Levomilnacipran interactions

Intervention: Avoid concomitant use of FETZIMA and alcohol [see Clinical Pharmacology ( 12.3 )] . (Levomilnacipran label, Drug interactions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

Discontinue treatment with ADDERALL XR and any concomitant serotonergic agents immediately if symptoms of serotonin syndrome occur, and initiate supportive symptomatic treatment. (Amphetamine and dextroamphetamine label, Warnings and precautions)

Serotonin Syndrome Serotonin-norepinephrine reuptake inhibitors (SNRIs), including FETZIMA, can precipitate serotonin syndrome, a potentially life-threatening condition. (Levomilnacipran label, Warnings and precautions)

Serotonergic Drugs : Concomitant use may result in serotonin syndrome. (Buprenorphine label, Drug interactions)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

…medical attention if they ‎experience symptoms of hyperalgesia, including worsening pain, increased ‎sensitivity to pain, or new pain [see WARNINGS ; ADVERSE REACTIONS ].‎ Serotonin Syndrome Inform patients that butorphanol tartrate could cause a rare but potentially life-threatening condition resulting from concomitant administration of serotonergic drugs. (Butorphanol label, Precautions)

Known hypersensitivity to tricyclic antidepressants ( 4 ) (Carbamazepine label, Contraindications)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

• Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Codeine label, Drug interactions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

…(12.3) ] • Concomitant use of drugs or herbal products that prolong the QT interval and might increase the risk of torsade de pointes, such as phenothiazine antipsychotics, tricyclic antidepressants, certain oral macrolide antibiotics, and Class I and III antiarrhythmics • Liver or lung toxicity related to the previous use of amiodarone • QTc interval >500 ms or… (Dronedarone label, Contraindications)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

Anticoagulants, Antiplatelets, Thrombolytics, and Selective Serotonin Reuptake Inhibitors (SSRIs)/Serotonin Norepinephrine Reuptake Inhibitors (SNRIs): Avoid concomitant use due to increased risk of bleeding. (Edoxaban label, Drug interactions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

• Serotonin Syndrome : Potentially life-threatening condition could result from concomitant serotonergic drug administration. (Fentanyl label, Warnings and precautions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

Serotonin Syndrome Inform patients that hydrocodone bitartrate and acetaminophen tablets could cause a rare but potentially life-threatening condition resulting from concomitant administration of serotonergic drugs. (Hydrocodone and acetaminophen label, Precautions)

• Serotonergic Drugs : Concomitant use may result in serotonin syndrome. (Hydromorphone label, Drug interactions)

FETZIMA is contraindicated: in patients with hypersensitivity to levomilnacipran, milnacipran HCl, or to any excipient in the formulation. with the use of MAOIs intended to treat psychiatric disorders with FETZIMA or within 7 days of stopping treatment with FETZIMA is contraindicated because of an increased risk of serotonin syndrome. (Levomilnacipran label, Contraindications)

Serotonin Syndrome Inform patients that opioids could cause a rare but potentially life-threatening condition resulting from concomitant administration of serotonergic drugs. (Levorphanol label, Precautions)

Starting FETZIMA in a patient who is being treated with MAOIs such as linezolid or intravenous methylene blue is also contraindicated because of an increased risk of serotonin syndrome [see Dosage and Administration ( 2.6 ) and Warnings and Precautions ( 5.2 )] . (Levomilnacipran label, Contraindications)

• Serotonin Syndrome: Increased risk when co-administered with serotonergic agents (e.g., SSRIs, SNRIs, triptans), but also during overdosage situations. (Lisdexamfetamine label, Warnings and precautions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

LOREEV XR should not be used in such patients without adequate antidepressant therapy. (Lorazepam label, Warnings and precautions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

Serotonin Syndrome : Potentially life-threatening condition could result from concomitant serotonergic drug administration. (Methadone label, Warnings and precautions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

• Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Morphine label, Drug interactions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

Serotonergic Drugs : Concomitant use may result in serotonin syndrome. (Oliceridine label, Drug interactions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

Serotonergic Drug s: Concomitant use may result in serotonin syndrome. (Oxycodone label, Drug interactions)

Serotonergic Drugs : Concomitant use may result in serotonin syndrome. (Oxymorphone label, Drug interactions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

Serotonin Syndrome Inform patients that opioids could cause a rare but potentially life-threatening condition resulting from concomitant administration of serotonergic drugs. (Pentazocine and naloxone label, Precautions)

FETZIMA is contraindicated: in patients with hypersensitivity to levomilnacipran, milnacipran HCl, or to any excipient in the formulation. with the use of MAOIs intended to treat psychiatric disorders with FETZIMA or within 7 days of stopping treatment with FETZIMA is contraindicated because of an increased risk of serotonin syndrome. (Levomilnacipran label, Contraindications)

…prolong, or intensify the sedative action of other central-nervous-system depressants, such as alcohol, sedatives/hypnotics (including barbiturates), narcotics, narcotic analgesics, general anesthetics, tricyclic antidepressants, and tranquilizers; therefore, such agents should be avoided or administered in reduced dosage to patients receiving promethazine HCl. (Promethazine label, Drug interactions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

FETZIMA is contraindicated: in patients with hypersensitivity to levomilnacipran, milnacipran HCl, or to any excipient in the formulation. with the use of MAOIs intended to treat psychiatric disorders with FETZIMA or within 7 days of stopping treatment with FETZIMA is contraindicated because of an increased risk of serotonin syndrome. (Levomilnacipran label, Contraindications)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

FETZIMA is contraindicated: in patients with hypersensitivity to levomilnacipran, milnacipran HCl, or to any excipient in the formulation. with the use of MAOIs intended to treat psychiatric disorders with FETZIMA or within 7 days of stopping treatment with FETZIMA is contraindicated because of an increased risk of serotonin syndrome. (Levomilnacipran label, Contraindications)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

Combining St. John's wort with antidepressants and other serotonergic drugs increases the risk of serotonin syndrome. (NCCIH, St. John's Wort)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

FETZIMA is contraindicated: in patients with hypersensitivity to levomilnacipran, milnacipran HCl, or to any excipient in the formulation. with the use of MAOIs intended to treat psychiatric disorders with FETZIMA or within 7 days of stopping treatment with FETZIMA is contraindicated because of an increased risk of serotonin syndrome. (Levomilnacipran label, Contraindications)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

Serotonin Syndrome Serotonin-norepinephrine reuptake inhibitors (SNRIs), including FETZIMA, can precipitate serotonin syndrome, a potentially life-threatening condition. (Levomilnacipran label, Warnings and precautions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

• Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Ziprasidone label, Warnings and precautions)

Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)

Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk. (Levomilnacipran label, Warnings and precautions)

Monoamine oxidase inhibitors and tricyclic antidepressants: Use with extreme caution. (Albuterol label, Drug interactions)

Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk. (Levomilnacipran label, Warnings and precautions)

Strong CYP3A4 inhibitors : Maximum recommended dosage is 80 mg once daily ( 7 ). (Levomilnacipran label, Drug interactions)

Increased Risk of Bleeding : Concomitant use of NSAIDs, aspirin, other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.5 ). (Levomilnacipran label, Warnings and precautions)

Strong CYP3A4 inhibitors : Maximum recommended dosage is 80 mg once daily ( 7 ). (Levomilnacipran label, Drug interactions)

The risk is increased with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, meperidine, methadone, tryptophan, buspirone, amphetamines, and St. (Levomilnacipran label, Warnings and precautions)

Inform patients about the increased risk of bleeding associated with the concomitant use of FETZIMA and NSAIDs, aspirin, or other drugs that affect coagulation [see Drug Interactions ( 7.1 )] . (Levomilnacipran label, Warnings and precautions)

Inform patients about the increased risk of bleeding associated with the concomitant use of FETZIMA and NSAIDs, aspirin, or other drugs that affect coagulation [see Drug Interactions ( 7.1 )] . (Levomilnacipran label, Warnings and precautions)

Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk. (Levomilnacipran label, Warnings and precautions)

Caution is advised in patients taking tricyclic antidepressants which can affect the metabolism and uptake of circulating amines. (Brimonidine label, Drug interactions)

Monoamine oxidase inhibitors and tricyclic antidepressants: Use with extreme caution. (Budesonide and formoterol label, Drug interactions)

Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk. (Levomilnacipran label, Warnings and precautions)

…hydrochloride extended-release tablets (XL), concurrent administration of bupropion hydrochloride extended-release tablets (XL) and agents that lower the seizure threshold (e.g., other bupropion products, antipsychotics, antidepressants, theophylline, or systemic corticosteroids) should be undertaken only with extreme caution [see Warnings and Precautions (5.3)] . (Bupropion label, Drug interactions)

The risk is increased with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, meperidine, methadone, tryptophan, buspirone, amphetamines, and St. (Levomilnacipran label, Warnings and precautions)

Since the sedative effects of carisoprodol and other CNS depressants (e.g., alcohol, benzodiazepines, opioids, tricyclic antidepressants) may be additive, appropriate caution should be exercised with patients who take more than one of these CNS depressants simultaneously. (Carisoprodol label, Warnings and precautions)

Increased Risk of Bleeding : Concomitant use of NSAIDs, aspirin, other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.5 ). (Levomilnacipran label, Warnings and precautions)

Strong CYP3A4 inhibitors : Maximum recommended dosage is 80 mg once daily ( 7 ). (Levomilnacipran label, Drug interactions)

Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk. (Levomilnacipran label, Warnings and precautions)

Increased Risk of Bleeding : Concomitant use of NSAIDs, aspirin, other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.5 ). (Levomilnacipran label, Warnings and precautions)

Strong CYP3A4 inhibitors : Maximum recommended dosage is 80 mg once daily ( 7 ). (Levomilnacipran label, Drug interactions)

…syndrome, uncorrected electrolyte imbalance, such as hypokalemia or hypomagnesemia and cardiac disease, such as heart failure, myocardial infarction, or bradycardia), and patients receiving Class IA antiarrhythmic agents (quinidine, procainamide), or Class III antiarrhythmic agents (amiodarone, sotalol), tricyclic antidepressants, macrolides, and antipsychotics. (Ciprofloxacin label, Warnings and precautions)

Examples: Ketoconazole, itraconazole, clarithromycin Alcohol Clinical Impact: Concomitant use of FETZIMA and alcohol may result in accelerated release of levomilnacipran. (Levomilnacipran label, Drug interactions)

…Interactions The CNS-depressant action of the benzodiazepine class of drugs may be potentiated by alcohol, narcotics, barbiturates, nonbarbiturate hypnotics, antianxiety agents, the phenothiazines, thioxanthene and butyrophenone classes of antipsychotic agents, monoamine oxidase inhibitors and the tricyclic antidepressants, and by other anticonvulsant drugs. (Clonazepam label, Drug interactions)

Tricyclic antidepressants Clinical Implication Concomitant use of tricyclic antidepressants with clonidine can increase blood pressure and may counteract the hypotensive effects of clonidine. (Clonidine label, Drug interactions)

Increased Risk of Bleeding : Concomitant use of NSAIDs, aspirin, other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.5 ). (Levomilnacipran label, Warnings and precautions)

Strong CYP3A4 inhibitors : Maximum recommended dosage is 80 mg once daily ( 7 ). (Levomilnacipran label, Drug interactions)

Increased Risk of Bleeding : Concomitant use of NSAIDs, aspirin, other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.5 ). (Levomilnacipran label, Warnings and precautions)

Co-administration with other CNS depressants (e.g., benzodiazepines, opioids, tricyclic antidepressants, alcohol) increases the risk of CNS depression, which can cause daytime impairment. (Daridorexant label, Warnings and precautions)

Caution should be taken when darifenacin extended-release tablets is used concomitantly with medications that are predominantly metabolized by CYP2D6 and which have a narrow therapeutic window, such as flecainide, thioridazine and tricyclic antidepressants ( 7.2 ) (Darifenacin label, Drug interactions)

…that may Increase Risk of Hyponatremia Concomitant administration of DESMODA with other drugs that may increase the risk of water intoxication with hyponatremia, (e.g., tricyclic antidepressants, selective serotonin re-uptake inhibitors, chlorpromazine, opiate analgesics, thiazide diuretics, NSAIDs, lamotrigine, sulfonylureas, particularly chlorpropamide, oxybutynin… (Desmopressin label, Drug interactions)

The risk is increased with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, meperidine, methadone, tryptophan, buspirone, amphetamines, and St. (Levomilnacipran label, Warnings and precautions)

…be given to the pharmacology of the agents employed particularly with compounds that may potentiate or be potentiated by the action of Valium, such as phenothiazines, antipsychotics, anxiolytics/sedatives, hypnotics, anticonvulsants, narcotic analgesics, anesthetics, sedative antihistamines, narcotics, barbiturates, MAO inhibitors and other antidepressants. (Diazepam label, Drug interactions)

Increased Risk of Bleeding : Concomitant use of NSAIDs, aspirin, other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.5 ). (Levomilnacipran label, Warnings and precautions)

…drugs including dicyclomine hydrochloride: amantadine, antiarrhythmic agents of Class I (e.g., quinidine), antihistamines, antipsychotic agents (e.g., phenothiazines), benzodiazepines, MAO inhibitors, narcotic analgesics (e.g., meperidine), nitrates and nitrites, sympathomimetic agents, tricyclic antidepressants, and other drugs having anticholinergic activity. (Dicyclomine label, Drug interactions)

Strong CYP3A4 inhibitors : Maximum recommended dosage is 80 mg once daily ( 7 ). (Levomilnacipran label, Drug interactions)

Increased Risk of Bleeding : Concomitant use of NSAIDs, aspirin, other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.5 ). (Levomilnacipran label, Warnings and precautions)

Concomitant use of other drugs that cause dizziness, confusion, sedation, or somnolence such as CNS depressants may increase this effect (e.g., barbiturates, benzodiazepines, lithium, opioids, buspirone, scopolamine, antihistamines, tricyclic antidepressants, other anticholinergic agents, and muscle relaxants). (Dronabinol label, Warnings and precautions)

Increased Risk of Bleeding : Concomitant use of NSAIDs, aspirin, other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.5 ). (Levomilnacipran label, Warnings and precautions)

• Drugs that potentiate the effects of epinephrine include sympathomimetics, beta blockers, tricyclic antidepressants, MAO inhibitors, COMT inhibitors, clonidine, doxapram, oxytocin, levothyroxine sodium, and certain antihistamines. (Epinephrine label, Drug interactions)

Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk. (Levomilnacipran label, Warnings and precautions)

Strong CYP3A4 inhibitors : Maximum recommended dosage is 80 mg once daily ( 7 ). (Levomilnacipran label, Drug interactions)

Additive effects occur with concomitant use of other CNS depressants (e.g., benzodiazepines, opioids, tricyclic antidepressants, alcohol), including daytime use. (Eszopiclone label, Warnings and precautions)

Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk. (Levomilnacipran label, Warnings and precautions)

Increased Risk of Bleeding : Concomitant use of NSAIDs, aspirin, other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.5 ). (Levomilnacipran label, Warnings and precautions)

Strong CYP3A4 inhibitors : Maximum recommended dosage is 80 mg once daily ( 7 ). (Levomilnacipran label, Drug interactions)

Strong CYP3A4 inhibitors : Maximum recommended dosage is 80 mg once daily ( 7 ). (Levomilnacipran label, Drug interactions)

Monoamine oxidase inhibitors and tricyclic antidepressants: Use with extreme caution. (Fluticasone and salmeterol label, Drug interactions)

Increased Risk of Bleeding : Concomitant use of NSAIDs, aspirin, other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.5 ). (Levomilnacipran label, Warnings and precautions)

• MAO inhibitors, tricyclic antidepressants and drugs that prolong QTc interval may potentiate effect on the cardiovascular system. (Formoterol label, Drug interactions)

Avoid co-administration of CONTEPO with drugs known to prolong the QT interval, such as class IA or class III antiarrhythmic medications, tricyclic antidepressants, macrolides, and antipsychotics [see Warnings and Precautions ( 5.2 )] . (Fosfomycin label, Drug interactions)

Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk. (Levomilnacipran label, Warnings and precautions)

Other Anticholinergic Drugs There is potential for an additive interaction between glycopyrrolate and concomitantly used anticholinergic drugs (e.g., tricyclic antidepressants, anti-epileptics, class I antiarrhythmics, anti­-spasmodics, amantadine) resulting in increased anticholinergic adverse reactions. (Glycopyrrolate label, Drug interactions)

Increased Risk of Bleeding : Concomitant use of NSAIDs, aspirin, other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.5 ). (Levomilnacipran label, Warnings and precautions)

Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk. (Levomilnacipran label, Warnings and precautions)

Increased Risk of Bleeding : Concomitant use of NSAIDs, aspirin, other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.5 ). (Levomilnacipran label, Warnings and precautions)

Strong CYP3A4 inhibitors : Maximum recommended dosage is 80 mg once daily ( 7 ). (Levomilnacipran label, Drug interactions)

Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk. (Levomilnacipran label, Warnings and precautions)

Increased Risk of Bleeding : Concomitant use of NSAIDs, aspirin, other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.5 ). (Levomilnacipran label, Warnings and precautions)

Examples: Ketoconazole, itraconazole, clarithromycin Alcohol Clinical Impact: Concomitant use of FETZIMA and alcohol may result in accelerated release of levomilnacipran. (Levomilnacipran label, Drug interactions)

Strong CYP3A4 inhibitors : Maximum recommended dosage is 80 mg once daily ( 7 ). (Levomilnacipran label, Drug interactions)

Examples: Ketoconazole, itraconazole, clarithromycin Alcohol Clinical Impact: Concomitant use of FETZIMA and alcohol may result in accelerated release of levomilnacipran. (Levomilnacipran label, Drug interactions)

Increased Risk of Bleeding : Concomitant use of NSAIDs, aspirin, other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.5 ). (Levomilnacipran label, Warnings and precautions)

Co-administration with other CNS depressants (e.g., benzodiazepines, opioids, tricyclic antidepressants, alcohol) increases the risk of CNS depression, which can cause daytime impairment. (Lemborexant label, Warnings and precautions)

Monoamine oxidase inhibitors (MAOs) or tricyclic antidepressants : May potentiate effect of albuterol on the cardiovascular system. (Levalbuterol label, Drug interactions)

Antidepressant Therapy Concurrent use of tricyclic (e.g., amitriptyline) or tetracyclic (e.g., maprotiline) antidepressants and levothyroxine may increase the therapeutic and toxic effects of both drugs, possibly due to increased receptor sensitivity to catecholamines. (Levothyroxine label, Drug interactions)

Clinically Significant Drug Interactions The administration of local anesthetic solutions containing epinephrine or norepinephrine to patients receiving monoamine oxidase inhibitors or tricyclic antidepressants may produce severe, prolonged hypertension. (Lidocaine label, Drug interactions)

Antidepressant Therapy Concurrent use of tricyclic (e.g., amitriptyline) or tetracyclic (e.g., maprotiline) antidepressants and liothyronine sodium may increase the therapeutic and toxic effects of both drugs, possibly due to increased receptor sensitivity to catecholamines. (Liothyronine label, Drug interactions)

Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk. (Levomilnacipran label, Warnings and precautions)

Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk. (Levomilnacipran label, Warnings and precautions)

Monitor all antidepressant-treated patients, especially during the initial few months of anti-depressant drug therapy, and at times of dosage changes. (Lumateperone label, Warnings and precautions)

Activation of Mania/Hypomania Antidepressant treatment can increase the risk of developing a manic or hypomanic episode, particularly in patients with bipolar disorder. (Lurasidone label, Warnings and precautions)

Increased Risk of Bleeding : Concomitant use of NSAIDs, aspirin, other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.5 ). (Levomilnacipran label, Warnings and precautions)

The risk is increased with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, meperidine, methadone, tryptophan, buspirone, amphetamines, and St. (Levomilnacipran label, Warnings and precautions)

Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk. (Levomilnacipran label, Warnings and precautions)

Strong CYP3A4 inhibitors : Maximum recommended dosage is 80 mg once daily ( 7 ). (Levomilnacipran label, Drug interactions)

The risk is increased with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, meperidine, methadone, tryptophan, buspirone, amphetamines, and St. (Levomilnacipran label, Warnings and precautions)

Pharmacokinetic studies between moxifloxacin and other drugs that prolong the QT interval such as cisapride, erythromycin, antipsychotics, and tricyclic antidepressants have not been performed. (Moxifloxacin label, Warnings and precautions)

Increased Risk of Bleeding : Concomitant use of NSAIDs, aspirin, other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.5 ). (Levomilnacipran label, Warnings and precautions)

Serotonergic Drugs The concomitant use of opioids with other drugs that affect the serotonergic neurotransmitter system, such as selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), triptans, 5-HT3 receptor antagonists, drugs that effect the serotonin neurotransmitter system… (Nalbuphine label, Drug interactions)

Increased Risk of Bleeding : Concomitant use of NSAIDs, aspirin, other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.5 ). (Levomilnacipran label, Warnings and precautions)

Strong CYP3A4 inhibitors : Maximum recommended dosage is 80 mg once daily ( 7 ). (Levomilnacipran label, Drug interactions)

Strong CYP3A4 inhibitors : Maximum recommended dosage is 80 mg once daily ( 7 ). (Levomilnacipran label, Drug interactions)

Strong CYP3A4 inhibitors : Maximum recommended dosage is 80 mg once daily ( 7 ). (Levomilnacipran label, Drug interactions)

The risk is increased with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, meperidine, methadone, tryptophan, buspirone, amphetamines, and St. (Levomilnacipran label, Warnings and precautions)

The risk is increased with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, meperidine, methadone, tryptophan, buspirone, amphetamines, and St. (Levomilnacipran label, Warnings and precautions)

Agonistic Effects (increase in BIORPHEN blood pressure effect) can occur with monoamine oxidase inhibitors (MAOI), oxytocin and oxytocic drugs, tricyclic antidepressants, angiotensin and aldosterone, atropine, steroids, norepinephrine transporter inhibitors, ergot alkaloids. (Phenylephrine label, Drug interactions)

…Ethosuximide, felbamate, oxcarbazepine, methsuximide, topiramate Azoles Fluconazole, ketoconazole, itraconazole, miconazole, voriconazole Antineoplastic agents Capecitabine, fluorouracil Antidepressants Fluoxetine, fluvoxamine, sertraline Gastric acid reducing agents H 2 antagonists (cimetidine), omeprazole Sulfonamides Sulfamethizole, sulfaphenazole, sulfadiazine,… (Phenytoin label, Drug interactions)

Strong CYP3A4 inhibitors : Maximum recommended dosage is 80 mg once daily ( 7 ). (Levomilnacipran label, Drug interactions)

Increased Risk of Bleeding : Concomitant use of NSAIDs, aspirin, other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.5 ). (Levomilnacipran label, Warnings and precautions)

It is generally believed (though not established in controlled trials) that treating such an episode with an antidepressant alone may increase the likelihood of precipitation of a mixed/manic episode in patients at risk for bipolar disorder. (Quetiapine label, Warnings and precautions)

Strong CYP3A4 inhibitors : Maximum recommended dosage is 80 mg once daily ( 7 ). (Levomilnacipran label, Drug interactions)

…5-HT3 Receptor Antagonists Ondansetron Decrease exposure Statins Metabolized by CYP3A4 Simvastatin Decrease exposure Thiazolidinediones Rosiglitazone Decrease AUC by 66% Tricyclic Antidepressants Nortriptyline A tuberculosis treatment regimen including rifampin (600 mg/day), isoniazid (300 mg/day), pyrazinamide (500 mg 3× per day), and pyridoxine (25 mg) was… (Rifampin label, Drug interactions)

Strong CYP3A4 inhibitors : Maximum recommended dosage is 80 mg once daily ( 7 ). (Levomilnacipran label, Drug interactions)

Increased Risk of Bleeding : Concomitant use of NSAIDs, aspirin, other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.5 ). (Levomilnacipran label, Warnings and precautions)

• Monoamine oxidase inhibitors and tricyclic antidepressants: Use with extreme caution. (Salmeterol label, Drug interactions)

Concomitant use of other drugs that cause central nervous system (CNS) adverse reactions (e.g., alcohol, sedatives, hypnotics, opiates, and anxiolytics) or have anticholinergic properties (e.g., other belladonna alkaloids, sedating antihistamines, meclizine, tricyclic antidepressants, and muscle relaxants) may increase this effect [see Drug Interactions ( 7.1 )] . (Scopolamine label, Warnings and precautions)

The concurrent use of Xyrem with other CNS depressants, including but not limited to opioid analgesics, benzodiazepines, sedating antidepressants or antipsychotics, sedating anti-epileptic drugs, general anesthetics, muscle relaxants, and/or illicit CNS depressants, may increase the risk of respiratory depression, hypotension, profound sedation, syncope, and… (Sodium oxybate label, Warnings and precautions)

Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk. (Levomilnacipran label, Warnings and precautions)

Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk. (Levomilnacipran label, Warnings and precautions)

The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

Strong CYP3A4 inhibitors : Maximum recommended dosage is 80 mg once daily ( 7 ). (Levomilnacipran label, Drug interactions)

The benzodiazepines, including temazepam, produce additive CNS-depressant effects when co-administered with other CNS depressants such as alcohol, barbiturates, antipsychotics, sedative/hypnotics, anxiolytics, antidepressants, narcotic analgesics, sedative antihistamines, anticonvulsants, and anesthetics. (Temazepam label, Drug interactions)

Monoamine Oxidase Inhibitors and Tricyclic Antidepressants Terbutaline sulfate should be administered with extreme caution to patients being treated with monoamine oxidase inhibitors or tricyclic antidepressants, or within 2 weeks of discontinuation of such agents, since the action of terbutaline sulfate on the vascular system may be potentiated. (Terbutaline label, Precautions)

Increased Risk of Bleeding : Concomitant use of NSAIDs, aspirin, other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.5 ). (Levomilnacipran label, Warnings and precautions)

The CNS depressant effects of Zanaflex with alcohol and other CNS depressants (e.g., benzodiazepines, opioids, tricyclic antidepressants) may be additive [see Drug Interactions ( 7.4 )] . (Tizanidine label, Warnings and precautions)

Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk. (Levomilnacipran label, Warnings and precautions)

Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk. (Levomilnacipran label, Warnings and precautions)

Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk. (Levomilnacipran label, Warnings and precautions)

• Monoamine oxidase inhibitors and tricyclic antidepressants: Use with extreme caution. (Umeclidinium and vilanterol label, Drug interactions)

Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk. (Levomilnacipran label, Warnings and precautions)

Strong CYP3A4 inhibitors : Maximum recommended dosage is 80 mg once daily ( 7 ). (Levomilnacipran label, Drug interactions)

Strong CYP3A4 inhibitors : Maximum recommended dosage is 80 mg once daily ( 7 ). (Levomilnacipran label, Drug interactions)

Examples: NSAIDs, aspirin, and warfarin Strong CYP3A4 Inhibitors Clinical Impact: Concomitant use of FETZIMA with strong CYP3A4 inhibitors increases levomilnacipran exposure [see Pharmacokinetics ( 12.3 )] . (Levomilnacipran label, Drug interactions)

Coadministration with other CNS depressants (e.g., benzodiazepines, opioids, tricyclic antidepressants, alcohol) increases the risk of CNS depression. (Zaleplon label, Warnings)

Additive effects occur with concomitant use of other CNS depressants (e.g., benzodiazepines, opioids, tricyclic antidepressants, alcohol), including daytime use [see Drug Interactions (7.1) ] . (Zolpidem label, Warnings and precautions)

Paralytic ileus, hyperthermia and heat stroke, all of which have sometimes been fatal, have occurred in patients taking anticholinergic-type antiparkinsonism drugs, including benztropine mesylate, in combination with phenothiazines and/or tricyclic antidepressants. (Benztropine label, Warnings)

However, there is substantial evidence from placebo-controlled maintenance studies in adults with MDD that antidepressants delay the recurrence of depression. (Brexpiprazole label, Warnings and precautions)

…placebo-controlled trials of adult patients with major depressive disorder, the proportion of patients with shifts in fasting glucose from normal (<100 mg/dL) to high (≥126 mg/dL) was greatest in the VRAYLAR 3 mg per day + antidepressant therapy arm (3.2%) compared with those taking VRAYLAR 1.5 mg per day + antidepressant therapy (2%) or those placebo-treated (1.3%). (Cariprazine label, Warnings and precautions)

Such drugs include specific antidepressants, phenothiazines, carbamazepine, and Type 1C antiarrhythmics (e.g., propafenone, flecainide, and encainide). (Clozapine label, Drug interactions)

In contrast, drugs that are inhibitors of cytochrome P450 isozymes, e.g., antidepressants, may be expected to have little effect on valproate clearance because cytochrome P450 microsomal mediated oxidation is a relatively minor secondary metabolic pathway compared to glucuronidation and beta-oxidation. (Divalproex (valproate) label, Drug interactions)

Such drugs include phenothiazines, cisapride, bepridil, tricyclic antidepressants, certain oral macrolides, and certain fluoroquinolones. (Dofetilide label, Warnings)

Examples: other SNRIs, SSRIs, triptans, tricyclic antidepressants, opioids, lithium, buspirone, amphetamines, tryptophan, and St. (Levomilnacipran label, Drug interactions)

…quinidine, procainamide) or Class III (e.g., amiodarone, sotalol) antiarrhythmics, certain antipsychotics (e.g., ziprasidone, iloperidone, clozapine, quetiapine, chlorpromazine), certain antidepressants (e.g., citalopram, fluoxetine), certain antibiotics (e.g., azithromycin, erythromycin, clarithromycin, gatifloxacin, moxifloxacin); and others (e.g., pentamidine, methadone,… (Hydroxyzine label, Precautions)

These include itraconazole, ketoconazole, posaconazole, voriconazole, the macrolide antibiotics erythromycin and clarithromycin, the ketolide antibiotic telithromycin, HIV protease inhibitors, boceprevir, telaprevir, the antidepressant nefazodone, or cobicistat-containing products. (Lovastatin label, Warnings)

Activation of mania/hypomania has also been reported in a small proportion of patients with mood disorders who were treated with other antidepressants. (Levomilnacipran label, Warnings and precautions)

Examples: other SNRIs, SSRIs, triptans, tricyclic antidepressants, opioids, lithium, buspirone, amphetamines, tryptophan, and St. (Levomilnacipran label, Drug interactions)

Such drugs may include many antiarrhythmics, some phenothiazines, tricyclic antidepressants, and oral macrolides. (Propafenone label, Warnings and precautions)

Antidepressants: The hypotensive effect of MAO inhibitors or tricyclic antidepressants may be exacerbated when administered with beta-blockers. (Propranolol label, Drug interactions)

Drugs predominantly metabolized by the CYP450 2D6 isozyme include the following drug classes: tricyclic antidepressants, selective serotonin reuptake inhibitors, beta-blockers, antiarrhythmics class 1C (e.g., flecainide and propafenone) and monoamine oxidase inhibitors Type B. (Terbinafine label, Drug interactions)

In most cases, patients were using concomitant medications (antidepressants, antipsychotics, stimulants, narcotics) that are thought to lower the seizure threshold. (Tiagabine label, Warnings)

Monoamine oxidase inhibitors and tricyclic antidepressants possessing significant anticholinergic activity may intensify the anticholinergic effects of antidyskinetic agents because of the secondary anticholinergic activities of these medications. (Trihexyphenidyl label, Drug interactions)

In contrast, drugs that are inhibitors of cytochrome P450 isozymes, e.g., antidepressants, may be expected to have little effect on valproate clearance because cytochrome P450 microsomal mediated oxidation is a relatively minor secondary metabolic pathway compared to glucuronidation and beta-oxidation. (Valproic acid label, Drug interactions)

Commonly Administered Drugs: Population analysis showed that commonly administered drugs (e.g., selegiline, amantadine, tricyclic antidepressants, benzodiazepines, ibuprofen, thiazides, antihistamines, anticholinergics) did not affect the clearance of ropinirole. (Ropinirole label, Drug interactions)