Drug interactions
Levomilnacipran + Palonosetron
Severity: Moderate
Levomilnacipran and 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
Levomilnacipran increases serotonin and norepinephrine, and 5-HT3 antagonists have been reported rarely in serotonin syndrome with serotonergic antidepressants. The risk with palonosetron is low but the syndrome can be serious.
What this interaction means in plain words
Levomilnacipran and 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; Palonosetron belongs to Gastrointestinal Tract.
Why it happens
Possible additive serotonergic effect; the 5-HT3 antagonist contribution is poorly established.
What to do
Monitor for signs of serotonin syndrome, particularly after dose changes. Stop both 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 Palonosetron
- Apomorphine + Palonosetron Contraindicated
- Isocarboxazid + Palonosetron Major
- Palonosetron + Phenelzine Major
- Palonosetron + Tranylcypromine Major
- Almotriptan + Palonosetron Moderate
- Amitriptyline + Palonosetron Moderate
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 Palonosetron?
MediHelp rates the interaction as moderate. Levomilnacipran and 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 increases serotonin and norepinephrine, and 5-HT3 antagonists have been reported rarely in serotonin syndrome with serotonergic antidepressants. The risk with palonosetron is low but the syndrome can be serious.
How serious is the interaction between Levomilnacipran and 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, particularly after dose changes. Stop both agents and give supportive care if symptoms develop.
What other medicines interact with Palonosetron?
MediHelp also lists interactions of Palonosetron with, for example, Apomorphine, Isocarboxazid, Phenelzine. The full list is on the Palonosetron page.
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