Drug interactions
Milnacipran + Warfarin
Severity: Moderate
Milnacipran and Warfarin: 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 may increase bleeding risk in patients taking warfarin, especially with other drugs affecting hemostasis. INR may not reflect the added risk.
What this interaction means in plain words
Milnacipran and Warfarin 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; Warfarin belongs to Cardiovascular.
Why it happens
Serotonin-norepinephrine reuptake inhibition depletes platelet serotonin and impairs platelet aggregation, adding to warfarin's effect.
What to do
Monitor for bleeding and check INR when starting or stopping milnacipran. Avoid additional NSAIDs or antiplatelets where possible.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Milnacipran and Warfarin, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Warfarin
- Defibrotide + Warfarin Contraindicated
- Ketorolac + Warfarin Contraindicated
- Abciximab + Warfarin Major
- Acetylsalicylic acid + Warfarin Major
- Adagrasib + Warfarin Major
- Amiodarone + Warfarin 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 Warfarin?
MediHelp rates the interaction as moderate. Milnacipran and Warfarin 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 may increase bleeding risk in patients taking warfarin, especially with other drugs affecting hemostasis. INR may not reflect the added risk.
How serious is the interaction between Milnacipran and Warfarin?
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 and check INR when starting or stopping milnacipran. Avoid additional NSAIDs or antiplatelets where possible.
What other medicines interact with Warfarin?
MediHelp also lists interactions of Warfarin with, for example, Defibrotide, Ketorolac, Abciximab. The full list is on the Warfarin page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
