Drug interactions
Levomilnacipran + Vortioxetine
Severity: Major
Levomilnacipran and Vortioxetine: 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 serotonergic activity, so combining them raises the risk of serotonin syndrome, with agitation, tremor, hyperthermia, clonus and autonomic instability. Levomilnacipran also adds noradrenergic effects such as increased blood pressure and heart rate.
What this interaction means in plain words
Levomilnacipran and Vortioxetine 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; Vortioxetine belongs to Central Nervous System.
Why it happens
Additive serotonergic effects from vortioxetine (serotonin reuptake inhibition and receptor modulation) and levomilnacipran (SNRI).
What to do
Avoid combining two serotonergic antidepressants unless clearly justified, and use a single agent where possible. If combined, use low doses and monitor for serotonin syndrome, especially after dose changes.
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 Vortioxetine
- Isocarboxazid + Vortioxetine Contraindicated
- Linezolid + Vortioxetine Contraindicated
- Methylene blue + Vortioxetine Contraindicated
- Phenelzine + Vortioxetine Contraindicated
- Rasagiline + Vortioxetine Contraindicated
- Selegiline transdermal + Vortioxetine 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 Vortioxetine?
MediHelp rates the interaction as major. Levomilnacipran and Vortioxetine 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 serotonergic activity, so combining them raises the risk of serotonin syndrome, with agitation, tremor, hyperthermia, clonus and autonomic instability. Levomilnacipran also adds noradrenergic effects such as increased blood pressure and heart rate.
How serious is the interaction between Levomilnacipran and Vortioxetine?
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 clearly justified, and use a single agent where possible. If combined, use low doses and monitor for serotonin syndrome, especially after dose changes.
What other medicines interact with Vortioxetine?
MediHelp also lists interactions of Vortioxetine with, for example, Isocarboxazid, Linezolid, Methylene blue. The full list is on the Vortioxetine page.
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