Drug interactions
Levomilnacipran + Tolmetin
Severity: Moderate
Levomilnacipran and Tolmetin: 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 deplete platelet serotonin and impair aggregation, and NSAIDs inhibit platelet function and injure the gastric mucosa. Together they increase the risk of bleeding, notably upper gastrointestinal bleeding.
What this interaction means in plain words
Levomilnacipran and Tolmetin 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; Tolmetin belongs to Musculoskeletal.
Why it happens
Additive impairment of platelet function (serotonin reuptake inhibition plus COX inhibition) with NSAID mucosal injury.
What to do
Monitor for gastrointestinal and other bleeding, and consider gastroprotection in at-risk patients. Prefer a non-NSAID analgesic if possible.
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 Tolmetin
- Ketorolac intranasal + Tolmetin Contraindicated
- Ketorolac + Tolmetin Contraindicated
- Aceclofenac + Tolmetin Major
- Acemetacin + Tolmetin Major
- Alteplase + Tolmetin Major
- Amlodipine-hydrochlorothiazide-valsartan + Tolmetin 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 Tolmetin?
MediHelp rates the interaction as moderate. Levomilnacipran and Tolmetin 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 deplete platelet serotonin and impair aggregation, and NSAIDs inhibit platelet function and injure the gastric mucosa. Together they increase the risk of bleeding, notably upper gastrointestinal bleeding.
How serious is the interaction between Levomilnacipran and Tolmetin?
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 and other bleeding, and consider gastroprotection in at-risk patients. Prefer a non-NSAID analgesic if possible.
What other medicines interact with Tolmetin?
MediHelp also lists interactions of Tolmetin with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Tolmetin page.
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