Drug interactions
Milnacipran + Vorapaxar
Severity: Moderate
Milnacipran and Vorapaxar: 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
Vorapaxar is a potent antiplatelet agent and milnacipran impairs platelet serotonin uptake, so combined use may increase the risk of bleeding.
What this interaction means in plain words
Milnacipran and Vorapaxar 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.
Why it happens
Additive antiplatelet effects: PAR-1 antagonism plus SNRI-related platelet serotonin depletion.
What to do
Monitor for bleeding, including GI and intracranial, and reassess the need for both drugs in patients with additional bleeding risk factors.
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 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 Vorapaxar?
MediHelp rates the interaction as moderate. Milnacipran and Vorapaxar 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. Vorapaxar is a potent antiplatelet agent and milnacipran impairs platelet serotonin uptake, so combined use may increase the risk of bleeding.
How serious is the interaction between Milnacipran and Vorapaxar?
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 bleeding, including GI and intracranial, and reassess the need for both drugs in patients with additional bleeding risk factors.
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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