Drug interactions
Levomilnacipran + Perphenazine
Severity: Moderate
Levomilnacipran and Perphenazine: 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 SNRI with an antipsychotic carries a risk of serotonin syndrome and may raise the risk of neuroleptic malignant syndrome. Levomilnacipran can also raise blood pressure and heart rate, and perphenazine may add QT and hypotensive effects.
What this interaction means in plain words
Levomilnacipran and Perphenazine 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; Perphenazine belongs to Central Nervous System.
Why it happens
Serotonergic and dopamine-blocking pharmacodynamic effects acting together.
What to do
Monitor for signs of serotonin toxicity (agitation, tremor, hyperreflexia, hyperthermia) and neuroleptic malignant syndrome (rigidity, fever, autonomic instability). Stop both agents and treat urgently if either occurs.
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 Perphenazine
- Ibutilide + Perphenazine Contraindicated
- Perphenazine + Pimozide Contraindicated
- Perphenazine + Thioridazine Contraindicated
- Adagrasib + Perphenazine Major
- Alfentanil + Perphenazine Major
- Amiodarone + Perphenazine 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 Perphenazine?
MediHelp rates the interaction as moderate. Levomilnacipran and Perphenazine 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 SNRI with an antipsychotic carries a risk of serotonin syndrome and may raise the risk of neuroleptic malignant syndrome. Levomilnacipran can also raise blood pressure and heart rate, and perphenazine may add QT and hypotensive effects.
How serious is the interaction between Levomilnacipran and Perphenazine?
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 toxicity (agitation, tremor, hyperreflexia, hyperthermia) and neuroleptic malignant syndrome (rigidity, fever, autonomic instability). Stop both agents and treat urgently if either occurs.
What other medicines interact with Perphenazine?
MediHelp also lists interactions of Perphenazine with, for example, Ibutilide, Pimozide, Thioridazine. The full list is on the Perphenazine page.
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