Drug interactions
Diclofenac + Milnacipran
Severity: Moderate
Diclofenac 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
Milnacipran, a serotonin-norepinephrine reuptake inhibitor, combined with diclofenac increases the risk of bleeding, particularly upper GI bleeding.
What this interaction means in plain words
Diclofenac 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.
Diclofenac belongs to Musculoskeletal; Milnacipran belongs to Central Nervous System.
Why it happens
Reduced platelet serotonin uptake by milnacipran combined with NSAID COX-1 platelet inhibition and gastric mucosal injury produces additive bleeding risk.
What to do
Monitor for signs of GI and other bleeding, and consider gastroprotection with a proton pump inhibitor in high-risk patients. Use the lowest effective NSAID dose.
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 Diclofenac
- Diclofenac + Ketorolac Contraindicated
- Diclofenac + Ketorolac intranasal Contraindicated
- Aceclofenac + Diclofenac Major
- Acemetacin + Diclofenac Major
- Alteplase + Diclofenac Major
- Amiloride + Diclofenac 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 Diclofenac with Milnacipran?
MediHelp rates the interaction as moderate. Diclofenac 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. Milnacipran, a serotonin-norepinephrine reuptake inhibitor, combined with diclofenac increases the risk of bleeding, particularly upper GI bleeding.
How serious is the interaction between Diclofenac 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 signs of GI and other bleeding, and consider gastroprotection with a proton pump inhibitor in high-risk patients. Use the lowest effective NSAID dose.
What other medicines interact with Diclofenac?
MediHelp also lists interactions of Diclofenac with, for example, Ketorolac, Ketorolac intranasal, Aceclofenac. The full list is on the Diclofenac page.
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