Drug interactions
Milnacipran + Tranylcypromine
Severity: Contraindicated
Milnacipran and Tranylcypromine: contraindicated 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
Milnacipran with tranylcypromine can cause fatal serotonin syndrome and hypertensive crisis. The combination is contraindicated in labeling.
What this interaction means in plain words
Milnacipran and Tranylcypromine 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; Tranylcypromine belongs to Central Nervous System.
Why it happens
Irreversible MAO inhibition combined with serotonin-noradrenaline reuptake inhibition produces severe monoamine excess.
What to do
Never coadminister. Wait at least 14 days after stopping tranylcypromine before starting milnacipran, and at least 5 days after stopping milnacipran before starting tranylcypromine.
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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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 Tranylcypromine
- 5-HTP + Tranylcypromine Contraindicated
- Amitriptyline + Tranylcypromine Contraindicated
- Amoxapine + Tranylcypromine Contraindicated
- Atomoxetine + Tranylcypromine Contraindicated
- Benzphetamine + Tranylcypromine Contraindicated
- Brimonidine + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Milnacipran with Tranylcypromine?
MediHelp rates the interaction as contraindicated. Milnacipran and Tranylcypromine 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 with tranylcypromine can cause fatal serotonin syndrome and hypertensive crisis. The combination is contraindicated in labeling.
How serious is the interaction between Milnacipran and Tranylcypromine?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Never coadminister. Wait at least 14 days after stopping tranylcypromine before starting milnacipran, and at least 5 days after stopping milnacipran before starting tranylcypromine.
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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