Drug interactions
Lithium + Milnacipran
Severity: Moderate
Lithium 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
Lithium enhances serotonergic transmission, so with milnacipran there is potential for serotonin syndrome or neurotoxicity. Reports are infrequent but the effects can be serious.
What this interaction means in plain words
Lithium 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.
Lithium belongs to Central Nervous System; Milnacipran belongs to Central Nervous System.
Why it happens
Additive serotonergic effects from lithium-enhanced serotonin activity and milnacipran reuptake blockade.
What to do
Monitor for tremor, clonus, agitation and hyperthermia, especially after dose changes. Check lithium levels periodically and stop the 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 Lithium
- Lithium + Thioridazine Contraindicated
- Lithium + Vandetanib Contraindicated
- Aceclofenac + Lithium Major
- Acemetacin + Lithium Major
- Amisulpride + Lithium Major
- Amlodipine-benazepril + Lithium Major
Frequently asked questions
Can I take Lithium with Milnacipran?
MediHelp rates the interaction as moderate. Lithium 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. Lithium enhances serotonergic transmission, so with milnacipran there is potential for serotonin syndrome or neurotoxicity. Reports are infrequent but the effects can be serious.
How serious is the interaction between Lithium 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: Monitor for tremor, clonus, agitation and hyperthermia, especially after dose changes. Check lithium levels periodically and stop the 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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