Drug interactions
Levomilnacipran + Mefenamic acid
Severity: Moderate
Levomilnacipran and Mefenamic acid: 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
SNRIs impair platelet serotonin uptake and, combined with NSAIDs, raise the risk of bleeding, especially in the upper gastrointestinal tract. The risk is greater in older patients and those with ulcer history or on anticoagulants.
What this interaction means in plain words
Levomilnacipran and Mefenamic acid 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.
Levomilnacipran belongs to Central Nervous System; Mefenamic acid belongs to Musculoskeletal.
Why it happens
Additive impairment of platelet function: SNRI depletes platelet serotonin and NSAID inhibits thromboxane production, plus NSAID mucosal injury.
What to do
Monitor for GI bleeding and bruising, and consider gastroprotection with a proton pump inhibitor in high-risk patients. Use the lowest NSAID dose for the shortest time.
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 Mefenamic acid
- Ketorolac intranasal + Mefenamic acid Contraindicated
- Ketorolac + Mefenamic acid Contraindicated
- Aceclofenac + Mefenamic acid Major
- Acemetacin + Mefenamic acid Major
- Acetylsalicylic acid + Mefenamic acid Major
- Alteplase + Mefenamic acid 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 Levomilnacipran with Mefenamic acid?
MediHelp rates the interaction as moderate. Levomilnacipran and Mefenamic acid 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. SNRIs impair platelet serotonin uptake and, combined with NSAIDs, raise the risk of bleeding, especially in the upper gastrointestinal tract. The risk is greater in older patients and those with ulcer history or on anticoagulants.
How serious is the interaction between Levomilnacipran and Mefenamic acid?
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 GI bleeding and bruising, and consider gastroprotection with a proton pump inhibitor in high-risk patients. Use the lowest NSAID dose for the shortest time.
What other medicines interact with Mefenamic acid?
MediHelp also lists interactions of Mefenamic acid with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Mefenamic acid page.
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