Fetzima Drug Interactions

When alcohol, diuretics, or medicines that thin the blood are taken with Fetzima, interactions may occur. When a drug interaction occurs, the levels of the medication in your blood can increase and side effects, such as hallucinations, a fast heartbeat, and seizures, may occur. The effectiveness of the medicines may also be decreased.

An Overview of Interactions With Fetzima

Fetzima™ (levomilnacipran) can potentially react with a number of medicines. Some of the products that can lead to Fetzima drug interactions include:

Alcohol
CYP 3A4 inducer medications, such as:
- Aminoglutethimide (Cytadren^®)
- Bosentan (Tracleer^®)
- Carbamazepine (Carbatrol^®, Epitol^®, Equetro^®, Tegretol^®)
- Dexamethasone (Decadron^®, Dexpak^®, Maxidex^®)
- Efavirenz (Sustiva^®)
- Efavirenz, emtricitabine, and tenofovir (Atripla^®)
- Etravirine (Intelence™)
- Fosphenytoin (Cerebyx^®)
- Nafcillin
- Nevirapine (Viramune^®)
- Oxcarbazepine (Trileptal^®)
- Pentobarbital (Nembutal^®)
- Phenobarbital (Luminal^®)
- Phenytoin (Dilantin^®, Phenytek^®)
- Primidone (Mysoline^®)
- Rifabutin (Mycobutin^®)
- Rifampin (Rifadin^®)
- Rifapentine (Priftin^®)
- St. John's wort

CYP 3A4 inhibitor medications, such as:
- Amprenavir (Agenerase^®)
- Aprepitant (Emend^®)
- Atazanavir (Reyataz^®)
- Clarithromycin (Biaxin^®)
- Conivaptan (Vaprisol^®)
- Darunavir (Prezista^®)
- Delavirdine (Rescriptor^®)
- Deferasirox (Exjade^®)
- Diltiazem (Cardizem^®, Cardizem CD^®, Cardizem LA^®, Cartia XT^®, Dilacor XR^®, Dilt-CD^®, Diltia XT^®, Dilt-XR^®, Taztia XT^®, Tiazac^®)
- Erythromycin
- Fosamprenavir (Lexiva^®)
- Imatinib (Gleevec^®)
- Indinavir (Crixivan^®)
- Isoniazid
- Itraconazole (Sporanox^®)
- Ketoconazole (Nizoral^®)
- Lopinavir and ritonavir (Kaletra^®)
- Miconazole
- Nefazodone (Serzone^®)
- Nelfinavir (Viracept^®)
- Nicardipine (Cardene^®)
- Posaconazole (Noxafil^®)
- Quinidine
- Ritonavir (Norvir^®)
- Saquinavir (Fortovase^®, Invirase^®)
- Telithromycin (Ketek^®)
- Verapamil (Calan^®, Calan SR^®, Covera-HS^®, Isoptin SR^®, Verelan^®, Verelan PM^®)
- Voriconazole (Vfend^®)

Diuretics ("water pills"), such as:
- Amiloride (Midamor^®) or amiloride-HCTZ (Moduretic^®)
- Bumetanide (Bumex^®)
- Chlorothiazide (Diuril^®)
- Chlorthalidone (Thalitone^®)
- Ethacrynic acid (Edecrin^®)
- Furosemide (Lasix^®)
- Hydrochlorothiazide (Esidrix^®, HydroDIURIL^®, Microzide^®, Oretic^®)
- Metolazone (Zaroxolyn^®)
- Spironolactone (Aldactone^®) or spironolactone-HCTZ (Aldactazide^®)
- Torsemide (Demadex^®)
- Triamterene (Dyrenium^®) or triamterene/HCTZ (Dyazide^®, Maxzide^®)

Medications that "thin" the blood (such as anticoagulant and antiplatelet drugs), such as:
- Antithrombin (ATryn^®, Thrombate III^®)
- Apixaban (Eliquis^®)
- Argatroban
- Aspirin (Bayer^® and others)
- Bivalirudin (Angiomax^®)
- Cilostazol (Pletal^®)
- Clopidogrel (Plavix^®)
- Dipyridamole (Persantine^®)
- Drotrecogin alfa (Xigris^®)
- Eptifibatide (Integrilin^®)
- Fondaparinux (Arixtra^®)
- Heparin or heparin-like products, including dalteparin (Fragmin^®), enoxaparin (Lovenox^®), or tinzaparin (Innohep^®)
- Lepirudin (Refludan^®)
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as:
  - Celecoxib (Celebrex^®)
  - Diclofenac (Cambia™, Cataflam^®, Flector^®, Pennsaid^®, Solaraze^® Gel, Voltaren^®, Voltaren^® Gel, Voltaren^®-XR, Voltaren Ophthalmic^®, Zipsor™)
  - Etodolac (Lodine^®, Lodine^® XL)
  - Ibuprofen (Motrin^®, Advil^®, Nuprin^®)
  - Indomethacin (Indocin^®, Indocin SR^®)
  - Ketoprofen (Orudis^®, Actron^®, Oruvail^®)
  - Ketorolac (Toradol^®)
  - Meloxicam (Mobic^®)
  - Nabumetone (Relafen^®)
  - Naproxen (Naprosyn^®) or naproxen sodium (Aleve^®, Anaprox^®, Naprelan^®)
  - Oxaprozin (Daypro^®)
  - Piroxicam (Feldene^®)
  - Others (see List of NSAIDs for a more complete list of these drugs)
- Pentoxifylline (Trental^®)
- Prasugrel (Effient^®)
- Rivaroxaban (Xarelto^®)
- Thrombolytics, such as:
  - Alteplase (Activase^®)
  - Reteplase (Retavase^®)
  - Streptokinase (Streptase^®)
  - Tenecteplase (TNKase^®)
- Ticagrelor (Brilinta^®)
- Ticlopidine (Ticlid^®)
- Tirofiban (Aggrastat^®)
- Warfarin (Coumadin^®, Jantoven^®)