Drug interactions
Levomilnacipran + Paroxetine
Severity: Major
Levomilnacipran and Paroxetine: major 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 enhance serotonergic and noradrenergic transmission, so combining them raises the risk of serotonin syndrome. Hypertension and tachycardia may also be additive.
What this interaction means in plain words
Levomilnacipran and Paroxetine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Levomilnacipran belongs to Central Nervous System; Paroxetine belongs to Central Nervous System.
Why it happens
Additive inhibition of serotonin reuptake.
What to do
Avoid combining two serotonergic antidepressants unless clearly justified. If used, monitor for serotonin toxicity and blood pressure, especially during dose changes.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Paroxetine
- Isocarboxazid + Paroxetine Contraindicated
- Methylene blue + Paroxetine Contraindicated
- Paroxetine + Phenelzine Contraindicated
- Paroxetine + Pimozide Contraindicated
- Paroxetine + Procarbazine Contraindicated
- Paroxetine + Selegiline Contraindicated
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 Paroxetine?
MediHelp rates the interaction as major. Levomilnacipran and Paroxetine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both drugs enhance serotonergic and noradrenergic transmission, so combining them raises the risk of serotonin syndrome. Hypertension and tachycardia may also be additive.
How serious is the interaction between Levomilnacipran and Paroxetine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combining two serotonergic antidepressants unless clearly justified. If used, monitor for serotonin toxicity and blood pressure, especially during dose changes.
What other medicines interact with Paroxetine?
MediHelp also lists interactions of Paroxetine with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Paroxetine page.
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