Drug interactions
Levomilnacipran + Tranylcypromine
Severity: Contraindicated
Levomilnacipran and Tranylcypromine: contraindicated 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 nonselective MAO inhibitor with a serotonin-norepinephrine reuptake inhibitor can cause serotonin syndrome, with hyperthermia, rigidity, autonomic instability and altered mental status. It can also raise blood pressure. The combination is contraindicated in labeling.
What this interaction means in plain words
Levomilnacipran and Tranylcypromine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Levomilnacipran belongs to Central Nervous System; Tranylcypromine belongs to Central Nervous System.
Why it happens
Irreversible MAO inhibition prevents monoamine breakdown while levomilnacipran blocks serotonin and norepinephrine reuptake, producing additive serotonergic and noradrenergic excess.
What to do
Do not co-administer. Allow at least 14 days after stopping tranylcypromine before starting levomilnacipran, and at least 7 days after stopping levomilnacipran before starting tranylcypromine.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Tranylcypromine
- 5-HTP + Tranylcypromine Contraindicated
- Amitriptyline + Tranylcypromine Contraindicated
- Amoxapine + Tranylcypromine Contraindicated
- Atomoxetine + Tranylcypromine Contraindicated
- Benzphetamine + Tranylcypromine Contraindicated
- Brimonidine + Tranylcypromine 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 Tranylcypromine?
MediHelp rates the interaction as contraindicated. Levomilnacipran and Tranylcypromine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Combining a nonselective MAO inhibitor with a serotonin-norepinephrine reuptake inhibitor can cause serotonin syndrome, with hyperthermia, rigidity, autonomic instability and altered mental status. It can also raise blood pressure. The combination is contraindicated in labeling.
How serious is the interaction between Levomilnacipran and Tranylcypromine?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not co-administer. Allow at least 14 days after stopping tranylcypromine before starting levomilnacipran, and at least 7 days after stopping levomilnacipran before starting tranylcypromine.
What other medicines interact with Tranylcypromine?
MediHelp also lists interactions of Tranylcypromine with, for example, 5-HTP, Amitriptyline, Amoxapine. The full list is on the Tranylcypromine page.
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