Drug interactions
Dosulepin + Milnacipran
Severity: Major
Dosulepin 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
Dosulepin is a tricyclic with serotonin and norepinephrine reuptake inhibition, so combining it with milnacipran increases the risk of serotonin syndrome and noradrenergic cardiovascular effects. Tricyclic arrhythmic potential adds to the concern.
What this interaction means in plain words
Dosulepin 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.
Dosulepin belongs to Central Nervous System; Milnacipran belongs to Central Nervous System.
Why it happens
Additive serotonergic and noradrenergic reuptake inhibition.
What to do
Avoid combining if possible; if needed, use low doses and monitor ECG, blood pressure and serotonin toxicity signs.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Dosulepin and Milnacipran, 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.
References
Other interactions of Milnacipran
- Isocarboxazid + Milnacipran Contraindicated
- Methylene blue + Milnacipran Contraindicated
- Milnacipran + Phenelzine Contraindicated
- Milnacipran + Procarbazine Contraindicated
- Milnacipran + Rasagiline Contraindicated
- Milnacipran + Safinamide Contraindicated
Other interactions of Dosulepin
- Dosulepin + Isocarboxazid Contraindicated
- Dosulepin + Phenelzine Contraindicated
- Dosulepin + Thioridazine Contraindicated
- Dosulepin + Tranylcypromine Contraindicated
- Amitriptyline + Dosulepin Major
- Buprenorphine + Dosulepin Major
Frequently asked questions
Can I take Dosulepin with Milnacipran?
MediHelp rates the interaction as major. Dosulepin 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. Dosulepin is a tricyclic with serotonin and norepinephrine reuptake inhibition, so combining it with milnacipran increases the risk of serotonin syndrome and noradrenergic cardiovascular effects. Tricyclic arrhythmic potential adds to the concern.
How serious is the interaction between Dosulepin 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: Avoid combining if possible; if needed, use low doses and monitor ECG, blood pressure and serotonin toxicity signs.
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.
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.
