Drug interactions
Isocarboxazid + Levomilnacipran
Severity: Contraindicated
Isocarboxazid and Levomilnacipran: contraindicated 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
Levomilnacipran with an MAOI can cause serotonin syndrome, with agitation, hyperthermia, rigidity, autonomic instability and seizures. Fatal cases have been reported with this class combination.
What this interaction means in plain words
Isocarboxazid and Levomilnacipran are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Isocarboxazid belongs to Central Nervous System; Levomilnacipran belongs to Central Nervous System.
Why it happens
MAO inhibition blocks serotonin and norepinephrine breakdown, while levomilnacipran blocks their reuptake, producing excess serotonergic activity.
What to do
Do not coadminister. Observe the labeled washout of 14 days after stopping the MAOI before starting levomilnacipran, and 7 days after stopping levomilnacipran before starting the MAOI.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Isocarboxazid
- 5-HTP + Isocarboxazid Contraindicated
- Amitriptyline + Isocarboxazid Contraindicated
- Amobarbital + Isocarboxazid Contraindicated
- Amoxapine + Isocarboxazid Contraindicated
- Apraclonidine + Isocarboxazid Contraindicated
- Atomoxetine + Isocarboxazid Contraindicated
Other interactions of Levomilnacipran
- Levomilnacipran + Linezolid Contraindicated
- Levomilnacipran + Methylthioninium chloride Contraindicated
- Levomilnacipran + Phenelzine Contraindicated
- Levomilnacipran + Procarbazine Contraindicated
- Levomilnacipran + Rasagiline Contraindicated
- Levomilnacipran + Safinamide Contraindicated
Frequently asked questions
Can I take Isocarboxazid with Levomilnacipran?
MediHelp rates the interaction as contraindicated. Isocarboxazid and Levomilnacipran are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Levomilnacipran with an MAOI can cause serotonin syndrome, with agitation, hyperthermia, rigidity, autonomic instability and seizures. Fatal cases have been reported with this class combination.
How serious is the interaction between Isocarboxazid and Levomilnacipran?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not coadminister. Observe the labeled washout of 14 days after stopping the MAOI before starting levomilnacipran, and 7 days after stopping levomilnacipran before starting the MAOI.
What other medicines interact with Isocarboxazid?
MediHelp also lists interactions of Isocarboxazid with, for example, 5-HTP, Amitriptyline, Amobarbital. The full list is on the Isocarboxazid page.
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