Drug interactions
Milnacipran + Tolmetin
Severity: Moderate
Milnacipran and Tolmetin: 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 impairs platelet function, and combined with an NSAID this increases bleeding risk, particularly upper gastrointestinal bleeding.
What this interaction means in plain words
Milnacipran and Tolmetin 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; Tolmetin belongs to Musculoskeletal.
Why it happens
Reduced platelet serotonin uptake from SNRI use adds to NSAID platelet inhibition and gastric mucosal injury.
What to do
Monitor for signs of gastrointestinal bleeding and bruising. Consider a proton pump inhibitor for high-risk patients or an alternative analgesic.
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 Tolmetin
- Ketorolac intranasal + Tolmetin Contraindicated
- Ketorolac + Tolmetin Contraindicated
- Aceclofenac + Tolmetin Major
- Acemetacin + Tolmetin Major
- Alteplase + Tolmetin Major
- Amlodipine-hydrochlorothiazide-valsartan + Tolmetin 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 Tolmetin?
MediHelp rates the interaction as moderate. Milnacipran and Tolmetin 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 impairs platelet function, and combined with an NSAID this increases bleeding risk, particularly upper gastrointestinal bleeding.
How serious is the interaction between Milnacipran and Tolmetin?
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 gastrointestinal bleeding and bruising. Consider a proton pump inhibitor for high-risk patients or an alternative analgesic.
What other medicines interact with Tolmetin?
MediHelp also lists interactions of Tolmetin with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Tolmetin page.
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