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Drug Interactions between milnacipran and solriamfetol

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

milnacipran solriamfetol

Applies to: milnacipran and solriamfetol

MONITOR: Additive or synergistic effects on blood pressure and/or heart rate may occur when solriamfetol is combined with other drugs that increase blood pressure and/or heart rate. The use of solriamfetol alone has been associated with dose-dependent increases in blood pressure and heart rate. Combined use of solriamfetol with other drugs that increase blood pressure and/or heart rate has not been studied.

MANAGEMENT: Caution is advised if solriamfetol is used with other drugs that increase blood pressure and/or heart rate. Blood pressure should be monitored prior to initiating solriamfetol therapy and regularly during treatment. In addition, hypertension should be controlled prior to treatment, and any new-onset hypertension or exacerbations of pre-existing hypertension that occur during solriamfetol therapy should be treated. Discontinuation of solriamfetol should be considered in patients who experience an increase in blood pressure or heart rate that cannot be managed with dose reduction of solriamfetol or other appropriate medical intervention.

References (1)
  1. (2019) "Product Information. Sunosi (solriamfetol)." Jazz Pharmaceuticals

Drug and food interactions

Moderate

milnacipran food

Applies to: milnacipran

GENERALLY AVOID: Use of milnacipran in conjunction with chronic alcohol consumption may potentiate the risk of liver injury. Milnacipran alone can increase serum transaminase levels. In placebo-controlled fibromyalgia trials, increases in ALT were more frequently observed in patients treated with milnacipran 100 mg/day (6%) and 200 mg/day (7%) compared to patients treated with placebo (3%). One patient receiving milnacipran 100 mg/day (0.2%) had an increase in ALT greater than 5 times the upper limit of normal (ULN) but did not exceed 10 times the ULN. Increases in AST were also more frequently observed in patients treated with milnacipran 100 mg/day (3%) and 200 mg/day (5%) than in patients treated with placebo (2%). There have been reported cases of increased liver enzymes and severe liver injury, including fulminant hepatitis, from foreign postmarketing experience with milnacipran. Significant underlying clinical conditions and/or use of multiple concomitant medications were present in the cases of severe liver injury.

MANAGEMENT: Due to the risk of liver injury, patients prescribed milnacipran should be counseled to avoid excessive use of alcohol. Milnacipran should generally not be prescribed to patients with substantial alcohol use.

References (1)
  1. (2009) "Product Information. Savella (milnacipran)." Forest Pharmaceuticals

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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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.

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