Drug interactions
Perhexiline + Venlafaxine
Severity: Moderate
Perhexiline and Venlafaxine: 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
Perhexiline is cleared by CYP2D6 and has a narrow therapeutic index with risks of hepatotoxicity and neurotoxicity at high concentrations. Venlafaxine is a weak CYP2D6 inhibitor and may modestly raise perhexiline levels, and venlafaxine is itself a CYP2D6 substrate.
What this interaction means in plain words
Perhexiline and Venlafaxine 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
Inhibition of CYP2D6-mediated perhexiline metabolism by venlafaxine.
What to do
Monitor plasma perhexiline concentrations after starting or changing venlafaxine and adjust the perhexiline dose accordingly. Watch for signs of toxicity such as nausea, ataxia and neuropathy.
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 Venlafaxine
- Isocarboxazid + Venlafaxine Contraindicated
- Methylene blue + Venlafaxine Contraindicated
- Phenelzine + Venlafaxine Contraindicated
- Procarbazine + Venlafaxine Contraindicated
- Rasagiline + Venlafaxine Contraindicated
- Safinamide + Venlafaxine Contraindicated
Frequently asked questions
Can I take Perhexiline with Venlafaxine?
MediHelp rates the interaction as moderate. Perhexiline and Venlafaxine 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. Perhexiline is cleared by CYP2D6 and has a narrow therapeutic index with risks of hepatotoxicity and neurotoxicity at high concentrations. Venlafaxine is a weak CYP2D6 inhibitor and may modestly raise perhexiline levels, and venlafaxine is itself a CYP2D6 substrate.
How serious is the interaction between Perhexiline and Venlafaxine?
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 plasma perhexiline concentrations after starting or changing venlafaxine and adjust the perhexiline dose accordingly. Watch for signs of toxicity such as nausea, ataxia and neuropathy.
What other medicines interact with Venlafaxine?
MediHelp also lists interactions of Venlafaxine with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Venlafaxine page.
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