Drug interactions
Diflunisal + Levomilnacipran
Severity: Moderate
Diflunisal and Levomilnacipran: 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
Combining an NSAID with an SNRI raises the risk of bleeding, especially gastrointestinal bleeding. The risk is greater in older patients, those with ulcer history, or those on anticoagulants or antiplatelets.
What this interaction means in plain words
Diflunisal and Levomilnacipran 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.
Diflunisal belongs to Musculoskeletal; Levomilnacipran belongs to Central Nervous System.
Why it happens
SNRIs deplete platelet serotonin and impair aggregation, while diflunisal inhibits platelet COX-1 and damages gastric mucosa, producing additive bleeding risk.
What to do
Monitor for signs of GI bleeding and bruising, and use the lowest effective NSAID dose for the shortest time. Consider gastroprotection with a proton pump inhibitor in high-risk patients.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Diflunisal and Levomilnacipran, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Diflunisal
- Diflunisal + Ketorolac Contraindicated
- Diflunisal + Ketorolac intranasal Contraindicated
- Acemetacin + Diflunisal Major
- Acetazolamide + Diflunisal Major
- Alteplase + Diflunisal Major
- Amiloride + Diflunisal Major
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 Diflunisal with Levomilnacipran?
MediHelp rates the interaction as moderate. Diflunisal and Levomilnacipran 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. Combining an NSAID with an SNRI raises the risk of bleeding, especially gastrointestinal bleeding. The risk is greater in older patients, those with ulcer history, or those on anticoagulants or antiplatelets.
How serious is the interaction between Diflunisal and Levomilnacipran?
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 bleeding and bruising, and use the lowest effective NSAID dose for the shortest time. Consider gastroprotection with a proton pump inhibitor in high-risk patients.
What other medicines interact with Diflunisal?
MediHelp also lists interactions of Diflunisal with, for example, Ketorolac, Ketorolac intranasal, Acemetacin. The full list is on the Diflunisal page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
