Drug interactions
Desvenlafaxine + Levorphanol
Severity: Major
Desvenlafaxine and Levorphanol: 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
Levorphanol inhibits serotonin reuptake, so combined use with desvenlafaxine may cause serotonin syndrome. Additive CNS and respiratory depression can also occur.
What this interaction means in plain words
Desvenlafaxine and Levorphanol 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.
Why it happens
Additive serotonergic effects from reuptake inhibition by both drugs, plus overlapping CNS depression.
What to do
Use the lowest effective doses and monitor closely for serotonin syndrome and sedation, especially at initiation and dose increases. Switch to a nonserotonergic opioid if signs of toxicity develop.
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
Frequently asked questions
Can I take Desvenlafaxine with Levorphanol?
MediHelp rates the interaction as major. Desvenlafaxine and Levorphanol 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. Levorphanol inhibits serotonin reuptake, so combined use with desvenlafaxine may cause serotonin syndrome. Additive CNS and respiratory depression can also occur.
How serious is the interaction between Desvenlafaxine and Levorphanol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective doses and monitor closely for serotonin syndrome and sedation, especially at initiation and dose increases. Switch to a nonserotonergic opioid if signs of toxicity develop.
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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