Drug interactions
Milnacipran + Ozanimod
Severity: Major
Milnacipran and Ozanimod: 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
The active metabolites of ozanimod inhibit MAO-B in vitro, so combining it with a drug that raises serotonin and norepinephrine such as milnacipran may cause hypertensive reactions or serotonin syndrome. The clinical relevance is uncertain but the potential harm is serious.
What this interaction means in plain words
Milnacipran and Ozanimod 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.
Milnacipran belongs to Central Nervous System; Ozanimod belongs to Central Nervous System.
Why it happens
Possible MAO inhibition by ozanimod metabolites adding to serotonin and norepinephrine reuptake inhibition.
What to do
Co-administration is not recommended; consider an alternative. If used together, monitor blood pressure, heart rate and serotonergic symptoms.
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
Other interactions of Ozanimod
- Isocarboxazid + Ozanimod Contraindicated
- Linezolid + Ozanimod Contraindicated
- Ozanimod + Phenelzine Contraindicated
- Ozanimod + Procarbazine Contraindicated
- Ozanimod + Rasagiline Contraindicated
- Ozanimod + Safinamide Contraindicated
Frequently asked questions
Can I take Milnacipran with Ozanimod?
MediHelp rates the interaction as major. Milnacipran and Ozanimod 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. The active metabolites of ozanimod inhibit MAO-B in vitro, so combining it with a drug that raises serotonin and norepinephrine such as milnacipran may cause hypertensive reactions or serotonin syndrome. The clinical relevance is uncertain but the potential harm is serious.
How serious is the interaction between Milnacipran and Ozanimod?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Co-administration is not recommended; consider an alternative. If used together, monitor blood pressure, heart rate and serotonergic symptoms.
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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