Drug interactions
Ibrutinib + Milnacipran
Severity: Moderate
Ibrutinib 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
Ibrutinib inhibits platelet function and is associated with bleeding, including serious hemorrhage. Milnacipran also impairs platelet serotonin uptake, so combined use may further increase bleeding risk.
What this interaction means in plain words
Ibrutinib 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.
Ibrutinib belongs to Oncology; Milnacipran belongs to Central Nervous System.
Why it happens
Additive impairment of platelet aggregation through BTK inhibition and SNRI-induced platelet serotonin depletion.
What to do
Monitor for bruising and gastrointestinal or other bleeding, and review other drugs affecting hemostasis. Consider an alternative antidepressant in patients at high bleeding risk.
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 Milnacipran
- Isocarboxazid + Milnacipran Contraindicated
- Methylene blue + Milnacipran Contraindicated
- Milnacipran + Phenelzine Contraindicated
- Milnacipran + Procarbazine Contraindicated
- Milnacipran + Rasagiline Contraindicated
- Milnacipran + Safinamide Contraindicated
Other interactions of Ibrutinib
- Abciximab + Ibrutinib Major
- Acetylsalicylic acid + Ibrutinib Major
- Alteplase + Ibrutinib Major
- Amobarbital + Ibrutinib Major
- Apalutamide + Ibrutinib Major
- Apixaban + Ibrutinib Major
Frequently asked questions
Can I take Ibrutinib with Milnacipran?
MediHelp rates the interaction as moderate. Ibrutinib 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. Ibrutinib inhibits platelet function and is associated with bleeding, including serious hemorrhage. Milnacipran also impairs platelet serotonin uptake, so combined use may further increase bleeding risk.
How serious is the interaction between Ibrutinib 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 bruising and gastrointestinal or other bleeding, and review other drugs affecting hemostasis. Consider an alternative antidepressant in patients at high bleeding risk.
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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