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Milnacipran Disease Interactions

There are 9 disease interactions with milnacipran.

Major

Duloxetine (applies to milnacipran) liver disease

Major Potential Hazard, Moderate plausibility.

Postmarketing studies have reported that duloxetine and some other SNRIs like milnacipran may aggravate preexisting liver disease. The use of duloxetine delayed-release and milnacipran should be avoided in patients with chronic liver disease or cirrhosis.

References

  1. "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
  2. "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
Major

SNRI antidepressants (applies to milnacipran) depression

Major Potential Hazard, Moderate plausibility. Applicable conditions: Bipolar Disorder

Adult and pediatric patients with depression and other psychiatric disorders may experience worsening of their symptoms and may have the emergence of suicidal thoughts and behavior. Patients should be monitored appropriately and observed closely for worsening of their symptoms, suicidality or changes in their behavior, especially during the first few months of treatment, and at times of dose changes. Discontinuing the medication should be considered if symptoms are persistently worse, or abrupt in onset. It may be prudent to refrain from dispensing large quantities of medication to these patients.

References

  1. "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
  2. "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
  3. "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
  4. "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
  5. "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
View all 5 references
Major

SNRI antidepressants (applies to milnacipran) renal disease

Major Potential Hazard, Moderate plausibility. Applicable conditions: Renal Dysfunction

The clearance of SNRI antidepressants is decreased in subjects with renal impairment. SNRIs should be used with caution in this group of patients and a dose adjustment is recommended in those with moderate and severe renal impairment. The use of SNRIs is not recommended in patients with end-stage renal disease.

References

  1. "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
  2. "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
  3. "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
  4. "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
View all 4 references
Moderate

SNRI antidepressants (applies to milnacipran) glaucoma

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Glaucoma (Narrow Angle)

SNRI antidepressants cause pupillary dilation that may trigger an angle closure attack in patients with anatomically narrow angle without iridectomy.

References

  1. "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
  2. "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
  3. "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
  4. "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
  5. "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
View all 5 references
Moderate

SNRI antidepressants (applies to milnacipran) hypertension

Moderate Potential Hazard, Moderate plausibility.

Selective serotonin and norepinephrine reuptake inhibitor antidepressants (SNRIs) have been associated with sustained increases in blood pressure. Therapy with SNRI antidepressants should be administered cautiously in patients with preexisting hypertension. Blood pressure should be assessed prior to initiating treatment and monitored regularly. The dose should be reduced or discontinued if necessary.

References

  1. "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
  2. "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
  3. "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
  4. "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
  5. "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
View all 5 references
Moderate

SNRI antidepressants (applies to milnacipran) hyponatremia

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Dehydration

Treatment with SNRI antidepressants can cause hyponatremia. Caution should be used when treating patients with hyponatremia or at greater risk of hyponatremia such as the elderly, patients taking diuretics or who are volume depleted.

References

  1. "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
  2. "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
  3. "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
  4. "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
  5. "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
View all 5 references
Moderate

SNRI antidepressants (applies to milnacipran) mania

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Bipolar Disorder

Therapy with SNRI antidepressants can cause activation of mania and hypomania and should be used with caution in patients with personal or family history of mania, hypomania, bipolar disorder, and other mood disorders.

References

  1. "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
  2. "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
  3. "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
  4. "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
  5. "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
View all 5 references
Moderate

SNRI antidepressants (applies to milnacipran) seizures

Moderate Potential Hazard, Moderate plausibility.

SNRI antidepressants may trigger seizures and should be administered with caution in patients with a seizure disorder.

References

  1. "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
  2. "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
  3. "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
  4. "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
  5. "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
View all 5 references
Moderate

SNRI antidepressants (applies to milnacipran) urinary tract obstruction

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Urinary Tract Infection

SNRI antidepressants have a noradrenergic effect and can affect urethral resistance. Caution should be used in patients with a history of dysuria, prostatic hypertrophy, prostatitis, and other lower urinary tract obstructive disorders.

References

  1. "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories (2001):
  2. "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
  3. "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
  4. "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
  5. "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
View all 5 references

Milnacipran drug interactions

There are 366 drug interactions with milnacipran.

Milnacipran alcohol/food interactions

There are 2 alcohol/food interactions with milnacipran.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.