Drug interactions
Levomilnacipran + Paliperidone
Severity: Moderate
Levomilnacipran and Paliperidone: 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
Combining a serotonergic antidepressant with an antipsychotic may rarely lead to serotonin syndrome or neuroleptic malignant syndrome. Levomilnacipran can also raise blood pressure and heart rate, and the combination is often used together in practice.
What this interaction means in plain words
Levomilnacipran and Paliperidone 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; Paliperidone belongs to Central Nervous System.
Why it happens
Serotonin reuptake inhibition combined with D2 and 5-HT2A antagonism may alter serotonergic and dopaminergic balance; the exact mechanism is not fully established.
What to do
Monitor for mental status change, hyperthermia, rigidity and autonomic instability, particularly after dose changes. Stop both drugs and treat urgently if serotonin syndrome or NMS is suspected.
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 Paliperidone
- Ibutilide + Paliperidone Contraindicated
- Paliperidone + Pimozide Contraindicated
- Paliperidone + Vandetanib Contraindicated
- Adagrasib + Paliperidone Major
- Amiodarone + Paliperidone Major
- Amisulpride + Paliperidone 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 Paliperidone?
MediHelp rates the interaction as moderate. Levomilnacipran and Paliperidone 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. Combining a serotonergic antidepressant with an antipsychotic may rarely lead to serotonin syndrome or neuroleptic malignant syndrome. Levomilnacipran can also raise blood pressure and heart rate, and the combination is often used together in practice.
How serious is the interaction between Levomilnacipran and Paliperidone?
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 mental status change, hyperthermia, rigidity and autonomic instability, particularly after dose changes. Stop both drugs and treat urgently if serotonin syndrome or NMS is suspected.
What other medicines interact with Paliperidone?
MediHelp also lists interactions of Paliperidone with, for example, Ibutilide, Pimozide, Vandetanib. The full list is on the Paliperidone page.
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