Drug interactions
Dextroamphetamine + Levomilnacipran
Severity: Major
Dextroamphetamine 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
Amphetamines release monoamines and, combined with an SNRI, raise the risk of serotonin syndrome. Additive increases in blood pressure and heart rate are also possible.
What this interaction means in plain words
Dextroamphetamine 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.
Dextroamphetamine belongs to Central Nervous System; Levomilnacipran belongs to Central Nervous System.
Why it happens
Additive serotonergic and noradrenergic effects from monoamine release and reuptake inhibition.
What to do
Avoid if possible, or use the lowest doses with monitoring for serotonin toxicity, blood pressure and heart rate. Stop both agents if serotonin syndrome is suspected.
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 Dextroamphetamine
- Dextroamphetamine + Isocarboxazid Contraindicated
- Dextroamphetamine + Linezolid Contraindicated
- Dextroamphetamine + Methylene blue Contraindicated
- Dextroamphetamine + Phenelzine Contraindicated
- Dextroamphetamine + Rasagiline Contraindicated
- Dextroamphetamine + Safinamide 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 Dextroamphetamine with Levomilnacipran?
MediHelp rates the interaction as major. Dextroamphetamine 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. Amphetamines release monoamines and, combined with an SNRI, raise the risk of serotonin syndrome. Additive increases in blood pressure and heart rate are also possible.
How serious is the interaction between Dextroamphetamine 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 if possible, or use the lowest doses with monitoring for serotonin toxicity, blood pressure and heart rate. Stop both agents if serotonin syndrome is suspected.
What other medicines interact with Dextroamphetamine?
MediHelp also lists interactions of Dextroamphetamine with, for example, Isocarboxazid, Linezolid, Methylene blue. The full list is on the Dextroamphetamine page.
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