Drug interactions
Lisdexamfetamine + Milnacipran
Severity: Moderate
Lisdexamfetamine and Milnacipran: 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
Amphetamines increase release of monoamines including serotonin, and milnacipran blocks serotonin and norepinephrine reuptake. Together they can raise the risk of serotonin syndrome and additive cardiovascular stimulation such as hypertension and tachycardia.
What this interaction means in plain words
Lisdexamfetamine and Milnacipran 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.
Lisdexamfetamine belongs to Central Nervous System; Milnacipran belongs to Central Nervous System.
Why it happens
Additive serotonergic and noradrenergic effects through monoamine release plus reuptake inhibition.
What to do
Start with low doses and titrate slowly, monitoring for agitation, tremor, hyperthermia, clonus and blood pressure or heart rate rises. Stop both agents if serotonin syndrome develops.
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 Milnacipran
- Isocarboxazid + Milnacipran Contraindicated
- Methylene blue + Milnacipran Contraindicated
- Milnacipran + Phenelzine Contraindicated
- Milnacipran + Procarbazine Contraindicated
- Milnacipran + Rasagiline Contraindicated
- Milnacipran + Safinamide Contraindicated
Other interactions of Lisdexamfetamine
- Isocarboxazid + Lisdexamfetamine Contraindicated
- Linezolid + Lisdexamfetamine Contraindicated
- Lisdexamfetamine + Phenelzine Contraindicated
- Lisdexamfetamine + Procarbazine Contraindicated
- Lisdexamfetamine + Rasagiline Contraindicated
- Lisdexamfetamine + Safinamide Contraindicated
Frequently asked questions
Can I take Lisdexamfetamine with Milnacipran?
MediHelp rates the interaction as moderate. Lisdexamfetamine and Milnacipran 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. Amphetamines increase release of monoamines including serotonin, and milnacipran blocks serotonin and norepinephrine reuptake. Together they can raise the risk of serotonin syndrome and additive cardiovascular stimulation such as hypertension and tachycardia.
How serious is the interaction between Lisdexamfetamine and Milnacipran?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start with low doses and titrate slowly, monitoring for agitation, tremor, hyperthermia, clonus and blood pressure or heart rate rises. Stop both agents if serotonin syndrome develops.
What other medicines interact with Milnacipran?
MediHelp also lists interactions of Milnacipran with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Milnacipran page.
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