Drug interactions
Milnacipran + Naproxen
Severity: Moderate
Milnacipran and Naproxen: 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
Milnacipran, a serotonin-norepinephrine reuptake inhibitor, combined with naproxen increases the risk of bleeding, particularly from the upper gastrointestinal tract.
What this interaction means in plain words
Milnacipran and Naproxen 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.
Milnacipran belongs to Central Nervous System; Naproxen belongs to Musculoskeletal.
Why it happens
Reduced platelet serotonin uptake impairs platelet aggregation, adding to NSAID antiplatelet effects and gastric mucosal injury.
What to do
Watch for signs of GI bleeding such as black stools or anemia, and consider gastroprotection in older patients or those with prior ulcers. Use the lowest effective NSAID dose.
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 Naproxen
- Ketorolac intranasal + Naproxen Contraindicated
- Ketorolac + Naproxen Contraindicated
- Aceclofenac + Naproxen Major
- Acemetacin + Naproxen Major
- Acetylsalicylic acid + Naproxen Major
- Alteplase + Naproxen 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 Milnacipran with Naproxen?
MediHelp rates the interaction as moderate. Milnacipran and Naproxen 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. Milnacipran, a serotonin-norepinephrine reuptake inhibitor, combined with naproxen increases the risk of bleeding, particularly from the upper gastrointestinal tract.
How serious is the interaction between Milnacipran and Naproxen?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Watch for signs of GI bleeding such as black stools or anemia, and consider gastroprotection in older patients or those with prior ulcers. Use the lowest effective NSAID dose.
What other medicines interact with Naproxen?
MediHelp also lists interactions of Naproxen with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Naproxen page.
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