Drug interactions
Mefenamic acid + Milnacipran
Severity: Moderate
Mefenamic acid 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
Serotonin-norepinephrine reuptake inhibitors impair platelet serotonin uptake and aggregation, and NSAIDs add antiplatelet and mucosal-damaging effects. The combination increases the risk of gastrointestinal and other bleeding.
What this interaction means in plain words
Mefenamic acid 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.
Mefenamic acid belongs to Musculoskeletal; Milnacipran belongs to Central Nervous System.
Why it happens
Additive platelet dysfunction (reduced platelet serotonin and cyclooxygenase inhibition) with NSAID gastric mucosal injury.
What to do
Monitor for signs of bleeding, particularly GI bleeding, and consider gastroprotection with a proton pump inhibitor in higher-risk patients. Use the lowest NSAID dose for the shortest time.
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 Mefenamic acid
- Ketorolac intranasal + Mefenamic acid Contraindicated
- Ketorolac + Mefenamic acid Contraindicated
- Aceclofenac + Mefenamic acid Major
- Acemetacin + Mefenamic acid Major
- Acetylsalicylic acid + Mefenamic acid Major
- Alteplase + Mefenamic acid Major
Other interactions of Milnacipran
- Isocarboxazid + Milnacipran Contraindicated
- Methylene blue + Milnacipran Contraindicated
- Milnacipran + Phenelzine Contraindicated
- Milnacipran + Procarbazine Contraindicated
- Milnacipran + Rasagiline Contraindicated
- Milnacipran + Safinamide Contraindicated
Frequently asked questions
Can I take Mefenamic acid with Milnacipran?
MediHelp rates the interaction as moderate. Mefenamic acid 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. Serotonin-norepinephrine reuptake inhibitors impair platelet serotonin uptake and aggregation, and NSAIDs add antiplatelet and mucosal-damaging effects. The combination increases the risk of gastrointestinal and other bleeding.
How serious is the interaction between Mefenamic acid 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 signs of bleeding, particularly GI bleeding, and consider gastroprotection with a proton pump inhibitor in higher-risk patients. Use the lowest NSAID dose for the shortest time.
What other medicines interact with Mefenamic acid?
MediHelp also lists interactions of Mefenamic acid with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Mefenamic acid page.
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