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Milnacipran Disease Interactions

There are 9 disease interactions with milnacipran:

Major

Duloxetine (Includes Milnacipran) ↔ Liver Disease

Severe Potential Hazard, Moderate plausibility

Applies to: Liver Disease

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.

Major

Snri Antidepressants (Includes Milnacipran) ↔ Depression

Severe Potential Hazard, Moderate plausibility

Applies to: Bipolar Disorder, Depression, Depressive Psychosis

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.

Major

Snri Antidepressants (Includes Milnacipran) ↔ Renal Disease

Severe Potential Hazard, Moderate plausibility

Applies to: 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.

Moderate

Snri Antidepressants (Includes Milnacipran) ↔ Glaucoma

Moderate Potential Hazard, Moderate plausibility

Applies to: Glaucoma (Narrow Angle)

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

Moderate

Snri Antidepressants (Includes Milnacipran) ↔ Hypertension

Moderate Potential Hazard, Moderate plausibility

Applies to: Hypertension

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, Philadelphia, PA.
  2. Settle EC "Antidepressant drugs: disturbing and potentially dangerous adverse effects." J Clin Psychiatry 59 Suppl 16 (1998): 25-30
  3. Cunningham LA, Borison RL, Carman JS, Chouinard G, Crowder JE, Diamond BI, Fischer DE, Hearst E "A comparison of venlafaxine, trazodone, and placebo in major depression." J Clin Psychopharmacol 14 (1994): 99-106
Moderate

Snri Antidepressants (Includes Milnacipran) ↔ Hyponatremia

Moderate Potential Hazard, Moderate plausibility

Applies to: Hyponatremia, 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.

Moderate

Snri Antidepressants (Includes Milnacipran) ↔ Mania

Moderate Potential Hazard, Moderate plausibility

Applies to: Bipolar Disorder, Mania

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.

Moderate

Snri Antidepressants (Includes Milnacipran) ↔ Seizures

Moderate Potential Hazard, Moderate plausibility

Applies to: Seizures

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

References

  1. Schlienger RG, Klink MH, Eggenberger C, Drewe J "Seizures associated with therapeutic doses of venlafaxine and trimipramine." Ann Pharmacother 34 (2000): 1402-5
  2. Schweizer E, Weise C, Clary C, Fox I, Rickels K "Placebo-controlled trial of venlafaxine for the treatment of major depression." J Clin Psychopharmacol 11 (1991): 233-6
  3. "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
View all 4 references
Moderate

Snri Antidepressants (Includes Milnacipran) ↔ Urinary Tract Obstruction

Moderate Potential Hazard, Moderate plausibility

Applies to: Urinary Tract Infection, Urinary Tract Obstruction, Benign Prostatic Hyperplasia

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.

milnacipran drug Interactions

There are 714 drug interactions with milnacipran

milnacipran alcohol/food Interactions

There are 2 alcohol/food interactions with milnacipran

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

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.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2016 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

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