Drug interactions
Milnacipran + Vilazodone
Severity: Major
Milnacipran and Vilazodone: 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
Both drugs enhance serotonergic transmission, so combining them raises the risk of serotonin syndrome and duplicates antidepressant therapy. Symptoms include confusion, hyperthermia, clonus and autonomic instability.
What this interaction means in plain words
Milnacipran and Vilazodone 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; Vilazodone belongs to Central Nervous System.
Why it happens
Additive serotonin reuptake inhibition plus vilazodone 5-HT1A partial agonism.
What to do
Avoid the combination where possible; if unavoidable, use low doses with close monitoring. Stop both and give supportive care if serotonin syndrome occurs.
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 Vilazodone
- Isocarboxazid + Vilazodone Contraindicated
- Methylene blue + Vilazodone Contraindicated
- Phenelzine + Vilazodone Contraindicated
- Rasagiline + Vilazodone Contraindicated
- Selegiline transdermal + Vilazodone Contraindicated
- Selegiline + Vilazodone Contraindicated
Frequently asked questions
Can I take Milnacipran with Vilazodone?
MediHelp rates the interaction as major. Milnacipran and Vilazodone 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. Both drugs enhance serotonergic transmission, so combining them raises the risk of serotonin syndrome and duplicates antidepressant therapy. Symptoms include confusion, hyperthermia, clonus and autonomic instability.
How serious is the interaction between Milnacipran and Vilazodone?
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 the combination where possible; if unavoidable, use low doses with close monitoring. Stop both and give supportive care if serotonin syndrome occurs.
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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