Drug interactions
Levomilnacipran + Netupitant-palonosetron
Severity: Moderate
Levomilnacipran and Netupitant-palonosetron: 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
Palonosetron, a 5-HT3 antagonist, has been associated with rare reports of serotonin syndrome when given with serotonergic antidepressants such as levomilnacipran. Features can include agitation, tremor, hyperreflexia, sweating, fever and autonomic instability. The risk is low in absolute terms but the outcome can be serious.
What this interaction means in plain words
Levomilnacipran and Netupitant-palonosetron 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; Netupitant-palonosetron belongs to Gastrointestinal Tract.
Why it happens
Additive serotonergic effects, although the contribution of 5-HT3 antagonism to serotonin syndrome is not well established.
What to do
Monitor for signs of serotonin syndrome, especially after starting or increasing doses. Stop the serotonergic agents and give supportive care if symptoms appear.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Levomilnacipran and Netupitant-palonosetron, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Netupitant-palonosetron
- Apomorphine + Netupitant-palonosetron Contraindicated
- Flibanserin + Netupitant-palonosetron Contraindicated
- Apalutamide + Netupitant-palonosetron Major
- Avapritinib + Netupitant-palonosetron Major
- Carbamazepine + Netupitant-palonosetron Major
- Cobimetinib + Netupitant-palonosetron 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 Netupitant-palonosetron?
MediHelp rates the interaction as moderate. Levomilnacipran and Netupitant-palonosetron 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. Palonosetron, a 5-HT3 antagonist, has been associated with rare reports of serotonin syndrome when given with serotonergic antidepressants such as levomilnacipran. Features can include agitation, tremor, hyperreflexia, sweating, fever and autonomic instability. The risk is low in absolute terms but the outcome can be serious.
How serious is the interaction between Levomilnacipran and Netupitant-palonosetron?
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 signs of serotonin syndrome, especially after starting or increasing doses. Stop the serotonergic agents and give supportive care if symptoms appear.
What other medicines interact with Netupitant-palonosetron?
MediHelp also lists interactions of Netupitant-palonosetron with, for example, Apomorphine, Flibanserin, Apalutamide. The full list is on the Netupitant-palonosetron page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
