Drug interactions
Fenfluramine + Milnacipran
Severity: Major
Fenfluramine and Milnacipran: major 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
Fenfluramine releases serotonin, and combining it with an SNRI raises the risk of serotonin syndrome. Fenfluramine labeling carries a warning about use with other serotonergic drugs.
What this interaction means in plain words
Fenfluramine 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.
Fenfluramine belongs to Central Nervous System; Milnacipran belongs to Central Nervous System.
Why it happens
Additive serotonergic effects from fenfluramine-induced serotonin release and milnacipran reuptake inhibition.
What to do
Avoid if possible; otherwise monitor closely for serotonin syndrome, especially at initiation and dose changes. Stop one or both drugs if symptoms occur.
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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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 Fenfluramine
- Fenfluramine + Isocarboxazid Contraindicated
- Fenfluramine + Linezolid Contraindicated
- Fenfluramine + Phenelzine Contraindicated
- Fenfluramine + Selegiline Contraindicated
- Fenfluramine + Tranylcypromine Contraindicated
- Almotriptan + Fenfluramine Major
Frequently asked questions
Can I take Fenfluramine with Milnacipran?
MediHelp rates the interaction as major. Fenfluramine 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. Fenfluramine releases serotonin, and combining it with an SNRI raises the risk of serotonin syndrome. Fenfluramine labeling carries a warning about use with other serotonergic drugs.
How serious is the interaction between Fenfluramine 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 if possible; otherwise monitor closely for serotonin syndrome, especially at initiation and dose changes. Stop one or both drugs if symptoms occur.
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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