Drug interactions
Milnacipran + Vortioxetine
Severity: Major
Milnacipran and Vortioxetine: 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 agents raise serotonin levels, so concurrent use increases the risk of serotonin syndrome. Milnacipran may also raise blood pressure and heart rate.
What this interaction means in plain words
Milnacipran and Vortioxetine 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; Vortioxetine belongs to Central Nervous System.
Why it happens
Additive serotonergic activity from combined serotonin reuptake inhibition and vortioxetine's receptor effects.
What to do
Avoid combining the two; use a single agent. If coadministration is unavoidable, monitor for serotonin toxicity and blood pressure.
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 Vortioxetine
- Isocarboxazid + Vortioxetine Contraindicated
- Linezolid + Vortioxetine Contraindicated
- Methylene blue + Vortioxetine Contraindicated
- Phenelzine + Vortioxetine Contraindicated
- Rasagiline + Vortioxetine Contraindicated
- Selegiline transdermal + Vortioxetine Contraindicated
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 Vortioxetine?
MediHelp rates the interaction as major. Milnacipran and Vortioxetine 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 agents raise serotonin levels, so concurrent use increases the risk of serotonin syndrome. Milnacipran may also raise blood pressure and heart rate.
How serious is the interaction between Milnacipran and Vortioxetine?
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 combining the two; use a single agent. If coadministration is unavoidable, monitor for serotonin toxicity and blood pressure.
What other medicines interact with Vortioxetine?
MediHelp also lists interactions of Vortioxetine with, for example, Isocarboxazid, Linezolid, Methylene blue. The full list is on the Vortioxetine page.
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