Drug interactions
Levomilnacipran + Sulindac
Severity: Moderate
Levomilnacipran and Sulindac: 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
SNRIs reduce platelet serotonin uptake and impair platelet aggregation, and NSAIDs add antiplatelet effects and gastric mucosal injury. The combination increases the risk of bleeding, especially upper gastrointestinal bleeding.
What this interaction means in plain words
Levomilnacipran and Sulindac 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; Sulindac belongs to Musculoskeletal.
Why it happens
Additive impairment of platelet function (serotonin depletion plus cyclooxygenase inhibition) with NSAID mucosal damage.
What to do
Monitor for gastrointestinal bleeding and anemia, especially in older patients. Consider gastroprotection with a proton pump inhibitor or a non-NSAID analgesic.
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 Sulindac
- Ketorolac intranasal + Sulindac Contraindicated
- Ketorolac + Sulindac Contraindicated
- Aceclofenac + Sulindac Major
- Acetylsalicylic acid + Sulindac Major
- Alteplase + Sulindac Major
- Amiloride + Sulindac 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 Sulindac?
MediHelp rates the interaction as moderate. Levomilnacipran and Sulindac 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. SNRIs reduce platelet serotonin uptake and impair platelet aggregation, and NSAIDs add antiplatelet effects and gastric mucosal injury. The combination increases the risk of bleeding, especially upper gastrointestinal bleeding.
How serious is the interaction between Levomilnacipran and Sulindac?
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 gastrointestinal bleeding and anemia, especially in older patients. Consider gastroprotection with a proton pump inhibitor or a non-NSAID analgesic.
What other medicines interact with Sulindac?
MediHelp also lists interactions of Sulindac with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Sulindac page.
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