Levomilnacipran and Linezolid interaction
Levomilnacipran and Linezolid: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.
What the FDA labels say
From the Levomilnacipran (Fetzima) label · effective 2024-04-30
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 )] .
In addition, do not start FETZIMA in a patient who is being treated with linezolid or intravenous methylene blue ( 4 ).
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.
The use of FETZIMA within 14 days of stopping an MAOI intended to treat psychiatric disorders is also contraindicated [see Dosage and Administration ( 2.5 ) and Warnings and Precautions ( 5.2 )] .
Do not use MAOIs intended to treat psychiatric disorders with FETZIMA or within 7 days of stopping treatment with FETZIMA.
From the Linezolid label · effective 2026-06-19
• Serotonin Syndrome: Monitor patients taking Linezolid injection concomitantly with serotonergic agents for signs of serotonin syndrome.
If signs or symptoms of serotonin syndrome occur, consider discontinuing Linezolid injection and/or concomitant serotonergic agents.
Serotonin Syndrome Spontaneous reports of serotonin syndrome including fatal cases associated with the concomitant use of linezolid and serotonergic agents have been reported.
Monitor patients for the emergence of serotonin syndrome with the concomitant use of Linezolid injection and serotonergic agents or with use of Linezolid injection in patients with carcinoid syndrome.
Inform patients of the increased risk of serotonin syndrome when Linezolid injection is used concomitantly with serotonergic agents.
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Open in the checkerNot medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.