Drug interactions
Diflunisal + Milnacipran
Severity: Moderate
Diflunisal 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
Serotonin-norepinephrine reuptake inhibitors impair platelet function, and combined with an NSAID the risk of bleeding, particularly upper gastrointestinal bleeding, is increased.
What this interaction means in plain words
Diflunisal 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.
Diflunisal belongs to Musculoskeletal; Milnacipran belongs to Central Nervous System.
Why it happens
Depletion of platelet serotonin by milnacipran adds to NSAID-induced platelet inhibition and gastric mucosal injury.
What to do
Monitor for signs of gastrointestinal bleeding and consider gastroprotection with a proton pump inhibitor in higher-risk patients. Limit NSAID dose and duration.
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 Diflunisal
- Diflunisal + Ketorolac Contraindicated
- Diflunisal + Ketorolac intranasal Contraindicated
- Acemetacin + Diflunisal Major
- Acetazolamide + Diflunisal Major
- Alteplase + Diflunisal Major
- Amiloride + Diflunisal 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 Diflunisal with Milnacipran?
MediHelp rates the interaction as moderate. Diflunisal 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. Serotonin-norepinephrine reuptake inhibitors impair platelet function, and combined with an NSAID the risk of bleeding, particularly upper gastrointestinal bleeding, is increased.
How serious is the interaction between Diflunisal 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 gastrointestinal bleeding and consider gastroprotection with a proton pump inhibitor in higher-risk patients. Limit NSAID dose and duration.
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.
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