Drug interactions
Milnacipran + Olanzapine / samidorphan
Severity: Moderate
Milnacipran and Olanzapine / samidorphan: 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
Olanzapine causes sedation and orthostatic hypotension, and milnacipran may add to CNS effects. Serotonergic and neuroleptic malignant syndrome effects are also possible but uncommon.
What this interaction means in plain words
Milnacipran and Olanzapine / samidorphan 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.
Why it happens
Additive CNS and blood pressure effects, with possible additive serotonergic activity.
What to do
Monitor blood pressure, sedation and signs of serotonin toxicity, particularly during dose changes. Counsel patients about rising slowly from sitting or lying positions.
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
Frequently asked questions
Can I take Milnacipran with Olanzapine / samidorphan?
MediHelp rates the interaction as moderate. Milnacipran and Olanzapine / samidorphan 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. Olanzapine causes sedation and orthostatic hypotension, and milnacipran may add to CNS effects. Serotonergic and neuroleptic malignant syndrome effects are also possible but uncommon.
How serious is the interaction between Milnacipran and Olanzapine / samidorphan?
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 blood pressure, sedation and signs of serotonin toxicity, particularly during dose changes. Counsel patients about rising slowly from sitting or lying positions.
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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