Drug interactions
Milnacipran + Phentermine
Severity: Major
Milnacipran and Phentermine: major interaction.
Last updated Sources: US FDA label
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
Phentermine is a sympathomimetic that releases norepinephrine and has some serotonergic effect. With milnacipran it may cause additive hypertension, tachycardia and, rarely, serotonin syndrome.
What this interaction means in plain words
Milnacipran and Phentermine 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; Phentermine belongs to Central Nervous System.
Why it happens
Additive noradrenergic and serotonergic stimulation through monoamine release and reuptake inhibition.
What to do
Avoid if possible. If combined, monitor blood pressure, heart rate and signs of serotonin toxicity.
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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References
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 Phentermine
- Isocarboxazid + Phentermine Contraindicated
- Linezolid + Phentermine Contraindicated
- Phenelzine + Phentermine Contraindicated
- Phentermine + Procarbazine Contraindicated
- Phentermine + Rasagiline Contraindicated
- Phentermine + Selegiline Contraindicated
Frequently asked questions
Can I take Milnacipran with Phentermine?
MediHelp rates the interaction as major. Milnacipran and Phentermine 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. Phentermine is a sympathomimetic that releases norepinephrine and has some serotonergic effect. With milnacipran it may cause additive hypertension, tachycardia and, rarely, serotonin syndrome.
How serious is the interaction between Milnacipran and Phentermine?
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 if possible. If combined, monitor blood pressure, heart rate and signs of serotonin toxicity.
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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