Drug interactions
Levomilnacipran + Ondansetron
Severity: Moderate
Levomilnacipran and Ondansetron: 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
Both drugs have been linked to serotonin syndrome, which can present with agitation, tremor, sweating, hyperreflexia, and hyperthermia. The risk with ondansetron appears low but is described in regulatory labeling and case reports.
What this interaction means in plain words
Levomilnacipran and Ondansetron 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; Ondansetron belongs to Gastrointestinal Tract.
Why it happens
Possible additive serotonergic effects; the contribution of 5-HT3 antagonism is not well established.
What to do
Monitor for signs of serotonin syndrome after starting or increasing either drug. Stop the agents and give supportive care if symptoms develop.
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 Ondansetron
- Apomorphine + Ondansetron Contraindicated
- Ondansetron + Thioridazine Contraindicated
- Ondansetron + Vandetanib Contraindicated
- Adagrasib + Ondansetron Major
- Amiodarone + Ondansetron Major
- Amisulpride + Ondansetron 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 Ondansetron?
MediHelp rates the interaction as moderate. Levomilnacipran and Ondansetron 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. Both drugs have been linked to serotonin syndrome, which can present with agitation, tremor, sweating, hyperreflexia, and hyperthermia. The risk with ondansetron appears low but is described in regulatory labeling and case reports.
How serious is the interaction between Levomilnacipran and Ondansetron?
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 after starting or increasing either drug. Stop the agents and give supportive care if symptoms develop.
What other medicines interact with Ondansetron?
MediHelp also lists interactions of Ondansetron with, for example, Apomorphine, Thioridazine, Vandetanib. The full list is on the Ondansetron page.
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