Drug interactions
Levomilnacipran + Lisdexamfetamine
Severity: Major
Levomilnacipran and Lisdexamfetamine: 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
Both drugs enhance monoaminergic transmission, so the combination can cause serotonin syndrome and additive increases in blood pressure and heart rate. The risk is highest when starting treatment or raising doses.
What this interaction means in plain words
Levomilnacipran and Lisdexamfetamine 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.
Levomilnacipran belongs to Central Nervous System; Lisdexamfetamine belongs to Central Nervous System.
Why it happens
Additive serotonergic and noradrenergic effects from amphetamine-induced monoamine release and levomilnacipran reuptake inhibition.
What to do
Avoid the combination if possible; otherwise start low and monitor for serotonin toxicity and for hypertension and tachycardia. Stop the serotonergic agents if serotonin syndrome occurs.
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 Lisdexamfetamine
- Isocarboxazid + Lisdexamfetamine Contraindicated
- Linezolid + Lisdexamfetamine Contraindicated
- Lisdexamfetamine + Phenelzine Contraindicated
- Lisdexamfetamine + Procarbazine Contraindicated
- Lisdexamfetamine + Rasagiline Contraindicated
- Lisdexamfetamine + Safinamide Contraindicated
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 Levomilnacipran with Lisdexamfetamine?
MediHelp rates the interaction as major. Levomilnacipran and Lisdexamfetamine 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. Both drugs enhance monoaminergic transmission, so the combination can cause serotonin syndrome and additive increases in blood pressure and heart rate. The risk is highest when starting treatment or raising doses.
How serious is the interaction between Levomilnacipran and Lisdexamfetamine?
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 the combination if possible; otherwise start low and monitor for serotonin toxicity and for hypertension and tachycardia. Stop the serotonergic agents if serotonin syndrome occurs.
What other medicines interact with Lisdexamfetamine?
MediHelp also lists interactions of Lisdexamfetamine with, for example, Isocarboxazid, Linezolid, Phenelzine. The full list is on the Lisdexamfetamine page.
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