Drug interactions
Milnacipran + Nefazodone
Severity: Major
Milnacipran and Nefazodone: major 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
Nefazodone inhibits serotonin reuptake and blocks 5-HT2A receptors, and it is also a strong CYP3A4 inhibitor. Used with milnacipran, it can contribute to serotonin toxicity.
What this interaction means in plain words
Milnacipran and Nefazodone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive serotonergic effects from combined reuptake inhibition.
What to do
Avoid combining two antidepressants unless clearly justified. If used, start at low doses and monitor for symptoms of serotonin syndrome.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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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
Frequently asked questions
Can I take Milnacipran with Nefazodone?
MediHelp rates the interaction as major. Milnacipran and Nefazodone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Nefazodone inhibits serotonin reuptake and blocks 5-HT2A receptors, and it is also a strong CYP3A4 inhibitor. Used with milnacipran, it can contribute to serotonin toxicity.
How serious is the interaction between Milnacipran and Nefazodone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combining two antidepressants unless clearly justified. If used, start at low doses and monitor for symptoms of serotonin syndrome.
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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