Drug interactions
Milnacipran + Safinamide
Severity: Contraindicated
Milnacipran and Safinamide: contraindicated 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
Safinamide is an MAO-B inhibitor, and with milnacipran it may cause serotonin syndrome or hypertensive reactions. Safinamide labeling contraindicates concurrent SNRIs.
What this interaction means in plain words
Milnacipran and Safinamide are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Milnacipran belongs to Central Nervous System; Safinamide belongs to Central Nervous System.
Why it happens
MAO-B inhibition combined with serotonin-noradrenaline reuptake inhibition causes monoamine excess.
What to do
Avoid the combination. Allow at least 14 days after stopping safinamide before starting milnacipran, and at least 5 days after stopping milnacipran before starting safinamide.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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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 + Selegiline Contraindicated
Other interactions of Safinamide
- Amitriptyline + Safinamide Contraindicated
- Amoxapine + Safinamide Contraindicated
- Amphetamine polistirex + Safinamide Contraindicated
- Clomipramine + Safinamide Contraindicated
- Cyclobenzaprine + Safinamide Contraindicated
- Desipramine + Safinamide Contraindicated
Frequently asked questions
Can I take Milnacipran with Safinamide?
MediHelp rates the interaction as contraindicated. Milnacipran and Safinamide are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Safinamide is an MAO-B inhibitor, and with milnacipran it may cause serotonin syndrome or hypertensive reactions. Safinamide labeling contraindicates concurrent SNRIs.
How serious is the interaction between Milnacipran and Safinamide?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination. Allow at least 14 days after stopping safinamide before starting milnacipran, and at least 5 days after stopping milnacipran before starting safinamide.
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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