Drug interactions
Milnacipran + Sulindac
Severity: Moderate
Milnacipran and Sulindac: 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
Milnacipran, a serotonin-norepinephrine reuptake inhibitor, impairs platelet function, and sulindac adds gastric mucosal injury and antiplatelet effects. Combining them increases the risk of gastrointestinal and other bleeding.
What this interaction means in plain words
Milnacipran and Sulindac 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.
Milnacipran belongs to Central Nervous System; Sulindac belongs to Musculoskeletal.
Why it happens
Additive effects: SNRI depletion of platelet serotonin impairs aggregation while NSAIDs inhibit platelet cyclooxygenase and damage the GI mucosa.
What to do
Monitor for signs of GI bleeding such as melena, anemia or abdominal pain. Consider gastroprotection with a proton pump inhibitor in high-risk patients and limit NSAID duration.
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 Sulindac
- Ketorolac intranasal + Sulindac Contraindicated
- Ketorolac + Sulindac Contraindicated
- Aceclofenac + Sulindac Major
- Acetylsalicylic acid + Sulindac Major
- Alteplase + Sulindac Major
- Amiloride + Sulindac Major
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 Sulindac?
MediHelp rates the interaction as moderate. Milnacipran and Sulindac 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. Milnacipran, a serotonin-norepinephrine reuptake inhibitor, impairs platelet function, and sulindac adds gastric mucosal injury and antiplatelet effects. Combining them increases the risk of gastrointestinal and other bleeding.
How serious is the interaction between Milnacipran and Sulindac?
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 for signs of GI bleeding such as melena, anemia or abdominal pain. Consider gastroprotection with a proton pump inhibitor in high-risk patients and limit NSAID duration.
What other medicines interact with Sulindac?
MediHelp also lists interactions of Sulindac with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Sulindac page.
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