Drug interactions
Granisetron + Levomilnacipran
Severity: Moderate
Granisetron 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
Serotonin syndrome has been reported when 5-HT3 antagonists are given with serotonergic antidepressants, though the absolute risk is low. Levomilnacipran increases synaptic serotonin and norepinephrine, so the combination could contribute to agitation, tremor, hyperthermia and autonomic instability.
What this interaction means in plain words
Granisetron 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.
Granisetron belongs to Gastrointestinal Tract; Levomilnacipran belongs to Central Nervous System.
Why it happens
Possible additive serotonergic effect; the 5-HT3 antagonist contribution is poorly established.
What to do
The combination can be used if needed; counsel the patient and monitor for signs of serotonin syndrome, especially after starting or raising a dose. Stop both agents and treat supportively if symptoms appear.
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 Granisetron
- Apomorphine + Granisetron Contraindicated
- Amiodarone + Granisetron Major
- Amisulpride + Granisetron Major
- Arsenic trioxide + Granisetron Major
- Artemether / lumefantrine + Granisetron Major
- Artemether + Granisetron 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 Granisetron with Levomilnacipran?
MediHelp rates the interaction as moderate. Granisetron 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. Serotonin syndrome has been reported when 5-HT3 antagonists are given with serotonergic antidepressants, though the absolute risk is low. Levomilnacipran increases synaptic serotonin and norepinephrine, so the combination could contribute to agitation, tremor, hyperthermia and autonomic instability.
How serious is the interaction between Granisetron 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: The combination can be used if needed; counsel the patient and monitor for signs of serotonin syndrome, especially after starting or raising a dose. Stop both agents and treat supportively if symptoms appear.
What other medicines interact with Granisetron?
MediHelp also lists interactions of Granisetron with, for example, Apomorphine, Amiodarone, Amisulpride. The full list is on the Granisetron page.
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