Desvenlafaxine + Levomilnacipran
Severity: Major
Desvenlafaxine and Levomilnacipran: major interaction.
Last updated Sources: US FDA label
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
Both are serotonin-norepinephrine reuptake inhibitors, so combined use gives duplicate therapy with a higher risk of serotonin syndrome, hypertension and tachycardia. There is no therapeutic advantage to the combination.
What this interaction means in plain words
Desvenlafaxine and Levomilnacipran can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Desvenlafaxine belongs to Central Nervous System; Levomilnacipran belongs to Central Nervous System.
Why it happens
Additive serotonin and norepinephrine reuptake inhibition.
What to do
Avoid using two SNRIs together and choose a single agent. If switching, taper the first drug before starting the second and monitor for serotonin toxicity.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Desvenlafaxine
- Desvenlafaxine + Isocarboxazid Contraindicated
- Desvenlafaxine + Methylene blue Contraindicated
- Desvenlafaxine + Phenelzine Contraindicated
- Desvenlafaxine + Rasagiline Contraindicated
- Desvenlafaxine + Safinamide Contraindicated
- Desvenlafaxine + Selegiline Contraindicated
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 Desvenlafaxine with Levomilnacipran?
MediHelp rates the interaction as major. Desvenlafaxine and Levomilnacipran can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both are serotonin-norepinephrine reuptake inhibitors, so combined use gives duplicate therapy with a higher risk of serotonin syndrome, hypertension and tachycardia. There is no therapeutic advantage to the combination.
How serious is the interaction between Desvenlafaxine and Levomilnacipran?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid using two SNRIs together and choose a single agent. If switching, taper the first drug before starting the second and monitor for serotonin toxicity.
What other medicines interact with Desvenlafaxine?
MediHelp also lists interactions of Desvenlafaxine with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Desvenlafaxine page.
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