Savella

Overview

milnacipran

SNRI

• antiplatelet effects
• CNS depression
• hypertensive effects
• hyponatremia
• lowers seizure threshold
• serotonergic effects
• tachycardia

• add MAO inhibitor to Interaction Check if recent (14 days) use

Contraindicated

• isocarboxazid
Savella (milnacipran)

+

isocarboxazid

1 interaction

Contraindicated

milnacipran + isocarboxazid

contraindicated; may initiate milnacipran 14 days after isocarboxazid D/C; may initiate isocarboxazid 5 days after milnacipran D/C: combo may incr. risk of serotonin syndrome, CNS depression, psychomotor impairment, HTN (additive effects)

• linezolid
Savella (milnacipran)

+

linezolid

1 interaction

Contraindicated

milnacipran + linezolid

contraindicated; hold milnacipran if urgent use; monitor sodium, serotonin syndrome sx x5 days after milnacipran D/C or 24h after last linezolid dose; may resume milnacipran 24h after last linezolid dose: combo may incr. risk of serotonin syndrome, hyponatremia, HTN (additive effects, linezolid reversibly inhibits monoamine oxidase)

• methylene blue injection
Savella (milnacipran)

+

methylene blue injection

1 interaction

Contraindicated

milnacipran + methylene blue injection

contraindicated; hold milnacipran if emergency use; monitor serotonin syndrome sx x5 days or up to 24h after last methylene blue dose; may resume milnacipran 24h after last methylene blue dose: combo may incr. risk of serotonin syndrome (additive effects, methylene blue reversibly inhibits monoamine oxidase)

• phenelzine
Savella (milnacipran)

+

phenelzine

1 interaction

Contraindicated

milnacipran + phenelzine

contraindicated; may initiate milnacipran 14 days after phenelzine D/C; may initiate phenelzine 5 days after milnacipran D/C: combo may incr. risk of serotonin syndrome, CNS depression, psychomotor impairment, HTN (additive effects)

• safinamide
Savella (milnacipran)

+

safinamide

1 interaction

Contraindicated

milnacipran + safinamide

contraindicated w/in 14 days of safinamide use: combo may incr. risk of serotonin syndrome, CNS depression, psychomotor impairment, HTN (additive effects)

• selegiline transdermal
Savella (milnacipran)

+

selegiline transdermal

1 interaction

Contraindicated

milnacipran + selegiline transdermal

contraindicated; may initiate milnacipran 14 days after selegiline D/C; may initiate selegiline 5 days after milnacipran D/C: combo may incr. risk of serotonin syndrome, CNS depression, psychomotor impairment, HTN (additive effects)

• tranylcypromine
Savella (milnacipran)

+

tranylcypromine

1 interaction

Contraindicated

milnacipran + tranylcypromine

contraindicated; may initiate milnacipran 14 days after tranylcypromine D/C; may initiate tranylcypromine 5 days after milnacipran D/C: combo may incr. risk of serotonin syndrome, CNS depression, psychomotor impairment, HTN (additive effects)

Avoid/Use Alternative

• 5-HTP
Savella (milnacipran)

+

5-HTP

1 interaction

Avoid/Use Alternative

milnacipran + 5-HTP

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome, CNS depression, psychomotor impairment (additive effects)

• albuterol
Savella (milnacipran)

+

albuterol

1 interaction

Avoid/Use Alternative

milnacipran + albuterol

use alternative or monitor BP, HR w/ oral albuterol; risk may be lower w/ inhaled albuterol: combo may incr. risk of HTN, tachycardia (additive effects)

• aldesleukin
Savella (milnacipran)

+

aldesleukin

1 interaction

Avoid/Use Alternative

milnacipran + aldesleukin

avoid combo: combo may incr. risk of CNS depression, psychomotor impairment, seizures (additive effects)

• alfentanil
Savella (milnacipran)

+

alfentanil

1 interaction

Avoid/Use Alternative

milnacipran + alfentanil

use alternative or monitor BP, respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome, hypotension (additive effects)

• almotriptan
Savella (milnacipran)

+

almotriptan

1 interaction

Avoid/Use Alternative

milnacipran + almotriptan

use alternative or monitor BP, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome, HTN, CNS depression, psychomotor impairment (additive effects)

• amifampridine
Savella (milnacipran)

+

amifampridine

1 interaction

Avoid/Use Alternative

milnacipran + amifampridine

consider alternative: combo may incr. risk of seizures (additive effects)

• amitriptyline
Savella (milnacipran)

+

amitriptyline

1 interaction

Avoid/Use Alternative

milnacipran + amitriptyline

use alternative or monitor BP, HR, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome, CNS depression, psychomotor impairment, HTN, tachycardia (additive effects)

• amoxapine
Savella (milnacipran)

+

amoxapine

1 interaction

Avoid/Use Alternative

milnacipran + amoxapine

use alternative or monitor BP, HR, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome, CNS depression, psychomotor impairment, HTN, tachycardia (additive effects)

• amphetamine
Savella (milnacipran)

+

amphetamine

1 interaction

Avoid/Use Alternative

milnacipran + amphetamine

use alternative or monitor BP, HR, serotonin syndrome sx, especially during initiation/titration; decr. amphetamine start dose: combo may incr. risk of HTN, tachycardia, serotonin syndrome (additive effects)

• black cohosh
Savella (milnacipran)

+

black cohosh

1 interaction

Avoid/Use Alternative

milnacipran + black cohosh

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

• bromocriptine
Savella (milnacipran)

+

bromocriptine

1 interaction

Avoid/Use Alternative

milnacipran + bromocriptine

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome, CNS depression, psychomotor impairment (additive effects)

• buprenorphine
Savella (milnacipran)

+

buprenorphine

1 interaction

Avoid/Use Alternative

milnacipran + buprenorphine

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• buspirone
Savella (milnacipran)

+

buspirone

1 interaction

Avoid/Use Alternative

milnacipran + buspirone

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome, CNS depression, psychomotor impairment (additive effects)

• butalbital
Savella (milnacipran)

+

butalbital

1 interaction

Avoid/Use Alternative

milnacipran + butalbital

avoid combo: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• butorphanol
Savella (milnacipran)

+

butorphanol

1 interaction

Avoid/Use Alternative

milnacipran + butorphanol

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of serotonin syndrome, profound CNS and respiratory depression, psychomotor impairment (additive effects)

• carbamazepine
Savella (milnacipran)

+

carbamazepine

1 interaction

Avoid/Use Alternative

milnacipran + carbamazepine

use alternative or monitor sodium, serotonin syndrome sx, especially during initiation/titration; consider decr. dose of one or both drugs: combo may incr. risk of hyponatremia, seizures, CNS depression, psychomotor impairment, serotonin syndrome (additive effects; antagonistic effects, milnacipran may decr. seizure threshold)

• citalopram
Savella (milnacipran)

+

citalopram

1 interaction

Avoid/Use Alternative

milnacipran + citalopram

avoid combo: combo may incr. risk of hyponatremia, serotonin syndrome, CNS depression, psychomotor impairment, bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• clomipramine
Savella (milnacipran)

+

clomipramine

1 interaction

Avoid/Use Alternative

milnacipran + clomipramine

use alternative or monitor BP, HR, sodium, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome, CNS depression, psychomotor impairment, HTN, tachycardia, hyponatremia, seizures (additive effects)

• clonidine
Savella (milnacipran)

+

clonidine

1 interaction

Avoid/Use Alternative

milnacipran + clonidine

if ADHD use, avoid combo; otherwise, monitor BP: combo may incr. risk of CNS depression, psychomotor impairment; may decr. antihypertensive agent efficacy (additive effects; antagonistic effects)

• cocaine
Savella (milnacipran)

+

cocaine

1 interaction

Avoid/Use Alternative

milnacipran + cocaine

use alternative or monitor BP, HR, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of HTN, tachycardia, serotonin syndrome (additive effects)

• codeine
Savella (milnacipran)

+

codeine

1 interaction

Avoid/Use Alternative

milnacipran + codeine

avoid combo if antitussive use; otherwise use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• cyclobenzaprine
Savella (milnacipran)

+

cyclobenzaprine

1 interaction

Avoid/Use Alternative

milnacipran + cyclobenzaprine

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome, CNS depression, psychomotor impairment (additive effects)

• desipramine
Savella (milnacipran)

+

desipramine

1 interaction

Avoid/Use Alternative

milnacipran + desipramine

use alternative or monitor BP, HR, sodium, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome, CNS depression, psychomotor impairment, HTN, tachycardia, hyponatremia (additive effects)

• desvenlafaxine
Savella (milnacipran)

+

desvenlafaxine

1 interaction

Avoid/Use Alternative

milnacipran + desvenlafaxine

avoid combo: combo may incr. risk of CNS depression, psychomotor impairment, HTN, hyponatremia, serotonin syndrome, bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake, duplicate therapy)

• dexmethylphenidate
Savella (milnacipran)

+

dexmethylphenidate

1 interaction

Avoid/Use Alternative

milnacipran + dexmethylphenidate

use alternative or monitor BP, HR, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome, HTN, tachycardia (additive effects)

• dextroamphetamine
Savella (milnacipran)

+

dextroamphetamine

1 interaction

Avoid/Use Alternative

milnacipran + dextroamphetamine

use alternative or monitor BP, HR, serotonin syndrome sx, especially during initiation/titration; decr. dextroamphetamine start dose: combo may incr. risk of HTN, tachycardia, serotonin syndrome (additive effects)

• dextromethorphan
Savella (milnacipran)

+

dextromethorphan

1 interaction

Avoid/Use Alternative

milnacipran + dextromethorphan

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

• digoxin
Savella (milnacipran)

+

digoxin

1 interaction

Avoid/Use Alternative

milnacipran + digoxin

avoid use w/ IV digoxin: combo may incr. risk of adverse hemodynamic effects, including orthostatic hypotension, tachycardia (additive effects)

• dihydrocodeine
Savella (milnacipran)

+

dihydrocodeine

1 interaction

Avoid/Use Alternative

milnacipran + dihydrocodeine

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• dihydroergotamine
Savella (milnacipran)

+

dihydroergotamine

1 interaction

Avoid/Use Alternative

milnacipran + dihydroergotamine

use alternative or monitor BP, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of severe HTN, vasospasm, ischemia, serotonin syndrome (additive effects)

• doxepin
Savella (milnacipran)

+

doxepin

1 interaction

Avoid/Use Alternative

milnacipran + doxepin

use alternative or monitor BP, HR, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome, CNS depression, psychomotor impairment, HTN, tachycardia (additive effects)

• doxepin topical
Savella (milnacipran)

+

doxepin topical

1 interaction

Avoid/Use Alternative

milnacipran + doxepin topical

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of CNS depression, psychomotor impairment, serotonin syndrome (additive effects)

• doxylamine
Savella (milnacipran)

+

doxylamine

1 interaction

Avoid/Use Alternative

milnacipran + doxylamine

avoid combo if doxylamine use for pregnancy-related nausea/vomiting, otherwise caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• dronabinol
Savella (milnacipran)

+

dronabinol

1 interaction

Avoid/Use Alternative

milnacipran + dronabinol

avoid combo: combo may incr. risk of HTN, tachycardia, CNS depression, psychomotor impairment (additive effects)

• duloxetine
Savella (milnacipran)

+

duloxetine

1 interaction

Avoid/Use Alternative

milnacipran + duloxetine

avoid combo: combo may incr. risk of hyponatremia, serotonin syndrome, CNS depression, psychomotor impairment, bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake; duplicate therapy)

• edoxaban
Savella (milnacipran)

+

edoxaban

1 interaction

Avoid/Use Alternative

milnacipran + edoxaban

use alternative or monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• eletriptan
Savella (milnacipran)

+

eletriptan

1 interaction

Avoid/Use Alternative

milnacipran + eletriptan

use alternative or monitor BP, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome, HTN, CNS depression, psychomotor impairment (additive effects)

• enoxaparin
Savella (milnacipran)

+

enoxaparin

1 interaction

Avoid/Use Alternative

milnacipran + enoxaparin

use alternative or monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• ephedra
Savella (milnacipran)

+

ephedra

1 interaction

Avoid/Use Alternative

milnacipran + ephedra

avoid combo: combo may incr. risk of HTN, tachycardia (additive effects)

• epinephrine inhaled
Savella (milnacipran)

+

epinephrine inhaled

1 interaction

Avoid/Use Alternative

milnacipran + epinephrine inhaled

avoid combo: combo may incr. risk of tachycardia, HTN, including hypertensive crisis (additive effects)

• ergotamine
Savella (milnacipran)

+

ergotamine

1 interaction

Avoid/Use Alternative

milnacipran + ergotamine

use alternative or monitor BP, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of severe HTN, vasospasm, ischemia, serotonin syndrome (additive effects)

• escitalopram
Savella (milnacipran)

+

escitalopram

1 interaction

Avoid/Use Alternative

milnacipran + escitalopram

avoid combo: combo may incr. risk of hyponatremia, serotonin syndrome, bleeding (including life-threatening), CNS depression, psychomotor impairment (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• ethanol (alcoholic beverage)
Savella (milnacipran)

+

ethanol (alcoholic beverage)

1 interaction

Avoid/Use Alternative

milnacipran + ethanol (alcoholic beverage)

avoid combo: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, GI or other bleeding (including life-threatening), HTN (chronic alcohol use) (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• ethanol injection
Savella (milnacipran)

+

ethanol injection

1 interaction

Avoid/Use Alternative

milnacipran + ethanol injection

use alternative or monitor respiratory rate: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• fenfluramine
Savella (milnacipran)

+

fenfluramine

1 interaction

Avoid/Use Alternative

milnacipran + fenfluramine

use alternative or monitor BP, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of HTN (including hypertensive crisis), serotonin syndrome, CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, milnacipran may decr. seizure threshold)

• fentanyl
Savella (milnacipran)

+

fentanyl

1 interaction

Avoid/Use Alternative

milnacipran + fentanyl

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• fluoxetine
Savella (milnacipran)

+

fluoxetine

1 interaction

Avoid/Use Alternative

milnacipran + fluoxetine

avoid combo: combo may incr. risk of serotonin syndrome, bleeding (including life-threatening), hyponatremia, CNS depression, psychomotor impairment (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• fluvoxamine
Savella (milnacipran)

+

fluvoxamine

1 interaction

Avoid/Use Alternative

milnacipran + fluvoxamine

avoid combo: combo may incr. risk of serotonin syndrome, CNS depression, psychomotor impairment, hyponatremia, bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• fondaparinux
Savella (milnacipran)

+

fondaparinux

1 interaction

Avoid/Use Alternative

milnacipran + fondaparinux

use alternative or monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• frovatriptan
Savella (milnacipran)

+

frovatriptan

1 interaction

Avoid/Use Alternative

milnacipran + frovatriptan

use alternative or monitor BP, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome, CNS depression, psychomotor impairment, HTN (additive effects)

• furosemide
Savella (milnacipran)

+

furosemide

1 interaction

Avoid/Use Alternative

milnacipran + furosemide

use alternative or monitor BP, sodium: combo may incr. risk of hyponatremia; may decr. antihypertensive agent efficacy (additive effects; antagonistic effects)

• gepirone
Savella (milnacipran)

+

gepirone

1 interaction

Avoid/Use Alternative

milnacipran + gepirone

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

• granisetron
Savella (milnacipran)

+

granisetron

1 interaction

Avoid/Use Alternative

milnacipran + granisetron

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

• haloperidol
Savella (milnacipran)

+

haloperidol

1 interaction

Avoid/Use Alternative

milnacipran + haloperidol

avoid combo: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• hydrocodone
Savella (milnacipran)

+

hydrocodone

1 interaction

Avoid/Use Alternative

milnacipran + hydrocodone

avoid combo if antitussive use; otherwise use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• hydromorphone
Savella (milnacipran)

+

hydromorphone

1 interaction

Avoid/Use Alternative

milnacipran + hydromorphone

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• imipramine
Savella (milnacipran)

+

imipramine

1 interaction

Avoid/Use Alternative

milnacipran + imipramine

use alternative or monitor BP, HR, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome, CNS depression, psychomotor impairment, HTN, tachycardia (additive effects)

• iohexol
Savella (milnacipran)

+

iohexol

1 interaction

Avoid/Use Alternative

milnacipran + iohexol

avoid combo if intrathecal iohexol use: combo may incr. risk of seizures (additive effects)

• isoniazid
Savella (milnacipran)

+

isoniazid

1 interaction

Avoid/Use Alternative

milnacipran + isoniazid

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects, isoniazid inhibits monoamine oxidase)

• kava
Savella (milnacipran)

+

kava

1 interaction

Avoid/Use Alternative

milnacipran + kava

avoid combo: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• kratom
Savella (milnacipran)

+

kratom

1 interaction

Avoid/Use Alternative

milnacipran + kratom

use alternative or monitor respiratory rate: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• landiolol
Savella (milnacipran)

+

landiolol

1 interaction

Avoid/Use Alternative

milnacipran + landiolol

use alternative or monitor HR, BP: combo may decr. landiolol efficacy (antagonistic effects)

• levomilnacipran
Savella (milnacipran)

+

levomilnacipran

1 interaction

Avoid/Use Alternative

milnacipran + levomilnacipran

avoid combo: combo may incr. risk of serotonin syndrome, HTN, tachycardia, hyponatremia, CNS depression, psychomotor impairment, bleeding, including life-threatening (additive effects, duplicate therapy)

• levorphanol
Savella (milnacipran)

+

levorphanol

1 interaction

Avoid/Use Alternative

milnacipran + levorphanol

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of serotonin syndrome, profound CNS and respiratory depression, psychomotor impairment (additive effects)

• lisdexamfetamine
Savella (milnacipran)

+

lisdexamfetamine

1 interaction

Avoid/Use Alternative

milnacipran + lisdexamfetamine

use alternative or decr. lisdexamfetamine start dose; monitor BP, HR, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome, HTN, tachycardia (additive effects)

• lithium
Savella (milnacipran)

+

lithium

1 interaction

Avoid/Use Alternative

milnacipran + lithium

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

• lumateperone
Savella (milnacipran)

+

lumateperone

1 interaction

Avoid/Use Alternative

milnacipran + lumateperone

use alternative or monitor sodium, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of CNS depression, psychomotor impairment, serotonin syndrome, hyponatremia (additive effects)

• meperidine
Savella (milnacipran)

+

meperidine

1 interaction

Avoid/Use Alternative

milnacipran + meperidine

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• metaxalone
Savella (milnacipran)

+

metaxalone

1 interaction

Avoid/Use Alternative

milnacipran + metaxalone

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• methadone
Savella (milnacipran)

+

methadone

1 interaction

Avoid/Use Alternative

milnacipran + methadone

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• methamphetamine
Savella (milnacipran)

+

methamphetamine

1 interaction

Avoid/Use Alternative

milnacipran + methamphetamine

use alternative or decr. methamphetamine start dose; monitor BP, HR, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome, HTN, tachycardia (additive effects)

• methylene blue oral
Savella (milnacipran)

+

methylene blue oral

1 interaction

Avoid/Use Alternative

milnacipran + methylene blue oral

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects, methylene blue reversibly inhibits monoamine oxidase)

• methylergonovine
Savella (milnacipran)

+

methylergonovine

1 interaction

Avoid/Use Alternative

milnacipran + methylergonovine

use alternative or monitor BP, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of severe HTN, vasospasm, ischemia, serotonin syndrome (additive effects)

• methylphenidate
Savella (milnacipran)

+

methylphenidate

1 interaction

Avoid/Use Alternative

milnacipran + methylphenidate

use alternative or monitor BP, HR, serotonin syndrome symptoms, especially during initiation/titration: combo may incr. risk of serotonin syndrome, HTN, tachycardia (additive effects)

• metoclopramide
Savella (milnacipran)

+

metoclopramide

1 interaction

Avoid/Use Alternative

milnacipran + metoclopramide

use alternative or monitor BP, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of CNS depression, psychomotor impairment, serotonin syndrome, HTN, dystonia (additive effects)

• midazolam
Savella (milnacipran)

+

midazolam

1 interaction

Avoid/Use Alternative

milnacipran + midazolam

use alternative or monitor respiratory rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, milnacipran may decr. seizure threshold)

• midodrine
Savella (milnacipran)

+

midodrine

1 interaction

Avoid/Use Alternative

milnacipran + midodrine

use alternative or monitor BP: combo may incr. risk of HTN (additive effects)

• mirtazapine
Savella (milnacipran)

+

mirtazapine

1 interaction

Avoid/Use Alternative

milnacipran + mirtazapine

use alternative or monitor sodium, serotonin syndrome sx, especially during initiation/titration; consider decr. dose of one or both drugs: combo may incr. risk of serotonin syndrome, CNS depression, psychomotor impairment, hyponatremia (additive effects)

• morphine
Savella (milnacipran)

+

morphine

1 interaction

Avoid/Use Alternative

milnacipran + morphine

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of serotonin syndrome, profound CNS and respiratory depression, psychomotor impairment (additive effects)

• nalbuphine
Savella (milnacipran)

+

nalbuphine

1 interaction

Avoid/Use Alternative

milnacipran + nalbuphine

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of serotonin syndrome, profound CNS and respiratory depression, psychomotor impairment (additive effects)

• naratriptan
Savella (milnacipran)

+

naratriptan

1 interaction

Avoid/Use Alternative

milnacipran + naratriptan

use alternative or monitor BP, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome, HTN, CNS depression, psychomotor impairment (additive effects)

• nefazodone
Savella (milnacipran)

+

nefazodone

1 interaction

Avoid/Use Alternative

milnacipran + nefazodone

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome, CNS depression, psychomotor impairment (additive effects)

• nortriptyline
Savella (milnacipran)

+

nortriptyline

1 interaction

Avoid/Use Alternative

milnacipran + nortriptyline

use alternative or monitor BP, HR, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome, CNS depression, psychomotor impairment, HTN, tachycardia (additive effects)

• oliceridine
Savella (milnacipran)

+

oliceridine

1 interaction

Avoid/Use Alternative

milnacipran + oliceridine

use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, hypotension, serotonin syndrome (additive effects)

• ondansetron
Savella (milnacipran)

+

ondansetron

1 interaction

Avoid/Use Alternative

milnacipran + ondansetron

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

• opium
Savella (milnacipran)

+

opium

1 interaction

Avoid/Use Alternative

milnacipran + opium

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of serotonin syndrome, profound CNS and respiratory depression, psychomotor impairment (additive effects)

• oxybate
Savella (milnacipran)

+

oxybate

1 interaction

Avoid/Use Alternative

milnacipran + oxybate

use alternative or monitor respiratory rate; decr. dose of one or both drugs: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, hypotension, syncope (additive effects)

• oxycodone
Savella (milnacipran)

+

oxycodone

1 interaction

Avoid/Use Alternative

milnacipran + oxycodone

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. oxycodone start dose by at least 50%, consider decr. milnacipran dose, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• oxymorphone
Savella (milnacipran)

+

oxymorphone

1 interaction

Avoid/Use Alternative

milnacipran + oxymorphone

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. oxymorphone start dose by at least 50%, consider decr. milnacipran dose, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of serotonin syndrome, profound CNS and respiratory depression, psychomotor impairment (additive effects)

• palonosetron
Savella (milnacipran)

+

palonosetron

1 interaction

Avoid/Use Alternative

milnacipran + palonosetron

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

• paroxetine
Savella (milnacipran)

+

paroxetine

1 interaction

Avoid/Use Alternative

milnacipran + paroxetine

avoid combo: combo may incr. risk of bleeding (including life-threatening), hyponatremia, CNS depression, psychomotor impairment, serotonin syndrome (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• pentazocine
Savella (milnacipran)

+

pentazocine

1 interaction

Avoid/Use Alternative

milnacipran + pentazocine

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of serotonin syndrome, profound CNS and respiratory depression, psychomotor impairment (additive effects)

• procarbazine
Savella (milnacipran)

+

procarbazine

1 interaction

Avoid/Use Alternative

milnacipran + procarbazine

use alternative or monitor BP, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of HTN, serotonin syndrome, CNS depression, psychomotor impairment (additive effects, procarbazine inhibits monoamine oxidase)

• promethazine
Savella (milnacipran)

+

promethazine

1 interaction

Avoid/Use Alternative

milnacipran + promethazine

use alternative or monitor respiratory rate; decr. dose of one or both drugs: combo may incr. risk of CNS and respiratory depression, psychomotor impairment, seizures (additive effects)

• protriptyline
Savella (milnacipran)

+

protriptyline

1 interaction

Avoid/Use Alternative

milnacipran + protriptyline

use alternative or monitor BP, HR, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome, CNS depression, psychomotor impairment, HTN, tachycardia (additive effects)

• rasagiline
Savella (milnacipran)

+

rasagiline

1 interaction

Avoid/Use Alternative

milnacipran + rasagiline

avoid combo w/in 14 days of rasagiline use: combo may incr. risk of serotonin syndrome, CNS depression, psychomotor impairment, HTN (additive effects)

• remifentanil
Savella (milnacipran)

+

remifentanil

1 interaction

Avoid/Use Alternative

milnacipran + remifentanil

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of serotonin syndrome, profound CNS and respiratory depression, psychomotor impairment (additive effects)

• rizatriptan
Savella (milnacipran)

+

rizatriptan

1 interaction

Avoid/Use Alternative

milnacipran + rizatriptan

use alternative or monitor BP, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome, HTN, CNS depression, psychomotor impairment (additive effects)

• ropeginterferon alfa-2b
Savella (milnacipran)

+

ropeginterferon alfa-2b

1 interaction

Avoid/Use Alternative

milnacipran + ropeginterferon alfa-2b

use alternative: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• SAMe
Savella (milnacipran)

+

SAMe

1 interaction

Avoid/Use Alternative

milnacipran + SAMe

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

• scopolamine
Savella (milnacipran)

+

scopolamine

1 interaction

Avoid/Use Alternative

milnacipran + scopolamine

use alternative: combo may increase risk of CNS depression, psychomotor impairment (additive effects)

• selegiline
Savella (milnacipran)

+

selegiline

1 interaction

Avoid/Use Alternative

milnacipran + selegiline

avoid combo w/in 14 days of selegiline use: combo may incr. risk of serotonin syndrome, CNS depression, psychomotor impairment, HTN (additive effects)

• sertraline
Savella (milnacipran)

+

sertraline

1 interaction

Avoid/Use Alternative

milnacipran + sertraline

avoid combo: combo may incr. risk of bleeding (including life-threatening), hyponatremia, serotonin syndrome, CNS depression, psychomotor impairment (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• St. John's wort
Savella (milnacipran)

+

St. John's wort

1 interaction

Avoid/Use Alternative

milnacipran + St. John's wort

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

• sufentanil
Savella (milnacipran)

+

sufentanil

1 interaction

Avoid/Use Alternative

milnacipran + sufentanil

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. sufentanil start dose, consider decr. milnacipran dose, use lowest effective doses: combo may incr. risk of serotonin syndrome, profound CNS and respiratory depression, psychomotor impairment (additive effects)

• sumatriptan
Savella (milnacipran)

+

sumatriptan

1 interaction

Avoid/Use Alternative

milnacipran + sumatriptan

use alternative or monitor BP, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome, CNS depression, psychomotor impairment, HTN (additive effects)

• tapentadol
Savella (milnacipran)

+

tapentadol

1 interaction

Avoid/Use Alternative

milnacipran + tapentadol

use alternative or monitor respiratory rate, BP, serotonin syndrome symptoms, especially during initiation/titration; decrease dose of one or both drugs, use lowest effective doses and shortest duration of concomitant treatment: combo may increase risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), serotonin syndrome (additive effects)

• tedizolid
Savella (milnacipran)

+

tedizolid

1 interaction

Avoid/Use Alternative

milnacipran + tedizolid

use alternative or monitor serotonin syndrome symptoms, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects, tedizolid reversibly inhibits monoamine oxidase)

• thalidomide
Savella (milnacipran)

+

thalidomide

1 interaction

Avoid/Use Alternative

milnacipran + thalidomide

use alternative or consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• tradipitant
Savella (milnacipran)

+

tradipitant

1 interaction

Avoid/Use Alternative

milnacipran + tradipitant

use alternative: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• tramadol
Savella (milnacipran)

+

tramadol

1 interaction

Avoid/Use Alternative

milnacipran + tramadol

use alternative or monitor sodium, respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hyponatremia, serotonin syndrome, seizures (additive effects)

• trazodone
Savella (milnacipran)

+

trazodone

1 interaction

Avoid/Use Alternative

milnacipran + trazodone

use alternative or monitor sodium, bleeding s/sx, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome, hyponatremia, CNS depression, psychomotor impairment, bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• trimethobenzamide
Savella (milnacipran)

+

trimethobenzamide

1 interaction

Avoid/Use Alternative

milnacipran + trimethobenzamide

use alternative or consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• trimipramine
Savella (milnacipran)

+

trimipramine

1 interaction

Avoid/Use Alternative

milnacipran + trimipramine

use alternative or monitor BP, HR, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome, CNS depression, psychomotor impairment, HTN, tachycardia (additive effects)

• venlafaxine
Savella (milnacipran)

+

venlafaxine

1 interaction

Avoid/Use Alternative

milnacipran + venlafaxine

avoid combo: combo may incr. risk of bleeding (including life-threatening), hyponatremia, serotonin syndrome, CNS depression, psychomotor impairment, HTN, other adverse effects (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake; duplicate therapy)

• vilazodone
Savella (milnacipran)

+

vilazodone

1 interaction

Avoid/Use Alternative

milnacipran + vilazodone

use alternative or monitor sodium, bleeding s/sx, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of hyponatremia, serotonin syndrome, CNS depression, psychomotor impairment, bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• vortioxetine
Savella (milnacipran)

+

vortioxetine

1 interaction

Avoid/Use Alternative

milnacipran + vortioxetine

avoid combo: combo may incr. risk of serotonin syndrome, hyponatremia, bleeding (including life-threatening), other adverse effects (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake; duplicate therapy)

• yohimbe
Savella (milnacipran)

+

yohimbe

1 interaction

Avoid/Use Alternative

milnacipran + yohimbe

use alternative or monitor BP, HR, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome, HTN, tachycardia (additive effects, yohimbe inhibits monoamine oxidase)

• ziprasidone
Savella (milnacipran)

+

ziprasidone

1 interaction

Avoid/Use Alternative

milnacipran + ziprasidone

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome, CNS depression, psychomotor impairment (additive effects)

• zolmitriptan
Savella (milnacipran)

+

zolmitriptan

1 interaction

Avoid/Use Alternative

milnacipran + zolmitriptan

use alternative or monitor BP, serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome, HTN, CNS depression, psychomotor impairment (additive effects)

• zuranolone
Savella (milnacipran)

+

zuranolone

1 interaction

Avoid/Use Alternative

milnacipran + zuranolone

use alternative or consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

Monitor/Modify Tx

• abiraterone acetate
Savella (milnacipran)

+

abiraterone acetate

1 interaction

Monitor/Modify Tx

milnacipran + abiraterone acetate

monitor BP: combo may incr. risk of HTN (additive effects)

• abrocitinib
Savella (milnacipran)

+

abrocitinib

1 interaction

Monitor/Modify Tx

milnacipran + abrocitinib

monitor platelets, bleeding s/sx, especially during abrocitinib tx initiation or if abrocitinib 200 mg/day: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• acalabrutinib
Savella (milnacipran)

+

acalabrutinib

1 interaction

Monitor/Modify Tx

milnacipran + acalabrutinib

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• acebutolol
Savella (milnacipran)

+

acebutolol

1 interaction

Monitor/Modify Tx

milnacipran + acebutolol

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• acetazolamide
Savella (milnacipran)

+

acetazolamide

1 interaction

Monitor/Modify Tx

milnacipran + acetazolamide

monitor sodium: combo may incr. risk of hyponatremia; may alter seizure control (additive effects; antagonistic effects, milnacipran may decr. seizure threshold)

• ado-trastuzumab emtansine
Savella (milnacipran)

+

ado-trastuzumab emtansine

1 interaction

Monitor/Modify Tx

milnacipran + ado-trastuzumab emtansine

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• afatinib
Savella (milnacipran)

+

afatinib

1 interaction

Monitor/Modify Tx

milnacipran + afatinib

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• albuterol inhaled
Savella (milnacipran)

+

albuterol inhaled

1 interaction

Monitor/Modify Tx

milnacipran + albuterol inhaled

monitor BP, HR: combo may incr. risk of HTN, tachycardia, other cardiovascular adverse effects (additive effects)

• aliskiren
Savella (milnacipran)

+

aliskiren

1 interaction

Monitor/Modify Tx

milnacipran + aliskiren

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• alpha-tocopherol (vitamin E)
Savella (milnacipran)

+

alpha-tocopherol (vitamin E)

1 interaction

Monitor/Modify Tx

milnacipran + alpha-tocopherol (vitamin E)

monitor bleeding signs/symptoms, especially with alpha-tocopherol doses >800 units/day: combo may increase risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• alprazolam
Savella (milnacipran)

+

alprazolam

1 interaction

Monitor/Modify Tx

milnacipran + alprazolam

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• alprostadil intracavernous
Savella (milnacipran)

+

alprostadil intracavernous

1 interaction

Monitor/Modify Tx

milnacipran + alprostadil intracavernous

monitor injection site bleeding signs/symptoms: combo may increase risk of localized bleeding (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• alprostadil intravenous
Savella (milnacipran)

+

alprostadil intravenous

1 interaction

Monitor/Modify Tx

milnacipran + alprostadil intravenous

monitor bleeding signs/symptoms: combo may increase risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• alteplase
Savella (milnacipran)

+

alteplase

1 interaction

Monitor/Modify Tx

milnacipran + alteplase

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• amiloride
Savella (milnacipran)

+

amiloride

1 interaction

Monitor/Modify Tx

milnacipran + amiloride

monitor BP, sodium: combo may incr. risk of hyponatremia; may decr. antihypertensive agent efficacy (antagonistic effects, additive effects)

• amlodipine
Savella (milnacipran)

+

amlodipine

1 interaction

Monitor/Modify Tx

milnacipran + amlodipine

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• anacaulase topical
Savella (milnacipran)

+

anacaulase topical

1 interaction

Monitor/Modify Tx

milnacipran + anacaulase topical

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• anagrelide
Savella (milnacipran)

+

anagrelide

1 interaction

Monitor/Modify Tx

milnacipran + anagrelide

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• angiotensin II
Savella (milnacipran)

+

angiotensin II

1 interaction

Monitor/Modify Tx

milnacipran + angiotensin II

monitor BP: combo may incr. risk of HTN (additive effects)

• antithrombin
Savella (milnacipran)

+

antithrombin

1 interaction

Monitor/Modify Tx

milnacipran + antithrombin

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• apixaban
Savella (milnacipran)

+

apixaban

1 interaction

Monitor/Modify Tx

milnacipran + apixaban

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• aprocitentan
Savella (milnacipran)

+

aprocitentan

1 interaction

Monitor/Modify Tx

milnacipran + aprocitentan

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• arformoterol inhaled
Savella (milnacipran)

+

arformoterol inhaled

1 interaction

Monitor/Modify Tx

milnacipran + arformoterol inhaled

monitor BP, HR: combo may incr. risk of HTN, tachycardia, other cardiovascular adverse effects (additive effects)

• argatroban
Savella (milnacipran)

+

argatroban

1 interaction

Monitor/Modify Tx

milnacipran + argatroban

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• armodafinil
Savella (milnacipran)

+

armodafinil

1 interaction

Monitor/Modify Tx

milnacipran + armodafinil

monitor BP, HR: combo may incr. risk of HTN, tachycardia (additive effects)

• asciminib
Savella (milnacipran)

+

asciminib

1 interaction

Monitor/Modify Tx

milnacipran + asciminib

monitor BP: combo may incr. risk of HTN (additive effects)

• asparaginase
Savella (milnacipran)

+

asparaginase

1 interaction

Monitor/Modify Tx

milnacipran + asparaginase

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• aspirin
Savella (milnacipran)

+

aspirin

1 interaction

Monitor/Modify Tx

milnacipran + aspirin

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• atenolol
Savella (milnacipran)

+

atenolol

1 interaction

Monitor/Modify Tx

milnacipran + atenolol

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• atogepant
Savella (milnacipran)

+

atogepant

1 interaction

Monitor/Modify Tx

milnacipran + atogepant

monitor BP: combo may incr. risk of HTN (additive effects)

• atomoxetine
Savella (milnacipran)

+

atomoxetine

1 interaction

Monitor/Modify Tx

milnacipran + atomoxetine

monitor BP, HR: combo may incr. risk of HTN, tachycardia (additive effects)

• atropine
Savella (milnacipran)

+

atropine

1 interaction

Monitor/Modify Tx

milnacipran + atropine

monitor HR: combo may incr. risk of tachycardia (additive effects)

• atropine ophthalmic
Savella (milnacipran)

+

atropine ophthalmic

1 interaction

Monitor/Modify Tx

milnacipran + atropine ophthalmic

monitor BP: combo may incr. risk of HTN (additive effects)

• avapritinib
Savella (milnacipran)

+

avapritinib

1 interaction

Monitor/Modify Tx

milnacipran + avapritinib

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• axitinib
Savella (milnacipran)

+

axitinib

1 interaction

Monitor/Modify Tx

milnacipran + axitinib

monitor bleeding s/sx, BP: combo may incr. risk of GI or other bleeding (including life-threatening), HTN (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• azilsartan medoxomil
Savella (milnacipran)

+

azilsartan medoxomil

1 interaction

Monitor/Modify Tx

milnacipran + azilsartan medoxomil

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• baclofen intrathecal
Savella (milnacipran)

+

baclofen intrathecal

1 interaction

Monitor/Modify Tx

milnacipran + baclofen intrathecal

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• benazepril
Savella (milnacipran)

+

benazepril

1 interaction

Monitor/Modify Tx

milnacipran + benazepril

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• benzphetamine
Savella (milnacipran)

+

benzphetamine

1 interaction

Monitor/Modify Tx

milnacipran + benzphetamine

monitor BP, HR: combo may incr. risk of HTN, tachycardia (additive effects)

• benztropine
Savella (milnacipran)

+

benztropine

1 interaction

Monitor/Modify Tx

milnacipran + benztropine

monitor HR: combo may incr. risk of tachycardia (additive effects)

• betamethasone
Savella (milnacipran)

+

betamethasone

1 interaction

Monitor/Modify Tx

milnacipran + betamethasone

monitor BP: combo may incr. risk of HTN (additive effects)

• betaxolol
Savella (milnacipran)

+

betaxolol

1 interaction

Monitor/Modify Tx

milnacipran + betaxolol

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• bevacizumab
Savella (milnacipran)

+

bevacizumab

1 interaction

Monitor/Modify Tx

milnacipran + bevacizumab

monitor BP, bleeding s/sx: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• binimetinib
Savella (milnacipran)

+

binimetinib

1 interaction

Monitor/Modify Tx

milnacipran + binimetinib

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• bismuth subsalicylate
Savella (milnacipran)

+

bismuth subsalicylate

1 interaction

Monitor/Modify Tx

milnacipran + bismuth subsalicylate

monitor BP w/ high-dose bismuth subsalicylate: combo may incr. risk of HTN (additive effects)

• bisoprolol
Savella (milnacipran)

+

bisoprolol

1 interaction

Monitor/Modify Tx

milnacipran + bisoprolol

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• bivalirudin
Savella (milnacipran)

+

bivalirudin

1 interaction

Monitor/Modify Tx

milnacipran + bivalirudin

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• brentuximab vedotin
Savella (milnacipran)

+

brentuximab vedotin

1 interaction

Monitor/Modify Tx

milnacipran + brentuximab vedotin

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• brigatinib
Savella (milnacipran)

+

brigatinib

1 interaction

Monitor/Modify Tx

milnacipran + brigatinib

monitor BP: combo may incr. risk of HTN (additive effects)

• bromelain
Savella (milnacipran)

+

bromelain

1 interaction

Monitor/Modify Tx

milnacipran + bromelain

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• bromfenac ophthalmic
Savella (milnacipran)

+

bromfenac ophthalmic

1 interaction

Monitor/Modify Tx

milnacipran + bromfenac ophthalmic

monitor bleeding s/sx: combo may incr. risk of postop ocular bleeding (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• budesonide
Savella (milnacipran)

+

budesonide

1 interaction

Monitor/Modify Tx

milnacipran + budesonide

monitor BP: combo may incr. risk of HTN (additive effects)

• bumetanide
Savella (milnacipran)

+

bumetanide

1 interaction

Monitor/Modify Tx

milnacipran + bumetanide

monitor BP, sodium: combo may incr. risk of hyponatremia; may decr. antihypertensive agent efficacy (additive effects; antagonistic effects)

• bupropion
Savella (milnacipran)

+

bupropion

1 interaction

Monitor/Modify Tx

milnacipran + bupropion

monitor BP; consider lower bupropion doses: combo may incr. risk of HTN, seizures (additive effects)

• cabazitaxel
Savella (milnacipran)

+

cabazitaxel

1 interaction

Monitor/Modify Tx

milnacipran + cabazitaxel

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• cabozantinib
Savella (milnacipran)

+

cabozantinib

1 interaction

Monitor/Modify Tx

milnacipran + cabozantinib

monitor BP, bleeding s/sx: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• caffeine
Savella (milnacipran)

+

caffeine

1 interaction

Monitor/Modify Tx

milnacipran + caffeine

monitor BP, HR; avoid excessive caffeine intake: combo may incr. risk of HTN, tachycardia (additive effects)

• caffeine citrate
Savella (milnacipran)

+

caffeine citrate

1 interaction

Monitor/Modify Tx

milnacipran + caffeine citrate

monitor BP, HR: combo may incr. risk of HTN, tachycardia (additive effects)

• calaspargase
Savella (milnacipran)

+

calaspargase

1 interaction

Monitor/Modify Tx

milnacipran + calaspargase

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• candesartan cilexetil
Savella (milnacipran)

+

candesartan cilexetil

1 interaction

Monitor/Modify Tx

milnacipran + candesartan cilexetil

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• cangrelor
Savella (milnacipran)

+

cangrelor

1 interaction

Monitor/Modify Tx

milnacipran + cangrelor

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• cannabis
Savella (milnacipran)

+

cannabis

1 interaction

Monitor/Modify Tx

milnacipran + cannabis

monitor BP, HR: combo may incr. risk of CNS depression, psychomotor impairment, HTN, tachycardia (additive effects)

• caplacizumab
Savella (milnacipran)

+

caplacizumab

1 interaction

Monitor/Modify Tx

milnacipran + caplacizumab

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• captopril
Savella (milnacipran)

+

captopril

1 interaction

Monitor/Modify Tx

milnacipran + captopril

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• carfilzomib
Savella (milnacipran)

+

carfilzomib

1 interaction

Monitor/Modify Tx

milnacipran + carfilzomib

monitor BP, bleeding s/sx: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• carvedilol
Savella (milnacipran)

+

carvedilol

1 interaction

Monitor/Modify Tx

milnacipran + carvedilol

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• celecoxib
Savella (milnacipran)

+

celecoxib

1 interaction

Monitor/Modify Tx

milnacipran + celecoxib

monitor bleeding s/sx, BP: combo may incr. risk of GI or other bleeding (including life-threatening), HTN (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• chlordiazepoxide
Savella (milnacipran)

+

chlordiazepoxide

1 interaction

Monitor/Modify Tx

milnacipran + chlordiazepoxide

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• chlorothiazide
Savella (milnacipran)

+

chlorothiazide

1 interaction

Monitor/Modify Tx

milnacipran + chlorothiazide

monitor sodium, BP: combo may incr. risk of hyponatremia, seizures; may decr. antihypertensive agent efficacy (additive effects; antagonistic effects)

• chlorpromazine
Savella (milnacipran)

+

chlorpromazine

1 interaction

Monitor/Modify Tx

milnacipran + chlorpromazine

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• chlorthalidone
Savella (milnacipran)

+

chlorthalidone

1 interaction

Monitor/Modify Tx

milnacipran + chlorthalidone

monitor sodium, BP: combo may incr. risk of hyponatremia; may decr. antihypertensive agent efficacy (additive effects; antagonistic effects)

• cilostazol
Savella (milnacipran)

+

cilostazol

1 interaction

Monitor/Modify Tx

milnacipran + cilostazol

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• cisplatin
Savella (milnacipran)

+

cisplatin

1 interaction

Monitor/Modify Tx

milnacipran + cisplatin

monitor sodium: combo may incr. risk of hyponatremia (additive effects)

• clevidipine
Savella (milnacipran)

+

clevidipine

1 interaction

Monitor/Modify Tx

milnacipran + clevidipine

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• clobazam
Savella (milnacipran)

+

clobazam

1 interaction

Monitor/Modify Tx

milnacipran + clobazam

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, milnacipran may decr. seizure threshold)

• clonazepam
Savella (milnacipran)

+

clonazepam

1 interaction

Monitor/Modify Tx

milnacipran + clonazepam

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, milnacipran may decr. seizure threshold)

• clopidogrel
Savella (milnacipran)

+

clopidogrel

1 interaction

Monitor/Modify Tx

milnacipran + clopidogrel

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• clorazepate
Savella (milnacipran)

+

clorazepate

1 interaction

Monitor/Modify Tx

milnacipran + clorazepate

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, milnacipran may decr. seizure threshold)

• collagenase clostridium histolyticum
Savella (milnacipran)

+

collagenase clostridium histolyticum

1 interaction

Monitor/Modify Tx

milnacipran + collagenase clostridium histolyticum

monitor injection site bleeding s/sx: combo may incr. risk of localized bleeding, including severe (additive effects)

• copanlisib
Savella (milnacipran)

+

copanlisib

1 interaction

Monitor/Modify Tx

milnacipran + copanlisib

monitor BP: combo may incr. risk of HTN (additive effects, copanlisib may cause infusion-related HTN)

• corticotropin
Savella (milnacipran)

+

corticotropin

1 interaction

Monitor/Modify Tx

milnacipran + corticotropin

monitor BP: combo may incr. risk of HTN (additive effects)

• cortisone
Savella (milnacipran)

+

cortisone

1 interaction

Monitor/Modify Tx

milnacipran + cortisone

monitor BP: combo may incr. risk of HTN (additive effects)

• cyclophosphamide
Savella (milnacipran)

+

cyclophosphamide

1 interaction

Monitor/Modify Tx

milnacipran + cyclophosphamide

monitor sodium: combo may incr. risk of hyponatremia, including life-threatening (additive effects)

• cyclosporine
Savella (milnacipran)

+

cyclosporine

1 interaction

Monitor/Modify Tx

milnacipran + cyclosporine

monitor BP: combo may incr. risk of HTN (additive effects)

• cysteamine
Savella (milnacipran)

+

cysteamine

1 interaction

Monitor/Modify Tx

milnacipran + cysteamine

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• dabigatran
Savella (milnacipran)

+

dabigatran

1 interaction

Monitor/Modify Tx

milnacipran + dabigatran

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• dalteparin
Savella (milnacipran)

+

dalteparin

1 interaction

Monitor/Modify Tx

milnacipran + dalteparin

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• danazol
Savella (milnacipran)

+

danazol

1 interaction

Monitor/Modify Tx

milnacipran + danazol

monitor BP: combo may incr. risk of HTN (additive effects)

• danshen
Savella (milnacipran)

+

danshen

1 interaction

Monitor/Modify Tx

milnacipran + danshen

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• darbepoetin alfa
Savella (milnacipran)

+

darbepoetin alfa

1 interaction

Monitor/Modify Tx

milnacipran + darbepoetin alfa

monitor BP: combo may incr. risk of HTN (additive effects)

• daridorexant
Savella (milnacipran)

+

daridorexant

1 interaction

Monitor/Modify Tx

milnacipran + daridorexant

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• dasatinib
Savella (milnacipran)

+

dasatinib

1 interaction

Monitor/Modify Tx

milnacipran + dasatinib

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• deferasirox
Savella (milnacipran)

+

deferasirox

1 interaction

Monitor/Modify Tx

milnacipran + deferasirox

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• defibrotide
Savella (milnacipran)

+

defibrotide

1 interaction

Monitor/Modify Tx

milnacipran + defibrotide

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• deflazacort
Savella (milnacipran)

+

deflazacort

1 interaction

Monitor/Modify Tx

milnacipran + deflazacort

monitor BP: combo may incr. risk of HTN (additive effects)

• desflurane
Savella (milnacipran)

+

desflurane

1 interaction

Monitor/Modify Tx

milnacipran + desflurane

monitor respiratory rate; consider decr. dose of one or both drugs: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• desmopressin
Savella (milnacipran)

+

desmopressin

1 interaction

Monitor/Modify Tx

milnacipran + desmopressin

monitor BP, sodium: combo may incr. risk of HTN, hyponatremia, including life-threatening (additive effects)

• deuruxolitinib
Savella (milnacipran)

+

deuruxolitinib

1 interaction

Monitor/Modify Tx

milnacipran + deuruxolitinib

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• dexamethasone
Savella (milnacipran)

+

dexamethasone

1 interaction

Monitor/Modify Tx

milnacipran + dexamethasone

monitor BP: combo may incr. risk of HTN (additive effects)

• dexmedetomidine
Savella (milnacipran)

+

dexmedetomidine

1 interaction

Monitor/Modify Tx

milnacipran + dexmedetomidine

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• dexmedetomidine injection
Savella (milnacipran)

+

dexmedetomidine injection

1 interaction

Monitor/Modify Tx

milnacipran + dexmedetomidine injection

monitor respiratory rate; consider decr. dose of one or both drugs: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• diazepam
Savella (milnacipran)

+

diazepam

1 interaction

Monitor/Modify Tx

milnacipran + diazepam

monitor respiratory rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, milnacipran may decr. seizure threshold)

• diclofenac
Savella (milnacipran)

+

diclofenac

1 interaction

Monitor/Modify Tx

milnacipran + diclofenac

monitor BP, bleeding s/sx: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• diclofenac ophthalmic
Savella (milnacipran)

+

diclofenac ophthalmic

1 interaction

Monitor/Modify Tx

milnacipran + diclofenac ophthalmic

monitor bleeding s/sx: combo may incr. risk of postop ocular bleeding (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• diclofenac topical
Savella (milnacipran)

+

diclofenac topical

1 interaction

Monitor/Modify Tx

milnacipran + diclofenac topical

monitor BP, bleeding s/sx: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• dicyclomine
Savella (milnacipran)

+

dicyclomine

1 interaction

Monitor/Modify Tx

milnacipran + dicyclomine

monitor HR: combo may incr. risk of tachycardia (additive effects)

• diethylpropion
Savella (milnacipran)

+

diethylpropion

1 interaction

Monitor/Modify Tx

milnacipran + diethylpropion

monitor BP, HR: combo may incr. risk of HTN, tachycardia (additive effects)

• diflunisal
Savella (milnacipran)

+

diflunisal

1 interaction

Monitor/Modify Tx

milnacipran + diflunisal

monitor BP, bleeding s/sx: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• diltiazem
Savella (milnacipran)

+

diltiazem

1 interaction

Monitor/Modify Tx

milnacipran + diltiazem

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• dimethyl fumarate
Savella (milnacipran)

+

dimethyl fumarate

1 interaction

Monitor/Modify Tx

milnacipran + dimethyl fumarate

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• dinutuximab
Savella (milnacipran)

+

dinutuximab

1 interaction

Monitor/Modify Tx

milnacipran + dinutuximab

monitor sodium: combo may incr. risk of severe hyponatremia (additive effects)

• diosmin
Savella (milnacipran)

+

diosmin

1 interaction

Monitor/Modify Tx

milnacipran + diosmin

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• dipyridamole
Savella (milnacipran)

+

dipyridamole

1 interaction

Monitor/Modify Tx

milnacipran + dipyridamole

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• diroximel fumarate
Savella (milnacipran)

+

diroximel fumarate

1 interaction

Monitor/Modify Tx

milnacipran + diroximel fumarate

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• dobutamine
Savella (milnacipran)

+

dobutamine

1 interaction

Monitor/Modify Tx

milnacipran + dobutamine

monitor BP, HR: combo may incr. risk of HTN, tachycardia (additive effects)

• dopamine
Savella (milnacipran)

+

dopamine

1 interaction

Monitor/Modify Tx

milnacipran + dopamine

monitor BP, HR: combo may incr. risk of HTN, tachycardia (additive effects)

• doxapram
Savella (milnacipran)

+

doxapram

1 interaction

Monitor/Modify Tx

milnacipran + doxapram

monitor BP: combo may incr. risk of HTN (additive effects)

• doxazosin
Savella (milnacipran)

+

doxazosin

1 interaction

Monitor/Modify Tx

milnacipran + doxazosin

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• droperidol
Savella (milnacipran)

+

droperidol

1 interaction

Monitor/Modify Tx

milnacipran + droperidol

decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• droxidopa
Savella (milnacipran)

+

droxidopa

1 interaction

Monitor/Modify Tx

milnacipran + droxidopa

monitor BP: combo may incr. risk of supine HTN (additive effects)

• enalapril
Savella (milnacipran)

+

enalapril

1 interaction

Monitor/Modify Tx

milnacipran + enalapril

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• enalaprilat
Savella (milnacipran)

+

enalaprilat

1 interaction

Monitor/Modify Tx

milnacipran + enalaprilat

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• encorafenib
Savella (milnacipran)

+

encorafenib

1 interaction

Monitor/Modify Tx

milnacipran + encorafenib

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• ephedrine injection
Savella (milnacipran)

+

ephedrine injection

1 interaction

Monitor/Modify Tx

milnacipran + ephedrine injection

monitor BP, HR: combo may incr. risk of HTN, tachycardia (additive effects)

• ephedrine oral
Savella (milnacipran)

+

ephedrine oral

1 interaction

Monitor/Modify Tx

milnacipran + ephedrine oral

monitor BP, HR: combo may incr. risk of HTN, tachycardia (additive effects)

• epinephrine
Savella (milnacipran)

+

epinephrine

1 interaction

Monitor/Modify Tx

milnacipran + epinephrine

monitor BP, HR: combo may incr. risk of HTN, tachycardia (additive effects)

• eplerenone
Savella (milnacipran)

+

eplerenone

1 interaction

Monitor/Modify Tx

milnacipran + eplerenone

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• epoetin alfa
Savella (milnacipran)

+

epoetin alfa

1 interaction

Monitor/Modify Tx

milnacipran + epoetin alfa

monitor BP: combo may incr. risk of HTN (additive effects)

• epoprostenol
Savella (milnacipran)

+

epoprostenol

1 interaction

Monitor/Modify Tx

milnacipran + epoprostenol

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• eptifibatide
Savella (milnacipran)

+

eptifibatide

1 interaction

Monitor/Modify Tx

milnacipran + eptifibatide

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• eptinezumab
Savella (milnacipran)

+

eptinezumab

1 interaction

Monitor/Modify Tx

milnacipran + eptinezumab

monitor BP: combo may incr. risk of HTN (additive effects)

• erenumab
Savella (milnacipran)

+

erenumab

1 interaction

Monitor/Modify Tx

milnacipran + erenumab

monitor BP: combo may incr. risk of HTN (additive effects)

• erlotinib
Savella (milnacipran)

+

erlotinib

1 interaction

Monitor/Modify Tx

milnacipran + erlotinib

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• esketamine
Savella (milnacipran)

+

esketamine

1 interaction

Monitor/Modify Tx

milnacipran + esketamine

monitor BP, respiratory rate: combo may incr. risk of HTN, CNS and respiratory depression, psychomotor impairment (additive effects)

• eslicarbazepine acetate
Savella (milnacipran)

+

eslicarbazepine acetate

1 interaction

Monitor/Modify Tx

milnacipran + eslicarbazepine acetate

monitor sodium: combo may incr. risk of CNS depression, psychomotor impairment, hyponatremia (including life-threatening), seizures (additive effects; antagonistic effects, milnacipran may decr. seizure threshold)

• esmolol
Savella (milnacipran)

+

esmolol

1 interaction

Monitor/Modify Tx

milnacipran + esmolol

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• estazolam
Savella (milnacipran)

+

estazolam

1 interaction

Monitor/Modify Tx

milnacipran + estazolam

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• estetrol (contraceptive)
Savella (milnacipran)

+

estetrol (contraceptive)

1 interaction

Monitor/Modify Tx

milnacipran + estetrol (contraceptive)

monitor BP: combo may incr. risk of HTN (additive effects)

• estradiol (contraceptive)
Savella (milnacipran)

+

estradiol (contraceptive)

1 interaction

Monitor/Modify Tx

milnacipran + estradiol (contraceptive)

monitor BP: combo may incr. risk of HTN (additive effects)

• eszopiclone
Savella (milnacipran)

+

eszopiclone

1 interaction

Monitor/Modify Tx

milnacipran + eszopiclone

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• ethacrynic acid
Savella (milnacipran)

+

ethacrynic acid

1 interaction

Monitor/Modify Tx

milnacipran + ethacrynic acid

monitor BP, sodium: combo may incr. risk of hyponatremia; may decr. antihypertensive agent efficacy (additive effects; antagonistic effects)

• ethinyl estradiol (contraceptive)
Savella (milnacipran)

+

ethinyl estradiol (contraceptive)

1 interaction

Monitor/Modify Tx

milnacipran + ethinyl estradiol (contraceptive)

monitor BP: combo may incr. risk of HTN (additive effects)

• etodolac
Savella (milnacipran)

+

etodolac

1 interaction

Monitor/Modify Tx

milnacipran + etodolac

monitor bleeding s/sx, BP: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• etomidate
Savella (milnacipran)

+

etomidate

1 interaction

Monitor/Modify Tx

milnacipran + etomidate

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• etrasimod
Savella (milnacipran)

+

etrasimod

1 interaction

Monitor/Modify Tx

milnacipran + etrasimod

monitor BP: combo may incr. risk of HTN (additive effects)

• evening primrose oil
Savella (milnacipran)

+

evening primrose oil

1 interaction

Monitor/Modify Tx

milnacipran + evening primrose oil

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• felodipine
Savella (milnacipran)

+

felodipine

1 interaction

Monitor/Modify Tx

milnacipran + felodipine

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• fenoldopam
Savella (milnacipran)

+

fenoldopam

1 interaction

Monitor/Modify Tx

milnacipran + fenoldopam

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• fenoprofen
Savella (milnacipran)

+

fenoprofen

1 interaction

Monitor/Modify Tx

milnacipran + fenoprofen

monitor bleeding s/sx, BP: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• fenugreek
Savella (milnacipran)

+

fenugreek

1 interaction

Monitor/Modify Tx

milnacipran + fenugreek

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• fingolimod
Savella (milnacipran)

+

fingolimod

1 interaction

Monitor/Modify Tx

milnacipran + fingolimod

monitor BP: combo may incr. risk of HTN (additive effects)

• fludrocortisone
Savella (milnacipran)

+

fludrocortisone

1 interaction

Monitor/Modify Tx

milnacipran + fludrocortisone

monitor BP: combo may incr. risk of HTN (additive effects)

• fluphenazine
Savella (milnacipran)

+

fluphenazine

1 interaction

Monitor/Modify Tx

milnacipran + fluphenazine

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• flurazepam
Savella (milnacipran)

+

flurazepam

1 interaction

Monitor/Modify Tx

milnacipran + flurazepam

monitor respiratory rate; consider decr. dose of one or both drugs: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• flurbiprofen
Savella (milnacipran)

+

flurbiprofen

1 interaction

Monitor/Modify Tx

milnacipran + flurbiprofen

monitor bleeding s/sx, BP: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• flurbiprofen ophthalmic
Savella (milnacipran)

+

flurbiprofen ophthalmic

1 interaction

Monitor/Modify Tx

milnacipran + flurbiprofen ophthalmic

monitor bleeding s/sx: combo may incr. risk of postop ocular bleeding (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• formoterol inhaled
Savella (milnacipran)

+

formoterol inhaled

1 interaction

Monitor/Modify Tx

milnacipran + formoterol inhaled

monitor BP, HR: combo may incr. risk of HTN, tachycardia, other cardiovascular adverse effects (additive effects)

• fosinopril
Savella (milnacipran)

+

fosinopril

1 interaction

Monitor/Modify Tx

milnacipran + fosinopril

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• fostamatinib
Savella (milnacipran)

+

fostamatinib

1 interaction

Monitor/Modify Tx

milnacipran + fostamatinib

monitor BP: combo may incr. risk of HTN (additive effects)

• fremanezumab
Savella (milnacipran)

+

fremanezumab

1 interaction

Monitor/Modify Tx

milnacipran + fremanezumab

monitor BP: combo may incr. risk of HTN (additive effects)

• fruquintinib
Savella (milnacipran)

+

fruquintinib

1 interaction

Monitor/Modify Tx

milnacipran + fruquintinib

monitor BP, bleeding s/sx: combo may incr. risk of HTN (including hypertensive crisis), GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• gabapentin
Savella (milnacipran)

+

gabapentin

1 interaction

Monitor/Modify Tx

milnacipran + gabapentin

monitor respiratory rate; consider decreasing gabapentin dose: combo may increase risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, milnacipran may decrease seizure threshold)

• gabapentin enacarbil
Savella (milnacipran)

+

gabapentin enacarbil

1 interaction

Monitor/Modify Tx

milnacipran + gabapentin enacarbil

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• galcanezumab
Savella (milnacipran)

+

galcanezumab

1 interaction

Monitor/Modify Tx

milnacipran + galcanezumab

monitor BP: combo may incr. risk of HTN (additive effects)

• garlic
Savella (milnacipran)

+

garlic

1 interaction

Monitor/Modify Tx

milnacipran + garlic

monitor bleeding s/sx, especially w/ supplemental garlic; dietary intake OK: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• gefitinib
Savella (milnacipran)

+

gefitinib

1 interaction

Monitor/Modify Tx

milnacipran + gefitinib

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• gemtuzumab ozogamicin
Savella (milnacipran)

+

gemtuzumab ozogamicin

1 interaction

Monitor/Modify Tx

milnacipran + gemtuzumab ozogamicin

monitor platelets, bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• ginkgo
Savella (milnacipran)

+

ginkgo

1 interaction

Monitor/Modify Tx

milnacipran + ginkgo

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• glycopyrrolate
Savella (milnacipran)

+

glycopyrrolate

1 interaction

Monitor/Modify Tx

milnacipran + glycopyrrolate

monitor HR: combo may incr. risk of tachycardia, CNS depression, psychomotor impairment (additive effects)

• guanfacine
Savella (milnacipran)

+

guanfacine

1 interaction

Monitor/Modify Tx

milnacipran + guanfacine

monitor BP: combo may incr. risk of CNS depression, psychomotor impairment; may decr. antihypertensive agent efficacy (additive effects; antagonistic effects)

• heparin
Savella (milnacipran)

+

heparin

1 interaction

Monitor/Modify Tx

milnacipran + heparin

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• hoodia
Savella (milnacipran)

+

hoodia

1 interaction

Monitor/Modify Tx

milnacipran + hoodia

monitor BP, HR: combo may incr. risk of HTN, tachycardia (additive effects)

• hydralazine
Savella (milnacipran)

+

hydralazine

1 interaction

Monitor/Modify Tx

milnacipran + hydralazine

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• hydrochlorothiazide
Savella (milnacipran)

+

hydrochlorothiazide

1 interaction

Monitor/Modify Tx

milnacipran + hydrochlorothiazide

monitor sodium, BP: combo may incr. risk of hyponatremia; may decr. antihypertensive agent efficacy (additive effects; antagonistic effects)

• hydrocortisone
Savella (milnacipran)

+

hydrocortisone

1 interaction

Monitor/Modify Tx

milnacipran + hydrocortisone

monitor bleeding s/sx, BP: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• hydroxocobalamin IV
Savella (milnacipran)

+

hydroxocobalamin IV

1 interaction

Monitor/Modify Tx

milnacipran + hydroxocobalamin IV

monitor BP: combo may incr. risk of HTN (additive effects)

• hydroxyzine
Savella (milnacipran)

+

hydroxyzine

1 interaction

Monitor/Modify Tx

milnacipran + hydroxyzine

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• hyoscyamine
Savella (milnacipran)

+

hyoscyamine

1 interaction

Monitor/Modify Tx

milnacipran + hyoscyamine

monitor HR: combo may incr. risk of CNS depression, psychomotor impairment, tachycardia (additive effects)

• ibrutinib
Savella (milnacipran)

+

ibrutinib

1 interaction

Monitor/Modify Tx

milnacipran + ibrutinib

monitor BP, bleeding s/sx: combo may incr. risk of HTN, bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• ibuprofen
Savella (milnacipran)

+

ibuprofen

1 interaction

Monitor/Modify Tx

milnacipran + ibuprofen

monitor bleeding s/sx, BP: combo may incr. risk of GI or other bleeding (including life-threatening), HTN (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• ibuprofen lysine
Savella (milnacipran)

+

ibuprofen lysine

1 interaction

Monitor/Modify Tx

milnacipran + ibuprofen lysine

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• icosapent ethyl
Savella (milnacipran)

+

icosapent ethyl

1 interaction

Monitor/Modify Tx

milnacipran + icosapent ethyl

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• ifosfamide
Savella (milnacipran)

+

ifosfamide

1 interaction

Monitor/Modify Tx

milnacipran + ifosfamide

monitor sodium; D/C one or both drugs if encephalopathy occurs: combo may incr. risk of CNS depression, psychomotor impairment, hyponatremia (additive effects)

• imatinib
Savella (milnacipran)

+

imatinib

1 interaction

Monitor/Modify Tx

milnacipran + imatinib

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• indapamide
Savella (milnacipran)

+

indapamide

1 interaction

Monitor/Modify Tx

milnacipran + indapamide

monitor BP, sodium: combo may incr. risk of severe hyponatremia; may decr. antihypertensive agent efficacy (additive effects; antagonistic effects)

• indomethacin
Savella (milnacipran)

+

indomethacin

1 interaction

Monitor/Modify Tx

milnacipran + indomethacin

monitor bleeding s/sx, BP: combo may incr. risk of GI or other bleeding (including life-threatening), HTN (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• iopamidol
Savella (milnacipran)

+

iopamidol

1 interaction

Monitor/Modify Tx

milnacipran + iopamidol

caution advised if intrathecal iopamidol use; consider holding milnacipran at least 48h before and at least 24h after intrathecal iopamidol: combo may incr. risk of seizures (additive effects)

• irbesartan
Savella (milnacipran)

+

irbesartan

1 interaction

Monitor/Modify Tx

milnacipran + irbesartan

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• isoflurane
Savella (milnacipran)

+

isoflurane

1 interaction

Monitor/Modify Tx

milnacipran + isoflurane

monitor respiratory rate: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• isoproterenol
Savella (milnacipran)

+

isoproterenol

1 interaction

Monitor/Modify Tx

milnacipran + isoproterenol

monitor HR: combo may incr. risk of tachycardia (additive effects)

• isradipine
Savella (milnacipran)

+

isradipine

1 interaction

Monitor/Modify Tx

milnacipran + isradipine

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• ketamine
Savella (milnacipran)

+

ketamine

1 interaction

Monitor/Modify Tx

milnacipran + ketamine

monitor respiratory rate, BP, HR; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression (including life-threatening), psychomotor impairment, HTN, tachycardia, other sympathomimetic adverse effects (additive effects)

• ketoprofen
Savella (milnacipran)

+

ketoprofen

1 interaction

Monitor/Modify Tx

milnacipran + ketoprofen

monitor bleeding s/sx, BP: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• ketorolac
Savella (milnacipran)

+

ketorolac

1 interaction

Monitor/Modify Tx

milnacipran + ketorolac

monitor bleeding s/sx, BP: combo may incr. risk of GI or other bleeding (including life-threatening), HTN (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• ketorolac ophthalmic
Savella (milnacipran)

+

ketorolac ophthalmic

1 interaction

Monitor/Modify Tx

milnacipran + ketorolac ophthalmic

monitor bleeding s/sx: combo may incr. risk of postop ocular bleeding (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• labetalol
Savella (milnacipran)

+

labetalol

1 interaction

Monitor/Modify Tx

milnacipran + labetalol

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• lanreotide
Savella (milnacipran)

+

lanreotide

1 interaction

Monitor/Modify Tx

milnacipran + lanreotide

monitor BP: combo may incr. risk of HTN (additive effects)

• leflunomide
Savella (milnacipran)

+

leflunomide

1 interaction

Monitor/Modify Tx

milnacipran + leflunomide

monitor BP: combo may incr. risk of HTN (additive effects)

• lemborexant
Savella (milnacipran)

+

lemborexant

1 interaction

Monitor/Modify Tx

milnacipran + lemborexant

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• lenvatinib
Savella (milnacipran)

+

lenvatinib

1 interaction

Monitor/Modify Tx

milnacipran + lenvatinib

monitor BP, bleeding s/sx: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• levalbuterol inhaled
Savella (milnacipran)

+

levalbuterol inhaled

1 interaction

Monitor/Modify Tx

milnacipran + levalbuterol inhaled

monitor BP, HR: combo may incr. risk of HTN, tachycardia, other cardiovascular adverse effects (additive effects)

• levothyroxine
Savella (milnacipran)

+

levothyroxine

1 interaction

Monitor/Modify Tx

milnacipran + levothyroxine

monitor BP, HR: combo may incr. risk of HTN, tachycardia (additive effects)

• licorice
Savella (milnacipran)

+

licorice

1 interaction

Monitor/Modify Tx

milnacipran + licorice

monitor BP w/ large amounts of licorice: combo may incr. risk of HTN (additive effects)

• lifileucel
Savella (milnacipran)

+

lifileucel

1 interaction

Monitor/Modify Tx

milnacipran + lifileucel

monitor HR, bleeding s/sx: combo may incr. risk of tachycardia, bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• liothyronine
Savella (milnacipran)

+

liothyronine

1 interaction

Monitor/Modify Tx

milnacipran + liothyronine

monitor BP, HR: combo may incr. risk of HTN, tachycardia (additive effects)

• liraglutide
Savella (milnacipran)

+

liraglutide

1 interaction

Monitor/Modify Tx

milnacipran + liraglutide

monitor HR: combo may incr. risk of tachycardia (additive effects)

• lisinopril
Savella (milnacipran)

+

lisinopril

1 interaction

Monitor/Modify Tx

milnacipran + lisinopril

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• lorazepam
Savella (milnacipran)

+

lorazepam

1 interaction

Monitor/Modify Tx

milnacipran + lorazepam

monitor respiratory rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, milnacipran may decr. seizure threshold)

• lorlatinib
Savella (milnacipran)

+

lorlatinib

1 interaction

Monitor/Modify Tx

milnacipran + lorlatinib

monitor BP: combo may incr. risk of HTN (additive effects)

• losartan
Savella (milnacipran)

+

losartan

1 interaction

Monitor/Modify Tx

milnacipran + losartan

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• lumacaftor/ivacaftor
Savella (milnacipran)

+

lumacaftor/ ivacaftor

1 interaction

Monitor/Modify Tx

milnacipran + lumacaftor/ ivacaftor

monitor BP: combo may incr. risk of HTN (additive effects)

• luspatercept
Savella (milnacipran)

+

luspatercept

1 interaction

Monitor/Modify Tx

milnacipran + luspatercept

monitor BP: combo may incr. risk of HTN (additive effects)

• magnesium citrate
Savella (milnacipran)

+

magnesium citrate

1 interaction

Monitor/Modify Tx

milnacipran + magnesium citrate

monitor sodium, especially if magnesium citrate bowel prep use: combo may incr. risk of hyponatremia, seizures (additive effects)

• magnesium salicylate
Savella (milnacipran)

+

magnesium salicylate

1 interaction

Monitor/Modify Tx

milnacipran + magnesium salicylate

monitor bleeding s/sx, BP w/ high-dose magnesium salicylate: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• mannitol
Savella (milnacipran)

+

mannitol

1 interaction

Monitor/Modify Tx

milnacipran + mannitol

monitor sodium: combo may incr. risk of hyponatremia (including life-threatening), seizures (additive effects)

• meclofenamate
Savella (milnacipran)

+

meclofenamate

1 interaction

Monitor/Modify Tx

milnacipran + meclofenamate

monitor BP, bleeding s/sx: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• mefenamic acid
Savella (milnacipran)

+

mefenamic acid

1 interaction

Monitor/Modify Tx

milnacipran + mefenamic acid

monitor bleeding s/sx, BP: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• meloxicam
Savella (milnacipran)

+

meloxicam

1 interaction

Monitor/Modify Tx

milnacipran + meloxicam

monitor BP, bleeding s/sx: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• methazolamide
Savella (milnacipran)

+

methazolamide

1 interaction

Monitor/Modify Tx

milnacipran + methazolamide

monitor sodium: combo may incr. risk of hyponatremia (additive effects)

• methohexital
Savella (milnacipran)

+

methohexital

1 interaction

Monitor/Modify Tx

milnacipran + methohexital

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• methotrexate
Savella (milnacipran)

+

methotrexate

1 interaction

Monitor/Modify Tx

milnacipran + methotrexate

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• methoxy polyethylene glycol-epoetin beta
Savella (milnacipran)

+

methoxy polyethylene glycol-epoetin beta

1 interaction

Monitor/Modify Tx

milnacipran + methoxy polyethylene glycol-epoetin beta

monitor BP: combo may incr. risk of HTN (additive effects)

• methscopolamine
Savella (milnacipran)

+

methscopolamine

1 interaction

Monitor/Modify Tx

milnacipran + methscopolamine

monitor HR: combo may incr. risk of tachycardia (additive effects)

• methyl salicylate topical
Savella (milnacipran)

+

methyl salicylate topical

1 interaction

Monitor/Modify Tx

milnacipran + methyl salicylate topical

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• methyldopa
Savella (milnacipran)

+

methyldopa

1 interaction

Monitor/Modify Tx

milnacipran + methyldopa

monitor BP: combo may incr. risk of CNS depression, psychomotor impairment; may decr. antihypertensive agent efficacy (additive effects; antagonistic effects)

• methylprednisolone
Savella (milnacipran)

+

methylprednisolone

1 interaction

Monitor/Modify Tx

milnacipran + methylprednisolone

monitor BP: combo may incr. risk of HTN (additive effects)

• methyltestosterone
Savella (milnacipran)

+

methyltestosterone

1 interaction

Monitor/Modify Tx

milnacipran + methyltestosterone

monitor BP: combo may incr. risk of HTN (additive effects)

• metolazone
Savella (milnacipran)

+

metolazone

1 interaction

Monitor/Modify Tx

milnacipran + metolazone

monitor sodium, BP: combo may incr. risk of hyponatremia; may decr. antihypertensive agent efficacy (additive effects; antagonistic effects)

• metoprolol
Savella (milnacipran)

+

metoprolol

1 interaction

Monitor/Modify Tx

milnacipran + metoprolol

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• minoxidil
Savella (milnacipran)

+

minoxidil

1 interaction

Monitor/Modify Tx

milnacipran + minoxidil

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• mirabegron
Savella (milnacipran)

+

mirabegron

1 interaction

Monitor/Modify Tx

milnacipran + mirabegron

monitor BP: combo may incr. risk of HTN (additive effects)

• mitotane
Savella (milnacipran)

+

mitotane

1 interaction

Monitor/Modify Tx

milnacipran + mitotane

monitor bleeding s/sx: combo may incr. risk of CNS depression, psychomotor impairment, bleeding, including life-threatening (hepatic metabolism induced; additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• modafinil
Savella (milnacipran)

+

modafinil

1 interaction

Monitor/Modify Tx

milnacipran + modafinil

monitor BP, HR: combo may incr. risk of HTN, tachycardia (additive effects)

• moexipril
Savella (milnacipran)

+

moexipril

1 interaction

Monitor/Modify Tx

milnacipran + moexipril

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• monomethyl fumarate
Savella (milnacipran)

+

monomethyl fumarate

1 interaction

Monitor/Modify Tx

milnacipran + monomethyl fumarate

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• mycophenolate mofetil
Savella (milnacipran)

+

mycophenolate mofetil

1 interaction

Monitor/Modify Tx

milnacipran + mycophenolate mofetil

monitor bleeding s/sx: combo may incr. risk of CNS depression, psychomotor impairment, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• mycophenolic acid
Savella (milnacipran)

+

mycophenolic acid

1 interaction

Monitor/Modify Tx

milnacipran + mycophenolic acid

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• nabumetone
Savella (milnacipran)

+

nabumetone

1 interaction

Monitor/Modify Tx

milnacipran + nabumetone

monitor BP, bleeding s/sx: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• nadolol
Savella (milnacipran)

+

nadolol

1 interaction

Monitor/Modify Tx

milnacipran + nadolol

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• naproxen
Savella (milnacipran)

+

naproxen

1 interaction

Monitor/Modify Tx

milnacipran + naproxen

monitor bleeding s/sx, BP: combo may incr. risk of GI or other bleeding (including life-threatening), HTN (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• nattokinase
Savella (milnacipran)

+

nattokinase

1 interaction

Monitor/Modify Tx

milnacipran + nattokinase

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• naxitamab
Savella (milnacipran)

+

naxitamab

1 interaction

Monitor/Modify Tx

milnacipran + naxitamab

monitor BP: combo may incr. risk of HTN (additive effects)

• nebivolol
Savella (milnacipran)

+

nebivolol

1 interaction

Monitor/Modify Tx

milnacipran + nebivolol

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• nelarabine
Savella (milnacipran)

+

nelarabine

1 interaction

Monitor/Modify Tx

milnacipran + nelarabine

withhold nelarabine if Grade 2 or greater somnolence occurs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• nepafenac ophthalmic
Savella (milnacipran)

+

nepafenac ophthalmic

1 interaction

Monitor/Modify Tx

milnacipran + nepafenac ophthalmic

monitor bleeding s/sx: combo may incr. risk of postop ocular bleeding (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• niacin (vitamin B3)
Savella (milnacipran)

+

niacin (vitamin B3)

1 interaction

Monitor/Modify Tx

milnacipran + niacin (vitamin B3)

monitor platelets, bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• nicardipine
Savella (milnacipran)

+

nicardipine

1 interaction

Monitor/Modify Tx

milnacipran + nicardipine

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• nifedipine
Savella (milnacipran)

+

nifedipine

1 interaction

Monitor/Modify Tx

milnacipran + nifedipine

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• nilotinib
Savella (milnacipran)

+

nilotinib

1 interaction

Monitor/Modify Tx

milnacipran + nilotinib

monitor sodium, bleeding s/sx: combo may incr. risk of hyponatremia, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• nimodipine
Savella (milnacipran)

+

nimodipine

1 interaction

Monitor/Modify Tx

milnacipran + nimodipine

monitor BP: combo may decr. nimodipine efficacy (antagonistic effects)

• nintedanib
Savella (milnacipran)

+

nintedanib

1 interaction

Monitor/Modify Tx

milnacipran + nintedanib

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• niraparib
Savella (milnacipran)

+

niraparib

1 interaction

Monitor/Modify Tx

milnacipran + niraparib

monitor BP: combo may incr. risk of HTN (additive effects)

• nisoldipine
Savella (milnacipran)

+

nisoldipine

1 interaction

Monitor/Modify Tx

milnacipran + nisoldipine

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• norepinephrine
Savella (milnacipran)

+

norepinephrine

1 interaction

Monitor/Modify Tx

milnacipran + norepinephrine

monitor BP: combo may incr. risk of severe HTN (additive effects)

• nusinersen
Savella (milnacipran)

+

nusinersen

1 interaction

Monitor/Modify Tx

milnacipran + nusinersen

monitor platelets, bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• obinutuzumab
Savella (milnacipran)

+

obinutuzumab

1 interaction

Monitor/Modify Tx

milnacipran + obinutuzumab

monitor BP, platelets, bleeding s/sx; consider holding milnacipran, especially during first obinutuzumab cycle: combo may incr. risk of HTN (including hypertensive crisis), severe bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• olanzapine
Savella (milnacipran)

+

olanzapine

1 interaction

Monitor/Modify Tx

milnacipran + olanzapine

monitor BP: combo may incr. risk of CNS depression, psychomotor impairment, hypotension, including orthostasis (additive effects)

• olmesartan medoxomil
Savella (milnacipran)

+

olmesartan medoxomil

1 interaction

Monitor/Modify Tx

milnacipran + olmesartan medoxomil

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• olodaterol inhaled
Savella (milnacipran)

+

olodaterol inhaled

1 interaction

Monitor/Modify Tx

milnacipran + olodaterol inhaled

monitor BP, HR: combo may incr. risk of HTN, tachycardia (additive effects)

• omega-3-acid
Savella (milnacipran)

+

omega-3-acid

1 interaction

Monitor/Modify Tx

milnacipran + omega-3-acid

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• opicapone
Savella (milnacipran)

+

opicapone

1 interaction

Monitor/Modify Tx

milnacipran + opicapone

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• orphenadrine
Savella (milnacipran)

+

orphenadrine

1 interaction

Monitor/Modify Tx

milnacipran + orphenadrine

monitor HR: combo may incr. risk of tachycardia, CNS depression, psychomotor impairment, other adverse effects (additive effects)

• osilodrostat
Savella (milnacipran)

+

osilodrostat

1 interaction

Monitor/Modify Tx

milnacipran + osilodrostat

monitor BP: combo may incr. risk of HTN (additive effects)

• oxaliplatin
Savella (milnacipran)

+

oxaliplatin

1 interaction

Monitor/Modify Tx

milnacipran + oxaliplatin

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• oxaprozin
Savella (milnacipran)

+

oxaprozin

1 interaction

Monitor/Modify Tx

milnacipran + oxaprozin

monitor bleeding s/sx, BP: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• oxazepam
Savella (milnacipran)

+

oxazepam

1 interaction

Monitor/Modify Tx

milnacipran + oxazepam

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• oxcarbazepine
Savella (milnacipran)

+

oxcarbazepine

1 interaction

Monitor/Modify Tx

milnacipran + oxcarbazepine

monitor sodium: combo may incr. risk of hyponatremia, seizures, CNS depression, psychomotor impairment (additive effects; antagonistic effects, milnacipran may decr. seizure threshold)

• oxybutynin
Savella (milnacipran)

+

oxybutynin

1 interaction

Monitor/Modify Tx

milnacipran + oxybutynin

decr. dose of one or both drugs or consider oxybutynin transdermal patch: combo may incr. risk of CNS depression, psychomotor impairment; somnolence less likely with oxybutynin transdermal patch (additive effects)

• oxymetazoline nasal
Savella (milnacipran)

+

oxymetazoline nasal

1 interaction

Monitor/Modify Tx

milnacipran + oxymetazoline nasal

monitor BP: combo may incr. risk of HTN (additive effects)

• oxytocin
Savella (milnacipran)

+

oxytocin

1 interaction

Monitor/Modify Tx

milnacipran + oxytocin

monitor sodium, BP: combo may incr. risk of hyponatremia, HTN, including life-threatening (additive effects)

• ozanimod
Savella (milnacipran)

+

ozanimod

1 interaction

Monitor/Modify Tx

milnacipran + ozanimod

monitor BP: combo may incr. risk of HTN, including hypertensive crisis (additive effects)

• pacritinib
Savella (milnacipran)

+

pacritinib

1 interaction

Monitor/Modify Tx

milnacipran + pacritinib

monitor platelets, bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• pazopanib
Savella (milnacipran)

+

pazopanib

1 interaction

Monitor/Modify Tx

milnacipran + pazopanib

monitor BP, bleeding s/sx: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• pegaspargase
Savella (milnacipran)

+

pegaspargase

1 interaction

Monitor/Modify Tx

milnacipran + pegaspargase

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• penicillin G
Savella (milnacipran)

+

penicillin G

1 interaction

Monitor/Modify Tx

milnacipran + penicillin G

monitor bleeding s/sx, especially w/ large penicillin G doses and/or concomitant renal impairment: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• pentobarbital
Savella (milnacipran)

+

pentobarbital

1 interaction

Monitor/Modify Tx

milnacipran + pentobarbital

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• pentosan polysulfate sodium
Savella (milnacipran)

+

pentosan polysulfate sodium

1 interaction

Monitor/Modify Tx

milnacipran + pentosan polysulfate sodium

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• pentoxifylline
Savella (milnacipran)

+

pentoxifylline

1 interaction

Monitor/Modify Tx

milnacipran + pentoxifylline

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• perindopril
Savella (milnacipran)

+

perindopril

1 interaction

Monitor/Modify Tx

milnacipran + perindopril

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• perphenazine
Savella (milnacipran)

+

perphenazine

1 interaction

Monitor/Modify Tx

milnacipran + perphenazine

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• pexidartinib
Savella (milnacipran)

+

pexidartinib

1 interaction

Monitor/Modify Tx

milnacipran + pexidartinib

monitor BP: combo may incr. risk of HTN (additive effects)

• phendimetrazine
Savella (milnacipran)

+

phendimetrazine

1 interaction

Monitor/Modify Tx

milnacipran + phendimetrazine

monitor BP, HR: combo may incr. risk of HTN, tachycardia (additive effects)

• phenobarbital
Savella (milnacipran)

+

phenobarbital

1 interaction

Monitor/Modify Tx

milnacipran + phenobarbital

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, milnacipran may decr. seizure threshold)

• phenoxybenzamine
Savella (milnacipran)

+

phenoxybenzamine

1 interaction

Monitor/Modify Tx

milnacipran + phenoxybenzamine

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• phentermine
Savella (milnacipran)

+

phentermine

1 interaction

Monitor/Modify Tx

milnacipran + phentermine

monitor BP, HR: combo may incr. risk of HTN, tachycardia (additive effects)

• phentolamine
Savella (milnacipran)

+

phentolamine

1 interaction

Monitor/Modify Tx

milnacipran + phentolamine

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• phenylephrine
Savella (milnacipran)

+

phenylephrine

1 interaction

Monitor/Modify Tx

milnacipran + phenylephrine

monitor BP, HR: combo may incr. risk of HTN, tachycardia (additive effects)

• phenylephrine injection
Savella (milnacipran)

+

phenylephrine injection

1 interaction

Monitor/Modify Tx

milnacipran + phenylephrine injection

monitor BP: combo may incr. risk of HTN, exaggerated pressor response (additive effects)

• phenylephrine nasal
Savella (milnacipran)

+

phenylephrine nasal

1 interaction

Monitor/Modify Tx

milnacipran + phenylephrine nasal

monitor BP: combo may incr. risk of HTN (additive effects)

• phenylephrine ophthalmic
Savella (milnacipran)

+

phenylephrine ophthalmic

1 interaction

Monitor/Modify Tx

milnacipran + phenylephrine ophthalmic

monitor BP, HR; risk may be lower w/ phenylephrine ophthalmic 2.5%: combo may incr. risk of HTN, tachycardia (additive effects)

• phenylephrine rectal
Savella (milnacipran)

+

phenylephrine rectal

1 interaction

Monitor/Modify Tx

milnacipran + phenylephrine rectal

monitor BP: combo may incr. risk of HTN (additive effects)

• pindolol
Savella (milnacipran)

+

pindolol

1 interaction

Monitor/Modify Tx

milnacipran + pindolol

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• piperacillin
Savella (milnacipran)

+

piperacillin

1 interaction

Monitor/Modify Tx

milnacipran + piperacillin

monitor bleeding s/sx, especially w/ prolonged piperacillin tx and/or concomitant renal impairment: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• piroxicam
Savella (milnacipran)

+

piroxicam

1 interaction

Monitor/Modify Tx

milnacipran + piroxicam

monitor bleeding s/sx, BP: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• pirtobrutinib
Savella (milnacipran)

+

pirtobrutinib

1 interaction

Monitor/Modify Tx

milnacipran + pirtobrutinib

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• plasminogen, human
Savella (milnacipran)

+

plasminogen, human

1 interaction

Monitor/Modify Tx

milnacipran + plasminogen, human

monitor bleeding s/sx, especially during and x4h after plasminogen infusion: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• polyethylene glycol
Savella (milnacipran)

+

polyethylene glycol

1 interaction

Monitor/Modify Tx

milnacipran + polyethylene glycol

monitor sodium, especially if polyethylene glycol bowel prep use: combo may incr. risk of hyponatremia, seizures (additive effects)

• polyethylene glycol/electrolytes
Savella (milnacipran)

+

polyethylene glycol/ electrolytes

1 interaction

Monitor/Modify Tx

milnacipran + polyethylene glycol/ electrolytes

monitor sodium: combo may incr. risk of hyponatremia, seizures (additive effects)

• ponatinib
Savella (milnacipran)

+

ponatinib

1 interaction

Monitor/Modify Tx

milnacipran + ponatinib

monitor BP, bleeding s/sx: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• ponesimod
Savella (milnacipran)

+

ponesimod

1 interaction

Monitor/Modify Tx

milnacipran + ponesimod

monitor BP: combo may incr. risk of HTN (additive effects)

• porfimer
Savella (milnacipran)

+

porfimer

1 interaction

Monitor/Modify Tx

milnacipran + porfimer

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• pralsetinib
Savella (milnacipran)

+

pralsetinib

1 interaction

Monitor/Modify Tx

milnacipran + pralsetinib

monitor BP, bleeding s/sx: combo may incr. risk of HTN, bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• prasugrel
Savella (milnacipran)

+

prasugrel

1 interaction

Monitor/Modify Tx

milnacipran + prasugrel

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• prazosin
Savella (milnacipran)

+

prazosin

1 interaction

Monitor/Modify Tx

milnacipran + prazosin

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• prednisolone
Savella (milnacipran)

+

prednisolone

1 interaction

Monitor/Modify Tx

milnacipran + prednisolone

monitor BP: combo may incr. risk of HTN (additive effects)

• prednisone
Savella (milnacipran)

+

prednisone

1 interaction

Monitor/Modify Tx

milnacipran + prednisone

monitor BP: combo may incr. risk of HTN (additive effects)

• pregabalin
Savella (milnacipran)

+

pregabalin

1 interaction

Monitor/Modify Tx

milnacipran + pregabalin

monitor respiratory rate: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, milnacipran may decr. seizure threshold)

• primidone
Savella (milnacipran)

+

primidone

1 interaction

Monitor/Modify Tx

milnacipran + primidone

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, milnacipran may decr. seizure threshold)

• propofol
Savella (milnacipran)

+

propofol

1 interaction

Monitor/Modify Tx

milnacipran + propofol

monitor respiratory rate; consider decr. dose of one or both drugs: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• propranolol
Savella (milnacipran)

+

propranolol

1 interaction

Monitor/Modify Tx

milnacipran + propranolol

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• pseudoephedrine
Savella (milnacipran)

+

pseudoephedrine

1 interaction

Monitor/Modify Tx

milnacipran + pseudoephedrine

monitor BP, HR: combo may incr. risk of HTN, tachycardia (additive effects)

• quazepam
Savella (milnacipran)

+

quazepam

1 interaction

Monitor/Modify Tx

milnacipran + quazepam

monitor respiratory rate; consider decr. dose of one or both drugs: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• quetiapine
Savella (milnacipran)

+

quetiapine

1 interaction

Monitor/Modify Tx

milnacipran + quetiapine

monitor BP, especially in pts <18 yo: combo may incr. risk of CNS depression, psychomotor impairment, HTN (additive effects)

• quinapril
Savella (milnacipran)

+

quinapril

1 interaction

Monitor/Modify Tx

milnacipran + quinapril

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• ramipril
Savella (milnacipran)

+

ramipril

1 interaction

Monitor/Modify Tx

milnacipran + ramipril

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• ramucirumab
Savella (milnacipran)

+

ramucirumab

1 interaction

Monitor/Modify Tx

milnacipran + ramucirumab

monitor BP, sodium, bleeding s/sx: combo may incr. risk of HTN, hyponatremia, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• ranibizumab
Savella (milnacipran)

+

ranibizumab

1 interaction

Monitor/Modify Tx

milnacipran + ranibizumab

monitor bleeding s/sx: combo may incr. risk of ocular hemorrhage (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• regorafenib
Savella (milnacipran)

+

regorafenib

1 interaction

Monitor/Modify Tx

milnacipran + regorafenib

monitor BP, bleeding s/sx: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• remibrutinib
Savella (milnacipran)

+

remibrutinib

1 interaction

Monitor/Modify Tx

milnacipran + remibrutinib

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• remimazolam
Savella (milnacipran)

+

remimazolam

1 interaction

Monitor/Modify Tx

milnacipran + remimazolam

monitor respiratory rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• resveratrol
Savella (milnacipran)

+

resveratrol

1 interaction

Monitor/Modify Tx

milnacipran + resveratrol

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• reteplase
Savella (milnacipran)

+

reteplase

1 interaction

Monitor/Modify Tx

milnacipran + reteplase

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• revakinagene taroretcel
Savella (milnacipran)

+

revakinagene taroretcel

1 interaction

Monitor/Modify Tx

milnacipran + revakinagene taroretcel

monitor bleeding s/sx: combo may incr. risk of ocular hemorrhage (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• rimegepant
Savella (milnacipran)

+

rimegepant

1 interaction

Monitor/Modify Tx

milnacipran + rimegepant

monitor BP: combo may incr. risk of HTN (additive effects)

• ripretinib
Savella (milnacipran)

+

ripretinib

1 interaction

Monitor/Modify Tx

milnacipran + ripretinib

monitor BP: combo may incr. risk of HTN (additive effects)

• rivaroxaban
Savella (milnacipran)

+

rivaroxaban

1 interaction

Monitor/Modify Tx

milnacipran + rivaroxaban

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• romidepsin
Savella (milnacipran)

+

romidepsin

1 interaction

Monitor/Modify Tx

milnacipran + romidepsin

monitor sodium: combo may incr. risk of hyponatremia (additive effects)

• ropinirole
Savella (milnacipran)

+

ropinirole

1 interaction

Monitor/Modify Tx

milnacipran + ropinirole

monitor BP: combo may incr. risk of CNS depression, psychomotor impairment, HTN (additive effects)

• rotigotine transdermal
Savella (milnacipran)

+

rotigotine transdermal

1 interaction

Monitor/Modify Tx

milnacipran + rotigotine transdermal

monitor BP, HR: combo may incr. risk of CNS depression, psychomotor impairment, HTN, tachycardia (additive effects)

• salmeterol inhaled
Savella (milnacipran)

+

salmeterol inhaled

1 interaction

Monitor/Modify Tx

milnacipran + salmeterol inhaled

monitor BP, HR: combo may incr. risk of HTN, tachycardia, other cardiovascular adverse effects (additive effects)

• salsalate
Savella (milnacipran)

+

salsalate

1 interaction

Monitor/Modify Tx

milnacipran + salsalate

monitor bleeding s/sx, BP w/ high-dose salsalate: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• saw palmetto
Savella (milnacipran)

+

saw palmetto

1 interaction

Monitor/Modify Tx

milnacipran + saw palmetto

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• selinexor
Savella (milnacipran)

+

selinexor

1 interaction

Monitor/Modify Tx

milnacipran + selinexor

monitor sodium: combo may incr. risk of CNS depression, psychomotor impairment, hyponatremia, including life-threatening (additive effects)

• selpercatinib
Savella (milnacipran)

+

selpercatinib

1 interaction

Monitor/Modify Tx

milnacipran + selpercatinib

monitor BP, bleeding s/sx: combo may incr. risk of HTN, bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• selumetinib
Savella (milnacipran)

+

selumetinib

1 interaction

Monitor/Modify Tx

milnacipran + selumetinib

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet and anticoagulant effects augmented by SNRI inhibition of platelet serotonin uptake and vitamin E content in selumetinib capsules)

• sepiapterin
Savella (milnacipran)

+

sepiapterin

1 interaction

Monitor/Modify Tx

milnacipran + sepiapterin

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• sevoflurane
Savella (milnacipran)

+

sevoflurane

1 interaction

Monitor/Modify Tx

milnacipran + sevoflurane

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• siponimod
Savella (milnacipran)

+

siponimod

1 interaction

Monitor/Modify Tx

milnacipran + siponimod

monitor BP: combo may incr. risk of HTN (additive effects)

• sirolimus albumin-bound
Savella (milnacipran)

+

sirolimus albumin-bound

1 interaction

Monitor/Modify Tx

milnacipran + sirolimus albumin-bound

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• solriamfetol
Savella (milnacipran)

+

solriamfetol

1 interaction

Monitor/Modify Tx

milnacipran + solriamfetol

monitor BP, HR: combo may incr. risk of HTN, tachycardia (additive effects)

• sorafenib
Savella (milnacipran)

+

sorafenib

1 interaction

Monitor/Modify Tx

milnacipran + sorafenib

monitor BP, bleeding s/sx: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• sotatercept
Savella (milnacipran)

+

sotatercept

1 interaction

Monitor/Modify Tx

milnacipran + sotatercept

monitor platelets, bleeding s/sx: combo may incr. risk of bleeding, including severe or life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• spironolactone
Savella (milnacipran)

+

spironolactone

1 interaction

Monitor/Modify Tx

milnacipran + spironolactone

monitor sodium, BP: combo may incr. risk of hyponatremia; may decr. antihypertensive agent efficacy (additive effects; antagonistic effects)

• sulfate bowel prep
Savella (milnacipran)

+

sulfate bowel prep

1 interaction

Monitor/Modify Tx

milnacipran + sulfate bowel prep

monitor sodium: combo may incr. risk of hyponatremia, seizures (additive effects)

• sulindac
Savella (milnacipran)

+

sulindac

1 interaction

Monitor/Modify Tx

milnacipran + sulindac

monitor BP, bleeding s/sx: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• sunitinib
Savella (milnacipran)

+

sunitinib

1 interaction

Monitor/Modify Tx

milnacipran + sunitinib

monitor BP, bleeding s/sx: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• suvorexant
Savella (milnacipran)

+

suvorexant

1 interaction

Monitor/Modify Tx

milnacipran + suvorexant

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• tacrolimus
Savella (milnacipran)

+

tacrolimus

1 interaction

Monitor/Modify Tx

milnacipran + tacrolimus

monitor BP: combo may incr. risk of HTN (additive effects)

• tagraxofusp
Savella (milnacipran)

+

tagraxofusp

1 interaction

Monitor/Modify Tx

milnacipran + tagraxofusp

monitor BP: combo may incr. risk of HTN (additive effects)

• telmisartan
Savella (milnacipran)

+

telmisartan

1 interaction

Monitor/Modify Tx

milnacipran + telmisartan

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• temazepam
Savella (milnacipran)

+

temazepam

1 interaction

Monitor/Modify Tx

milnacipran + temazepam

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• temsirolimus
Savella (milnacipran)

+

temsirolimus

1 interaction

Monitor/Modify Tx

milnacipran + temsirolimus

monitor bleeding signs/symptoms: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• tenecteplase
Savella (milnacipran)

+

tenecteplase

1 interaction

Monitor/Modify Tx

milnacipran + tenecteplase

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• terazosin
Savella (milnacipran)

+

terazosin

1 interaction

Monitor/Modify Tx

milnacipran + terazosin

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• terbutaline
Savella (milnacipran)

+

terbutaline

1 interaction

Monitor/Modify Tx

milnacipran + terbutaline

monitor BP, HR: combo may incr. risk of HTN, tachycardia, other cardiovascular adverse effects (additive effects)

• teriflunomide
Savella (milnacipran)

+

teriflunomide

1 interaction

Monitor/Modify Tx

milnacipran + teriflunomide

monitor BP: combo may incr. risk of HTN (additive effects)

• testosterone
Savella (milnacipran)

+

testosterone

1 interaction

Monitor/Modify Tx

milnacipran + testosterone

monitor BP: combo may incr. risk of HTN (additive effects)

• thioridazine
Savella (milnacipran)

+

thioridazine

1 interaction

Monitor/Modify Tx

milnacipran + thioridazine

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• thiothixene
Savella (milnacipran)

+

thiothixene

1 interaction

Monitor/Modify Tx

milnacipran + thiothixene

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• thyroid
Savella (milnacipran)

+

thyroid

1 interaction

Monitor/Modify Tx

milnacipran + thyroid

monitor BP, HR: combo may incr. risk of HTN, tachycardia (additive effects)

• ticagrelor
Savella (milnacipran)

+

ticagrelor

1 interaction

Monitor/Modify Tx

milnacipran + ticagrelor

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• timolol
Savella (milnacipran)

+

timolol

1 interaction

Monitor/Modify Tx

milnacipran + timolol

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• tipranavir
Savella (milnacipran)

+

tipranavir

1 interaction

Monitor/Modify Tx

milnacipran + tipranavir

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• tirofiban
Savella (milnacipran)

+

tirofiban

1 interaction

Monitor/Modify Tx

milnacipran + tirofiban

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• tisotumab vedotin
Savella (milnacipran)

+

tisotumab vedotin

1 interaction

Monitor/Modify Tx

milnacipran + tisotumab vedotin

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• tivozanib
Savella (milnacipran)

+

tivozanib

1 interaction

Monitor/Modify Tx

milnacipran + tivozanib

monitor BP, bleeding s/sx: combo may incr. risk HTN (including hypertensive crisis), GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• tolmetin
Savella (milnacipran)

+

tolmetin

1 interaction

Monitor/Modify Tx

milnacipran + tolmetin

monitor BP, bleeding s/sx: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• torsemide
Savella (milnacipran)

+

torsemide

1 interaction

Monitor/Modify Tx

milnacipran + torsemide

monitor BP, sodium: combo may incr. risk of hyponatremia; may decr. antihypertensive agent efficacy (additive effects; antagonistic effects)

• tovorafenib
Savella (milnacipran)

+

tovorafenib

1 interaction

Monitor/Modify Tx

milnacipran + tovorafenib

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• trametinib
Savella (milnacipran)

+

trametinib

1 interaction

Monitor/Modify Tx

milnacipran + trametinib

monitor BP, bleeding s/sx, especially w/ concomitant dabrafenib use: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• trandolapril
Savella (milnacipran)

+

trandolapril

1 interaction

Monitor/Modify Tx

milnacipran + trandolapril

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• treprostinil
Savella (milnacipran)

+

treprostinil

1 interaction

Monitor/Modify Tx

milnacipran + treprostinil

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• triamcinolone
Savella (milnacipran)

+

triamcinolone

1 interaction

Monitor/Modify Tx

milnacipran + triamcinolone

monitor BP: combo may incr. risk of HTN (additive effects)

• triamterene
Savella (milnacipran)

+

triamterene

1 interaction

Monitor/Modify Tx

milnacipran + triamterene

monitor BP, sodium: combo may incr. risk of hyponatremia; may decr. antihypertensive agent efficacy (additive effects; antagonistic effects)

• triazolam
Savella (milnacipran)

+

triazolam

1 interaction

Monitor/Modify Tx

milnacipran + triazolam

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• trospium
Savella (milnacipran)

+

trospium

1 interaction

Monitor/Modify Tx

milnacipran + trospium

monitor HR: combo may incr. risk of tachycardia, CNS depression, psychomotor impairment (additive effects)

• ubrogepant
Savella (milnacipran)

+

ubrogepant

1 interaction

Monitor/Modify Tx

milnacipran + ubrogepant

monitor BP: combo may incr. risk of HTN (additive effects)

• upadacitinib
Savella (milnacipran)

+

upadacitinib

1 interaction

Monitor/Modify Tx

milnacipran + upadacitinib

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• vadadustat
Savella (milnacipran)

+

vadadustat

1 interaction

Monitor/Modify Tx

milnacipran + vadadustat

monitor BP, bleeding s/sx: combo may incr. risk of HTN (including hypertensive effects), GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• valproic acid
Savella (milnacipran)

+

valproic acid

1 interaction

Monitor/Modify Tx

milnacipran + valproic acid

monitor bleeding s/sx: combo may incr. risk of bleeding (including life-threatening), CNS depression, psychomotor impairment; may alter seizure control (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake; antagonistic effects, milnacipran may decr. seizure threshold)

• valsartan
Savella (milnacipran)

+

valsartan

1 interaction

Monitor/Modify Tx

milnacipran + valsartan

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• vamorolone
Savella (milnacipran)

+

vamorolone

1 interaction

Monitor/Modify Tx

milnacipran + vamorolone

monitor BP: combo may incr. risk of HTN (additive effects)

• vandetanib
Savella (milnacipran)

+

vandetanib

1 interaction

Monitor/Modify Tx

milnacipran + vandetanib

monitor BP, bleeding s/sx: combo may incr. risk of HTN, bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• vasopressin
Savella (milnacipran)

+

vasopressin

1 interaction

Monitor/Modify Tx

milnacipran + vasopressin

monitor BP, sodium: combo may incr. risk of HTN, hyponatremia (additive effects)

• verapamil
Savella (milnacipran)

+

verapamil

1 interaction

Monitor/Modify Tx

milnacipran + verapamil

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

• vilanterol inhaled
Savella (milnacipran)

+

vilanterol inhaled

1 interaction

Monitor/Modify Tx

milnacipran + vilanterol inhaled

monitor BP, HR: combo may incr. risk of HTN, tachycardia, other cardiovascular adverse effects (additive effects)

• viloxazine
Savella (milnacipran)

+

viloxazine

1 interaction

Monitor/Modify Tx

milnacipran + viloxazine

monitor BP, HR: combo may incr. risk of HTN, tachycardia, CNS depression, psychomotor impairment (additive effects)

• vinpocetine
Savella (milnacipran)

+

vinpocetine

1 interaction

Monitor/Modify Tx

milnacipran + vinpocetine

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• voclosporin
Savella (milnacipran)

+

voclosporin

1 interaction

Monitor/Modify Tx

milnacipran + voclosporin

monitor BP: combo may incr. risk of HTN (additive effects)

• vorapaxar
Savella (milnacipran)

+

vorapaxar

1 interaction

Monitor/Modify Tx

milnacipran + vorapaxar

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• warfarin
Savella (milnacipran)

+

warfarin

1 interaction

Monitor/Modify Tx

milnacipran + warfarin

monitor INR, bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (synergistic effects, anticoagulant effects augmented by inhibition of platelet serotonin uptake)

• willow bark
Savella (milnacipran)

+

willow bark

1 interaction

Monitor/Modify Tx

milnacipran + willow bark

monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake; willow bark may contain salicylates)

• zaleplon
Savella (milnacipran)

+

zaleplon

1 interaction

Monitor/Modify Tx

milnacipran + zaleplon

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• zanubrutinib
Savella (milnacipran)

+

zanubrutinib

1 interaction

Monitor/Modify Tx

milnacipran + zanubrutinib

monitor bleeding s/sx: combo may incr. risk of bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• zavegepant
Savella (milnacipran)

+

zavegepant

1 interaction

Monitor/Modify Tx

milnacipran + zavegepant

monitor BP: combo may incr. risk of HTN (additive effects)

• ziconotide
Savella (milnacipran)

+

ziconotide

1 interaction

Monitor/Modify Tx

milnacipran + ziconotide

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• ziv-aflibercept
Savella (milnacipran)

+

ziv-aflibercept

1 interaction

Monitor/Modify Tx

milnacipran + ziv-aflibercept

monitor BP, bleeding s/sx: combo may incr. risk of HTN, GI or other bleeding, including life-threatening (additive effects, antiplatelet effects augmented by inhibition of platelet serotonin uptake)

• zolpidem
Savella (milnacipran)

+

zolpidem

1 interaction

Monitor/Modify Tx

milnacipran + zolpidem

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)