Drug interactions
Iloperidone + Milnacipran
Severity: Moderate
Iloperidone 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
Iloperidone has 5-HT2A antagonism and dopamine blockade, and serotonergic antidepressants may increase the risk of serotonin syndrome or neuroleptic malignant syndrome. Both are rare but serious. Iloperidone also prolongs the QT interval.
What this interaction means in plain words
Iloperidone 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.
Iloperidone belongs to Central Nervous System; Milnacipran belongs to Central Nervous System.
Why it happens
Additive effects on serotonergic and dopaminergic neurotransmission; the mechanism is not fully established.
What to do
Monitor for mental status change, hyperthermia, rigidity and autonomic instability, especially at initiation. Stop one or both drugs if either syndrome is suspected.
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 Iloperidone
- Iloperidone + Thioridazine Contraindicated
- Alfuzosin + Iloperidone Major
- Amiodarone + Iloperidone Major
- Amisulpride + Iloperidone Major
- Amitriptyline + Iloperidone Major
- Anagrelide + Iloperidone Major
Frequently asked questions
Can I take Iloperidone with Milnacipran?
MediHelp rates the interaction as moderate. Iloperidone 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. Iloperidone has 5-HT2A antagonism and dopamine blockade, and serotonergic antidepressants may increase the risk of serotonin syndrome or neuroleptic malignant syndrome. Both are rare but serious. Iloperidone also prolongs the QT interval.
How serious is the interaction between Iloperidone 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 mental status change, hyperthermia, rigidity and autonomic instability, especially at initiation. Stop one or both drugs if either syndrome is suspected.
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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