Drug interactions
Levomilnacipran + Ziprasidone
Severity: Moderate
Levomilnacipran and Ziprasidone: 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
Both agents affect serotonergic transmission, so combined use may rarely cause serotonin syndrome. Serotonergic drugs given with antipsychotics have also been linked with neuroleptic malignant syndrome, and levomilnacipran may raise heart rate and blood pressure.
What this interaction means in plain words
Levomilnacipran and Ziprasidone 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; Ziprasidone belongs to Central Nervous System.
Why it happens
Additive serotonergic activity (serotonin-norepinephrine reuptake inhibition plus serotonin receptor effects of ziprasidone), with possible enhanced dopamine blockade.
What to do
Monitor for mental status changes, autonomic instability, hyperthermia, muscle rigidity and neuromuscular hyperactivity, especially at initiation and dose increases. Stop one or both drugs if serotonin syndrome or NMS is suspected.
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 Ziprasidone
- Amiodarone + Ziprasidone Contraindicated
- Amitriptyline + Ziprasidone Contraindicated
- Arsenic trioxide + Ziprasidone Contraindicated
- Bedaquiline + Ziprasidone Contraindicated
- Chloroquine + Ziprasidone Contraindicated
- Citalopram + Ziprasidone 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 Ziprasidone?
MediHelp rates the interaction as moderate. Levomilnacipran and Ziprasidone 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. Both agents affect serotonergic transmission, so combined use may rarely cause serotonin syndrome. Serotonergic drugs given with antipsychotics have also been linked with neuroleptic malignant syndrome, and levomilnacipran may raise heart rate and blood pressure.
How serious is the interaction between Levomilnacipran and Ziprasidone?
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 mental status changes, autonomic instability, hyperthermia, muscle rigidity and neuromuscular hyperactivity, especially at initiation and dose increases. Stop one or both drugs if serotonin syndrome or NMS is suspected.
What other medicines interact with Ziprasidone?
MediHelp also lists interactions of Ziprasidone with, for example, Amiodarone, Amitriptyline, Arsenic trioxide. The full list is on the Ziprasidone page.
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