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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®)
- Monoamine oxidase inhibitors (MAOIs), such as:
- Isocarboxazid (Marplan®)
- Phenelzine (Nardil®)
- Rasagiline (Azilect®)
- Selegiline (Eldepryl®, Emsam®, Zelapar®)
- Tranylcypromine (Parnate®)
- Other medications that affect serotonin levels, such as:
- Amphetamines or amphetamine-like medications, such as:
- Benzphetamine (Didrex®)
- Dextroamphetamine (Dexedrine®)
- Dextroamphetamine and amphetamine (Adderall®)
- Dextroamphetamine-amphetamine extended release (Adderall XR®)
- Lisdexamfetamine (Vyvanse®)
- Methamphetamine (Desoxyn®)
- Phendimetrazine (Bontril®)
- Phentermine (Adipex-P®)
- Atomoxetine (Strattera®)
- Buspirone (BuSpar®)
- Fentanyl (Abstral®, Actiq®, Duragesic®, Fentora®, Lazanda®, Onsolis®, Subsys®)
- Lithium (Eskalith®, Eskalith CR®, Lithobid®)
- Linezolid (Zyvox®)
- Intravenous methylene blue
- Other antidepressants
- Triptans, such as:
- Almotriptan (Axert®)
- Eletriptan (Relpax®)
- Frovatriptan (Frova®)
- Naratriptan (Amerge®)
- Rizatriptan (Maxalt®)
- Sumatriptan (Alsuma™, Imitrex®, Sumavel®) or sumatriptan/naproxen sodium (Treximet®)
- Zolmitriptan (Zomig®)
- St. John's wort
- Tramadol (Rybix™ ODT, Ryzolt®, Ultram®, Ultram® ER) or tramadol/acetaminophen (Ultracet®)
- Tryptophan.
- Amphetamines or amphetamine-like medications, such as:
Written by/reviewed by: Susan Lakey, PharmD, MPH, BCPP
Last reviewed by: Kristi Monson, PharmD