Drug interactions
Dextroamphetamine transdermal + Milnacipran
Severity: Major
Dextroamphetamine transdermal and Milnacipran: 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 increase monoamine release and can add to the serotonergic effects of milnacipran, raising the risk of serotonin syndrome. Both also raise blood pressure and heart rate.
What this interaction means in plain words
Dextroamphetamine transdermal and Milnacipran 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 and noradrenergic effects from monoamine release and reuptake inhibition.
What to do
Use the lowest effective doses and monitor for serotonin syndrome, particularly at initiation and dose increases. Also monitor blood pressure and heart rate, and stop both drugs if serotonin syndrome occurs.
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 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 Dextroamphetamine transdermal with Milnacipran?
MediHelp rates the interaction as major. Dextroamphetamine transdermal and Milnacipran 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 increase monoamine release and can add to the serotonergic effects of milnacipran, raising the risk of serotonin syndrome. Both also raise blood pressure and heart rate.
How serious is the interaction between Dextroamphetamine transdermal and Milnacipran?
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 for serotonin syndrome, particularly at initiation and dose increases. Also monitor blood pressure and heart rate, and stop both drugs if serotonin syndrome occurs.
What other medicines interact with Milnacipran?
MediHelp also lists interactions of Milnacipran with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Milnacipran page.
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