Drug interactions
Levomilnacipran + Sertraline
Severity: Major
Levomilnacipran and Sertraline: 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 increase synaptic serotonin, so taking them together raises the risk of serotonin syndrome. Features include agitation, tremor, sweating, hyperthermia, clonus and diarrhea, and severe cases can be life-threatening.
What this interaction means in plain words
Levomilnacipran and Sertraline 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; Sertraline belongs to Central Nervous System.
Why it happens
Additive serotonergic effect through inhibition of serotonin reuptake by both drugs.
What to do
Avoid combining two serotonergic antidepressants unless under specialist supervision. If a switch is needed, taper one drug and allow for washout, and watch closely for serotonin toxicity.
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 Sertraline
- Isocarboxazid + Sertraline Contraindicated
- Methylene blue + Sertraline Contraindicated
- Phenelzine + Sertraline Contraindicated
- Pimozide + Sertraline Contraindicated
- Selegiline transdermal + Sertraline Contraindicated
- Selegiline + Sertraline 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 Sertraline?
MediHelp rates the interaction as major. Levomilnacipran and Sertraline 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 increase synaptic serotonin, so taking them together raises the risk of serotonin syndrome. Features include agitation, tremor, sweating, hyperthermia, clonus and diarrhea, and severe cases can be life-threatening.
How serious is the interaction between Levomilnacipran and Sertraline?
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 under specialist supervision. If a switch is needed, taper one drug and allow for washout, and watch closely for serotonin toxicity.
What other medicines interact with Sertraline?
MediHelp also lists interactions of Sertraline with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Sertraline page.
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