Identification

Name
Levomilnacipran
Accession Number
DB08918
Type
Small Molecule
Groups
Approved
Description

Levomilnacipran is a selective serotonin and norepinephrine reuptake inhibitor. Chemically, levomilnacipran is the 1S,2R-enantiomer of milnacipran. FDA approved on July 25, 2013.

Structure
Thumb
Synonyms
  • (1S,2R)-milnacipran
External IDs
F 2695 / F-2695 / F2695
Product Ingredients
IngredientUNIICASInChI Key
Levomilnacipran hydrochloride371U2ZK31U175131-60-9XNCDYJFPRPDERF-NQQJLSKUSA-N
Product Images
Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
FetzimaCapsule, extended release40 mg/1OralAvera Mc Kennan Hospital2015-03-09Not applicableUs
FetzimaCapsule, extended release40 mg/1OralAllergan2013-07-25Not applicableUs
FetzimaKitOralAllergan2013-07-25Not applicableUs
FetzimaCapsule, extended release40 mgOralAllergan Pharma Co.2015-11-19Not applicableCanada
FetzimaCapsule, extended release20 mg/1OralAllergan2013-07-25Not applicableUs00456 2220 30 nlmimage10 6b4a3581
FetzimaCapsule, extended release120 mgOralAllergan Pharma Co.2016-04-22Not applicableCanada
FetzimaCapsule, extended release20 mgOralAllergan Pharma Co.2015-11-19Not applicableCanada
FetzimaCapsule, extended release80 mg/1OralAllergan2013-07-25Not applicableUs
FetzimaCapsule, extended release120 mg/1OralAllergan2013-07-25Not applicableUs
FetzimaCapsule, extended release80 mgOralAllergan Pharma Co.2016-04-22Not applicableCanada
Categories
UNII
UGM0326TXX
CAS number
96847-54-0
Weight
Average: 246.348
Monoisotopic: 246.173213336
Chemical Formula
C15H22N2O
InChI Key
GJJFMKBJSRMPLA-DZGCQCFKSA-N
InChI
InChI=1S/C15H22N2O/c1-3-17(4-2)14(18)15(10-13(15)11-16)12-8-6-5-7-9-12/h5-9,13H,3-4,10-11,16H2,1-2H3/t13-,15+/m0/s1
IUPAC Name
(1S,2R)-2-(aminomethyl)-N,N-diethyl-1-phenylcyclopropane-1-carboxamide
SMILES
CCN(CC)C(=O)[[email protected]]1(C[[email protected]]1CN)C1=CC=CC=C1

Pharmacology

Indication

Levomilnacipran is a serotonin and norepinephrine reuptake inhibitor and is indicated for the treatment of major depressive disorder (MDD).

Structured Indications
Pharmacodynamics

Levomilnacipran binds with high affinity to human serotonin (5-HT) and norepinephrine (NE) transporters (Ki = 11 and 91 nM, respectively). It potently inhibits 5-HT and NE reuptake (IC50 = 16 - 19 and 11 nM, respectively). Levomilnacipran does not bind to any other receptors, ion channels, or transporters, including serotonergic (5HT1-7), α- and β adrenergic, muscarinic, or histaminergic receptors and Ca2+, Na+, K+ or Cl- channels to a significant degree. Levomilnacipran did not inhibit monoamine oxidase (MAO). Furthermore, levomilnacipran does not prolong the QTc interval to a clinically relevant extent.

Mechanism of action

The exact mechanism of the antidepressant action of levomilnacipran is unknown but is thought to be related to the potentiation of serotonin and norephinephrine in the central nervous system through inhibition of reuptake at serotonin and norepinephrine transporters.

TargetActionsOrganism
ASodium-dependent serotonin transporter
inhibitor
Human
ASodium-dependent noradrenaline transporter
inhibitor
Human
Absorption

The relative bioavailability after administration of the extended-release capsule was 92% when compared to oral solution. Food does not affect the concentration of levomilnacipran. After daily dosing of levomilnacipran (extended-release capsule) the mean Cmax is 341 ng/mL, and the mean steady-state AUC value is 5196 ng·h/mL. The Tmax is 6 - 8 hours after oral administration. Interconversion of stereoisomers does not occur in humans.

Volume of distribution
  • 387 - 473 L [apparent volume of distribution]
Protein binding

22% bound to human plasma protein over concentration range of 10 to 1000 ng/mL.

Metabolism

Hepatic. Levomilnacipran undergoes desethylation to form desethyl levomilnacipran and hydroxylation to form p-hydroxy-levomilnacipran. Desethylation is facilitated primarily by CYP3A4 and by CYP2C8, 2C19, 2D6, and 2J2 to a lesser extent. Both metabolites undergo further conjugation with glucuronide to form conjugates.

Route of elimination

Levomilnacipran and its metabolites are eliminated primarily by renal excretion. 58% of the dose is excreted in urine as unchanged levomilnacipran. N-desethyl levomilnacipran is the major metabolite excreted in the urine and accounted for approximately 18% of the dose. Other identifiable metabolites excreted in the urine are levomilnacipran glucuronide (4%), desethyl-levomilnacipran glucuronide (3%), p-hydroxy levomilnacipran glucuronide (1%), and p-hydroxylevomilnacipran (1%). The metabolites are inactive.

Half life

12 hours

Clearance
  • 21 - 29 L/h [mean apparent total clearance]
Toxicity

The most common adverse reactions are nausea, constipation, hyperhidrosis, heart rate increase, erectile dysfunction, tachycardia, vomiting, and palpitations.

Affected organisms
  • Humans and other mammals
Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
DrugInteractionDrug group
7-NitroindazoleThe risk or severity of adverse effects can be increased when 7-Nitroindazole is combined with Levomilnacipran.Experimental
7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline may increase the serotonergic activities of Levomilnacipran.Experimental
AbirateroneThe serum concentration of Levomilnacipran can be increased when it is combined with Abiraterone.Approved
AcebutololThe serum concentration of Acebutolol can be increased when it is combined with Levomilnacipran.Approved
AcenocoumarolThe risk or severity of adverse effects can be increased when Levomilnacipran is combined with Acenocoumarol.Approved
AcepromazineThe risk or severity of adverse effects can be increased when Acepromazine is combined with Levomilnacipran.Approved, Vet Approved
AceprometazineThe risk or severity of adverse effects can be increased when Aceprometazine is combined with Levomilnacipran.Approved
Acetylsalicylic acidLevomilnacipran may increase the antiplatelet activities of Acetylsalicylic acid.Approved, Vet Approved
AdipiplonThe risk or severity of adverse effects can be increased when Adipiplon is combined with Levomilnacipran.Investigational
AgomelatineThe risk or severity of adverse effects can be increased when Agomelatine is combined with Levomilnacipran.Approved, Investigational
AlaproclateLevomilnacipran may increase the serotonergic activities of Alaproclate.Experimental
AlfaxaloneThe risk or severity of adverse effects can be increased when Alfaxalone is combined with Levomilnacipran.Vet Approved
AlfentanilAlfentanil may increase the serotonergic activities of Levomilnacipran.Approved, Illicit
AlimemazineThe risk or severity of adverse effects can be increased when Alimemazine is combined with Levomilnacipran.Approved, Vet Approved
AllopregnanoloneThe risk or severity of adverse effects can be increased when Allopregnanolone is combined with Levomilnacipran.Investigational
AlphacetylmethadolAlphacetylmethadol may increase the serotonergic activities of Levomilnacipran.Experimental, Illicit
AlphaprodineAlphaprodine may increase the serotonergic activities of Levomilnacipran.Illicit
AlprazolamThe risk or severity of adverse effects can be increased when Alprazolam is combined with Levomilnacipran.Approved, Illicit, Investigational
AlprenololThe serum concentration of Alprenolol can be increased when it is combined with Levomilnacipran.Approved, Withdrawn
AmiodaroneThe serum concentration of Levomilnacipran can be increased when it is combined with Amiodarone.Approved, Investigational
AmisulprideThe risk or severity of adverse effects can be increased when Amisulpride is combined with Levomilnacipran.Approved, Investigational
AmobarbitalThe risk or severity of adverse effects can be increased when Amobarbital is combined with Levomilnacipran.Approved, Illicit
AmoxapineLevomilnacipran may increase the serotonergic activities of Amoxapine.Approved
AmperozideThe risk or severity of adverse effects can be increased when Amperozide is combined with Levomilnacipran.Experimental
AmphetamineThe risk or severity of adverse effects can be increased when Levomilnacipran is combined with Amphetamine.Approved, Illicit
AprepitantThe serum concentration of Levomilnacipran can be increased when it is combined with Aprepitant.Approved, Investigational
AripiprazoleThe risk or severity of adverse effects can be increased when Aripiprazole is combined with Levomilnacipran.Approved, Investigational
ArmodafinilThe metabolism of Levomilnacipran can be decreased when combined with Armodafinil.Approved, Investigational
ArotinololThe serum concentration of Arotinolol can be increased when it is combined with Levomilnacipran.Approved, Investigational
ArtemetherThe metabolism of Levomilnacipran can be decreased when combined with Artemether.Approved
ArticaineThe risk or severity of adverse effects can be increased when Articaine is combined with Levomilnacipran.Approved
AsenapineThe risk or severity of adverse effects can be increased when Asenapine is combined with Levomilnacipran.Approved
AtazanavirThe serum concentration of Levomilnacipran can be increased when it is combined with Atazanavir.Approved, Investigational
AtenololThe serum concentration of Atenolol can be increased when it is combined with Levomilnacipran.Approved
AtomoxetineThe metabolism of Levomilnacipran can be decreased when combined with Atomoxetine.Approved
AzaperoneThe risk or severity of adverse effects can be increased when Azaperone is combined with Levomilnacipran.Investigational, Vet Approved
BarbitalThe risk or severity of adverse effects can be increased when Barbital is combined with Levomilnacipran.Illicit
BefunololThe serum concentration of Befunolol can be increased when it is combined with Levomilnacipran.Experimental
BendroflumethiazideLevomilnacipran may increase the hyponatremic activities of Bendroflumethiazide.Approved
BenperidolThe risk or severity of adverse effects can be increased when Benperidol is combined with Levomilnacipran.Investigational
BenzocaineThe risk or severity of adverse effects can be increased when Benzocaine is combined with Levomilnacipran.Approved
Benzyl alcoholThe risk or severity of adverse effects can be increased when Benzyl alcohol is combined with Levomilnacipran.Approved
BetaxololThe metabolism of Levomilnacipran can be decreased when combined with Betaxolol.Approved
BetrixabanThe risk or severity of bleeding can be increased when Betrixaban is combined with Levomilnacipran.Approved, Investigational
BevantololThe serum concentration of Bevantolol can be increased when it is combined with Levomilnacipran.Approved
BezitramideBezitramide may increase the serotonergic activities of Levomilnacipran.Experimental, Illicit, Withdrawn
BisoprololThe serum concentration of Bisoprolol can be increased when it is combined with Levomilnacipran.Approved
BL-1020The risk or severity of adverse effects can be increased when BL-1020 is combined with Levomilnacipran.Investigational
BoceprevirThe serum concentration of Levomilnacipran can be increased when it is combined with Boceprevir.Approved, Withdrawn
BopindololThe serum concentration of Bopindolol can be increased when it is combined with Levomilnacipran.Approved
BortezomibThe metabolism of Levomilnacipran can be decreased when combined with Bortezomib.Approved, Investigational
BosentanThe serum concentration of Levomilnacipran can be decreased when it is combined with Bosentan.Approved, Investigational
BrofaromineThe risk or severity of adverse effects can be increased when Levomilnacipran is combined with Brofaromine.Experimental
BromazepamThe risk or severity of adverse effects can be increased when Bromazepam is combined with Levomilnacipran.Approved, Illicit
BromisovalThe risk or severity of adverse effects can be increased when Bromisoval is combined with Levomilnacipran.Experimental
BromperidolThe risk or severity of adverse effects can be increased when Bromperidol is combined with Levomilnacipran.Investigational
BrotizolamThe risk or severity of adverse effects can be increased when Brotizolam is combined with Levomilnacipran.Approved, Investigational, Withdrawn
BucindololThe serum concentration of Bucindolol can be increased when it is combined with Levomilnacipran.Investigational
BufuralolThe serum concentration of Bufuralol can be increased when it is combined with Levomilnacipran.Experimental, Investigational
BupivacaineThe risk or severity of adverse effects can be increased when Bupivacaine is combined with Levomilnacipran.Approved, Investigational
BupranololThe serum concentration of Bupranolol can be increased when it is combined with Levomilnacipran.Approved
BuprenorphineBuprenorphine may increase the serotonergic activities of Levomilnacipran.Approved, Illicit, Investigational, Vet Approved
BupropionThe metabolism of Levomilnacipran can be decreased when combined with Bupropion.Approved
BuspironeBuspirone may increase the serotonergic activities of Levomilnacipran.Approved, Investigational
ButabarbitalThe risk or severity of adverse effects can be increased when Butabarbital is combined with Levomilnacipran.Approved, Illicit
ButacaineThe risk or severity of adverse effects can be increased when Butacaine is combined with Levomilnacipran.Vet Approved
ButambenThe risk or severity of adverse effects can be increased when Butamben is combined with Levomilnacipran.Approved
ButethalThe risk or severity of adverse effects can be increased when Butethal is combined with Levomilnacipran.Approved, Illicit
ButorphanolButorphanol may increase the serotonergic activities of Levomilnacipran.Approved, Illicit, Vet Approved
CanertinibThe risk or severity of adverse effects can be increased when Canertinib is combined with Levomilnacipran.Investigational
CarbamazepineThe metabolism of Carbamazepine can be decreased when combined with Levomilnacipran.Approved, Investigational
CarfentanilCarfentanil may increase the serotonergic activities of Levomilnacipran.Illicit, Investigational, Vet Approved
CarteololThe serum concentration of Carteolol can be increased when it is combined with Levomilnacipran.Approved
CarvedilolThe serum concentration of Carvedilol can be increased when it is combined with Levomilnacipran.Approved, Investigational
CelecoxibLevomilnacipran may increase the antiplatelet activities of Celecoxib.Approved, Investigational
CeliprololThe serum concentration of Celiprolol can be increased when it is combined with Levomilnacipran.Approved, Investigational
CeritinibThe serum concentration of Levomilnacipran can be increased when it is combined with Ceritinib.Approved
Chloral hydrateThe risk or severity of adverse effects can be increased when Chloral hydrate is combined with Levomilnacipran.Approved, Illicit, Vet Approved
ChloramphenicolThe metabolism of Levomilnacipran can be decreased when combined with Chloramphenicol.Approved, Vet Approved
ChlordiazepoxideThe risk or severity of adverse effects can be increased when Chlordiazepoxide is combined with Levomilnacipran.Approved, Illicit
ChlormezanoneThe risk or severity of adverse effects can be increased when Chlormezanone is combined with Levomilnacipran.Approved, Investigational, Withdrawn
ChloroprocaineThe risk or severity of adverse effects can be increased when Chloroprocaine is combined with Levomilnacipran.Approved
ChloroquineThe metabolism of Levomilnacipran can be decreased when combined with Chloroquine.Approved, Vet Approved
ChlorothiazideLevomilnacipran may increase the hyponatremic activities of Chlorothiazide.Approved, Vet Approved
ChlorproethazineThe risk or severity of adverse effects can be increased when Chlorproethazine is combined with Levomilnacipran.Experimental
ChlorpromazineThe metabolism of Levomilnacipran can be decreased when combined with Chlorpromazine.Approved, Vet Approved
ChlorprothixeneThe risk or severity of adverse effects can be increased when Chlorprothixene is combined with Levomilnacipran.Approved, Investigational, Withdrawn
ChlorthalidoneLevomilnacipran may increase the hyponatremic activities of Chlorthalidone.Approved
CholecalciferolThe metabolism of Levomilnacipran can be decreased when combined with Cholecalciferol.Approved, Nutraceutical
CimetidineThe metabolism of Levomilnacipran can be decreased when combined with Cimetidine.Approved
CinacalcetThe metabolism of Levomilnacipran can be decreased when combined with Cinacalcet.Approved
CinchocaineThe risk or severity of adverse effects can be increased when Cinchocaine is combined with Levomilnacipran.Approved, Vet Approved
CitalopramLevomilnacipran may increase the serotonergic activities of Citalopram.Approved
ClarithromycinThe serum concentration of Levomilnacipran can be increased when it is combined with Clarithromycin.Approved
ClemastineThe metabolism of Levomilnacipran can be decreased when combined with Clemastine.Approved
ClobazamThe metabolism of Levomilnacipran can be decreased when combined with Clobazam.Approved, Illicit
clomethiazoleThe risk or severity of adverse effects can be increased when clomethiazole is combined with Levomilnacipran.Investigational
ClomipramineLevomilnacipran may increase the serotonergic activities of Clomipramine.Approved, Vet Approved
ClopenthixolThe risk or severity of adverse effects can be increased when Clopenthixol is combined with Levomilnacipran.Experimental
CloranololThe serum concentration of Cloranolol can be increased when it is combined with Levomilnacipran.Experimental
ClorazepateThe risk or severity of adverse effects can be increased when Clorazepate is combined with Levomilnacipran.Approved, Illicit
ClorindioneThe risk or severity of adverse effects can be increased when Levomilnacipran is combined with Clorindione.Experimental
ClothiapineThe risk or severity of adverse effects can be increased when Clothiapine is combined with Levomilnacipran.Experimental
ClotrimazoleThe metabolism of Levomilnacipran can be decreased when combined with Clotrimazole.Approved, Vet Approved
ClozapineThe serum concentration of Clozapine can be increased when it is combined with Levomilnacipran.Approved
CobicistatThe serum concentration of Levomilnacipran can be increased when it is combined with Cobicistat.Approved
CocaineThe metabolism of Levomilnacipran can be decreased when combined with Cocaine.Approved, Illicit
CodeineCodeine may increase the serotonergic activities of Levomilnacipran.Approved, Illicit
ConivaptanThe serum concentration of Conivaptan can be increased when it is combined with Levomilnacipran.Approved, Investigational
CrisaboroleThe metabolism of Levomilnacipran can be decreased when combined with Crisaborole.Approved, Investigational
CrizotinibThe metabolism of Levomilnacipran can be decreased when combined with Crizotinib.Approved
CyclobenzaprineThe risk or severity of adverse effects can be increased when Cyclobenzaprine is combined with Levomilnacipran.Approved
CyclopenthiazideLevomilnacipran may increase the hyponatremic activities of Cyclopenthiazide.Experimental
CyclosporineThe metabolism of Levomilnacipran can be decreased when combined with Cyclosporine.Approved, Investigational, Vet Approved
CyproheptadineThe therapeutic efficacy of Levomilnacipran can be decreased when used in combination with Cyproheptadine.Approved
DabrafenibThe serum concentration of Levomilnacipran can be decreased when it is combined with Dabrafenib.Approved
DapiprazoleThe risk or severity of adverse effects can be increased when Dapiprazole is combined with Levomilnacipran.Approved
DapoxetineThe risk or severity of adverse effects can be increased when Dapoxetine is combined with Levomilnacipran.Investigational
DarifenacinThe metabolism of Levomilnacipran can be decreased when combined with Darifenacin.Approved, Investigational
DarunavirThe serum concentration of Levomilnacipran can be increased when it is combined with Darunavir.Approved
DasatinibThe serum concentration of Levomilnacipran can be increased when it is combined with Dasatinib.Approved, Investigational
DeferasiroxThe serum concentration of Levomilnacipran can be decreased when it is combined with Deferasirox.Approved, Investigational
DelavirdineThe metabolism of Levomilnacipran can be decreased when combined with Delavirdine.Approved
DeramciclaneThe risk or severity of adverse effects can be increased when Deramciclane is combined with Levomilnacipran.Investigational
DesfluraneThe risk or severity of adverse effects can be increased when Desflurane is combined with Levomilnacipran.Approved
DesipramineThe metabolism of Levomilnacipran can be decreased when combined with Desipramine.Approved
DesmopressinThe risk or severity of adverse effects can be increased when Levomilnacipran is combined with Desmopressin.Approved
DesvenlafaxineDesvenlafaxine may increase the serotonergic activities of Levomilnacipran.Approved
DetomidineThe risk or severity of adverse effects can be increased when Detomidine is combined with Levomilnacipran.Vet Approved
DexmedetomidineThe risk or severity of adverse effects can be increased when Dexmedetomidine is combined with Levomilnacipran.Approved, Vet Approved
DextromethorphanLevomilnacipran may increase the serotonergic activities of Dextromethorphan.Approved
DextromoramideDextromoramide may increase the serotonergic activities of Levomilnacipran.Experimental, Illicit
DextropropoxypheneDextropropoxyphene may increase the serotonergic activities of Levomilnacipran.Approved, Illicit, Investigational, Withdrawn
DezocineDezocine may increase the serotonergic activities of Levomilnacipran.Approved, Investigational
DiazepamThe risk or severity of adverse effects can be increased when Diazepam is combined with Levomilnacipran.Approved, Illicit, Vet Approved
DicoumarolThe risk or severity of adverse effects can be increased when Levomilnacipran is combined with Dicoumarol.Approved
Diethyl etherThe risk or severity of adverse effects can be increased when Diethyl ether is combined with Levomilnacipran.Experimental
DihydrocodeineDihydrocodeine may increase the serotonergic activities of Levomilnacipran.Approved, Illicit
DihydroergotamineThe metabolism of Levomilnacipran can be decreased when combined with Dihydroergotamine.Approved
DihydroetorphineDihydroetorphine may increase the serotonergic activities of Levomilnacipran.Experimental, Illicit
DihydromorphineDihydromorphine may increase the serotonergic activities of Levomilnacipran.Experimental, Illicit
DiltiazemThe metabolism of Levomilnacipran can be decreased when combined with Diltiazem.Approved
DiphenadioneThe risk or severity of adverse effects can be increased when Levomilnacipran is combined with Diphenadione.Experimental
DiphenhydramineThe metabolism of Levomilnacipran can be decreased when combined with Diphenhydramine.Approved
DiphenoxylateDiphenoxylate may increase the serotonergic activities of Levomilnacipran.Approved, Illicit
DixyrazineThe risk or severity of adverse effects can be increased when Dixyrazine is combined with Levomilnacipran.Experimental
DoramectinThe risk or severity of adverse effects can be increased when Doramectin is combined with Levomilnacipran.Vet Approved
DosulepinThe serum concentration of Dosulepin can be increased when it is combined with Levomilnacipran.Approved
DoxycyclineThe metabolism of Levomilnacipran can be decreased when combined with Doxycycline.Approved, Investigational, Vet Approved
DPDPEDPDPE may increase the serotonergic activities of Levomilnacipran.Experimental
DronedaroneThe metabolism of Levomilnacipran can be decreased when combined with Dronedarone.Approved
DroperidolThe risk or severity of adverse effects can be increased when Droperidol is combined with Levomilnacipran.Approved, Vet Approved
DrotebanolThe risk or severity of adverse effects can be increased when Drotebanol is combined with Levomilnacipran.Experimental, Illicit
DuloxetineDuloxetine may increase the serotonergic activities of Levomilnacipran.Approved
DyclonineThe risk or severity of adverse effects can be increased when Dyclonine is combined with Levomilnacipran.Approved
EcgonineThe risk or severity of adverse effects can be increased when Ecgonine is combined with Levomilnacipran.Experimental, Illicit
EcopipamThe risk or severity of adverse effects can be increased when Ecopipam is combined with Levomilnacipran.Investigational
EfavirenzThe metabolism of Levomilnacipran can be decreased when combined with Efavirenz.Approved, Investigational
EliglustatThe metabolism of Levomilnacipran can be decreased when combined with Eliglustat.Approved
EltanoloneThe risk or severity of adverse effects can be increased when Eltanolone is combined with Levomilnacipran.Investigational
EnfluraneThe risk or severity of adverse effects can be increased when Enflurane is combined with Levomilnacipran.Approved, Investigational, Vet Approved
EnzalutamideThe serum concentration of Levomilnacipran can be decreased when it is combined with Enzalutamide.Approved
EpanololThe serum concentration of Epanolol can be increased when it is combined with Levomilnacipran.Experimental
ErythromycinThe metabolism of Levomilnacipran can be decreased when combined with Erythromycin.Approved, Vet Approved
EscitalopramLevomilnacipran may increase the serotonergic activities of Escitalopram.Approved, Investigational
Eslicarbazepine acetateThe metabolism of Levomilnacipran can be decreased when combined with Eslicarbazepine acetate.Approved
EsmololThe serum concentration of Esmolol can be increased when it is combined with Levomilnacipran.Approved
EsomeprazoleThe metabolism of Levomilnacipran can be decreased when combined with Esomeprazole.Approved, Investigational
EstazolamThe risk or severity of adverse effects can be increased when Estazolam is combined with Levomilnacipran.Approved, Illicit
EszopicloneThe risk or severity of adverse effects can be increased when Eszopiclone is combined with Levomilnacipran.Approved
EthanolEthanol can cause an increase in the absorption of Levomilnacipran resulting in an increased serum concentration and potentially a worsening of adverse effects.Approved
EthchlorvynolThe risk or severity of adverse effects can be increased when Ethchlorvynol is combined with Levomilnacipran.Approved, Illicit, Withdrawn
Ethyl biscoumacetateThe risk or severity of adverse effects can be increased when Levomilnacipran is combined with Ethyl biscoumacetate.Withdrawn
Ethyl carbamateThe risk or severity of adverse effects can be increased when Ethyl carbamate is combined with Levomilnacipran.Withdrawn
Ethyl chlorideThe risk or severity of adverse effects can be increased when Ethyl chloride is combined with Levomilnacipran.Experimental, Investigational
Ethyl loflazepateThe risk or severity of adverse effects can be increased when Ethyl loflazepate is combined with Levomilnacipran.Approved, Illicit
EthylmorphineEthylmorphine may increase the serotonergic activities of Levomilnacipran.Approved, Illicit
EtidocaineThe risk or severity of adverse effects can be increased when Etidocaine is combined with Levomilnacipran.Approved
EtifoxineThe risk or severity of adverse effects can be increased when Etifoxine is combined with Levomilnacipran.Investigational, Withdrawn
EtizolamThe risk or severity of adverse effects can be increased when Etizolam is combined with Levomilnacipran.Approved
EtodolacLevomilnacipran may increase the antiplatelet activities of Etodolac.Approved, Investigational, Vet Approved
EtomidateThe risk or severity of adverse effects can be increased when Etomidate is combined with Levomilnacipran.Approved
EtoperidoneEtoperidone may increase the serotonergic activities of Levomilnacipran.Withdrawn
EtoricoxibLevomilnacipran may increase the antiplatelet activities of Etoricoxib.Approved, Investigational
EtorphineEtorphine may increase the serotonergic activities of Levomilnacipran.Illicit, Vet Approved
EtravirineThe metabolism of Levomilnacipran can be decreased when combined with Etravirine.Approved
FelodipineThe metabolism of Levomilnacipran can be decreased when combined with Felodipine.Approved, Investigational
FencamfamineThe risk or severity of adverse effects can be increased when Fencamfamine is combined with Levomilnacipran.Approved, Illicit, Withdrawn
FenfluramineLevomilnacipran may increase the serotonergic activities of Fenfluramine.Illicit, Investigational, Withdrawn
FentanylFentanyl may increase the serotonergic activities of Levomilnacipran.Approved, Illicit, Investigational, Vet Approved
FluanisoneThe risk or severity of adverse effects can be increased when Fluanisone is combined with Levomilnacipran.Experimental
FluconazoleThe metabolism of Levomilnacipran can be decreased when combined with Fluconazole.Approved
FludiazepamThe risk or severity of adverse effects can be increased when Fludiazepam is combined with Levomilnacipran.Approved, Illicit
FluindioneThe risk or severity of adverse effects can be increased when Levomilnacipran is combined with Fluindione.Investigational
FlunitrazepamThe risk or severity of adverse effects can be increased when Flunitrazepam is combined with Levomilnacipran.Approved, Illicit
FluoxetineThe metabolism of Levomilnacipran can be decreased when combined with Fluoxetine.Approved, Vet Approved
FlupentixolThe risk or severity of adverse effects can be increased when Flupentixol is combined with Levomilnacipran.Approved, Withdrawn
FluphenazineThe risk or severity of adverse effects can be increased when Fluphenazine is combined with Levomilnacipran.Approved
FlurazepamThe risk or severity of adverse effects can be increased when Flurazepam is combined with Levomilnacipran.Approved, Illicit
FluspirileneThe risk or severity of adverse effects can be increased when Fluspirilene is combined with Levomilnacipran.Approved, Investigational
FluvoxamineThe metabolism of Levomilnacipran can be decreased when combined with Fluvoxamine.Approved, Investigational
FosamprenavirThe metabolism of Levomilnacipran can be decreased when combined with Fosamprenavir.Approved
FosaprepitantThe serum concentration of Levomilnacipran can be increased when it is combined with Fosaprepitant.Approved
FosphenytoinThe metabolism of Levomilnacipran can be increased when combined with Fosphenytoin.Approved
FospropofolThe risk or severity of adverse effects can be increased when Fospropofol is combined with Levomilnacipran.Approved, Illicit, Investigational
FurazolidoneFurazolidone may increase the serotonergic activities of Levomilnacipran.Approved, Investigational, Vet Approved
Fusidic AcidThe serum concentration of Levomilnacipran can be increased when it is combined with Fusidic Acid.Approved
GabapentinThe risk or severity of adverse effects can be increased when Gabapentin is combined with Levomilnacipran.Approved, Investigational
GalantamineThe metabolism of Galantamine can be decreased when combined with Levomilnacipran.Approved
Gamma Hydroxybutyric AcidThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Levomilnacipran.Approved, Illicit, Investigational
GemfibrozilThe metabolism of Levomilnacipran can be decreased when combined with Gemfibrozil.Approved
GepironeThe risk or severity of adverse effects can be increased when Gepirone is combined with Levomilnacipran.Investigational
GlutethimideThe risk or severity of adverse effects can be increased when Glutethimide is combined with Levomilnacipran.Approved, Illicit
HalazepamThe risk or severity of adverse effects can be increased when Halazepam is combined with Levomilnacipran.Approved, Illicit, Withdrawn
HaloperidolThe metabolism of Levomilnacipran can be decreased when combined with Haloperidol.Approved
HalothaneThe risk or severity of adverse effects can be increased when Halothane is combined with Levomilnacipran.Approved, Vet Approved
HarmalineThe risk or severity of adverse effects can be increased when Levomilnacipran is combined with Harmaline.Experimental
HeroinHeroin may increase the serotonergic activities of Levomilnacipran.Approved, Illicit, Investigational
HexobarbitalThe risk or severity of adverse effects can be increased when Hexobarbital is combined with Levomilnacipran.Approved
HydrochlorothiazideLevomilnacipran may increase the hyponatremic activities of Hydrochlorothiazide.Approved, Vet Approved
HydrocodoneHydrocodone may increase the serotonergic activities of Levomilnacipran.Approved, Illicit
HydroflumethiazideLevomilnacipran may increase the hyponatremic activities of Hydroflumethiazide.Approved, Investigational
HydromorphoneHydromorphone may increase the serotonergic activities of Levomilnacipran.Approved, Illicit
IdelalisibThe serum concentration of Levomilnacipran can be increased when it is combined with Idelalisib.Approved
ImatinibThe metabolism of Levomilnacipran can be decreased when combined with Imatinib.Approved
ImipramineThe metabolism of Levomilnacipran can be decreased when combined with Imipramine.Approved
IndalpineLevomilnacipran may increase the serotonergic activities of Indalpine.Investigational, Withdrawn
IndapamideLevomilnacipran may increase the hyponatremic activities of Indapamide.Approved
IndenololThe serum concentration of Indenolol can be increased when it is combined with Levomilnacipran.Withdrawn
IndinavirThe serum concentration of Levomilnacipran can be increased when it is combined with Indinavir.Approved
IndiplonThe risk or severity of adverse effects can be increased when Indiplon is combined with Levomilnacipran.Investigational
IobenguaneThe therapeutic efficacy of Iobenguane can be decreased when used in combination with Levomilnacipran.Approved, Investigational
Ioflupane I-123Levomilnacipran may decrease effectiveness of Ioflupane I-123 as a diagnostic agent.Approved
IproniazidIproniazid may increase the serotonergic activities of Levomilnacipran.Withdrawn
IrbesartanThe metabolism of Levomilnacipran can be decreased when combined with Irbesartan.Approved, Investigational
IsavuconazoniumThe metabolism of Levomilnacipran can be decreased when combined with Isavuconazonium.Approved, Investigational
IsofluraneThe risk or severity of adverse effects can be increased when Isoflurane is combined with Levomilnacipran.Approved, Vet Approved
IsoniazidThe metabolism of Levomilnacipran can be decreased when combined with Isoniazid.Approved
IsradipineThe metabolism of Levomilnacipran can be decreased when combined with Isradipine.Approved
ItraconazoleThe serum concentration of Levomilnacipran can be increased when it is combined with Itraconazole.Approved, Investigational
IvacaftorThe serum concentration of Levomilnacipran can be increased when it is combined with Ivacaftor.Approved
KetamineThe risk or severity of adverse effects can be increased when Ketamine is combined with Levomilnacipran.Approved, Vet Approved
KetazolamThe risk or severity of adverse effects can be increased when Ketazolam is combined with Levomilnacipran.Approved
KetobemidoneKetobemidone may increase the serotonergic activities of Levomilnacipran.Approved, Investigational
KetoconazoleThe serum concentration of Levomilnacipran can be increased when it is combined with Ketoconazole.Approved, Investigational
L-TryptophanL-Tryptophan may increase the serotonergic activities of Levomilnacipran.Approved, Nutraceutical, Withdrawn
LabetalolThe serum concentration of Labetalol can be increased when it is combined with Levomilnacipran.Approved
LandiololThe serum concentration of Landiolol can be increased when it is combined with Levomilnacipran.Investigational
LapatinibThe metabolism of Levomilnacipran can be decreased when combined with Lapatinib.Approved, Investigational
LevobunololThe serum concentration of Levobunolol can be increased when it is combined with Levomilnacipran.Approved
LevobupivacaineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Levomilnacipran.Approved, Investigational
Levomethadyl AcetateLevomethadyl Acetate may increase the serotonergic activities of Levomilnacipran.Approved, Investigational
LevorphanolLevorphanol may increase the serotonergic activities of Levomilnacipran.Approved
LidocaineThe risk or severity of adverse effects can be increased when Lidocaine is combined with Levomilnacipran.Approved, Vet Approved
LinezolidLinezolid may increase the serotonergic activities of Levomilnacipran.Approved, Investigational
LithiumLithium may increase the serotonergic activities of Levomilnacipran.Approved
LobeglitazoneThe metabolism of Levomilnacipran can be decreased when combined with Lobeglitazone.Approved, Investigational
LofentanilLofentanil may increase the serotonergic activities of Levomilnacipran.Illicit
LopinavirThe serum concentration of Levomilnacipran can be increased when it is combined with Lopinavir.Approved
LoprazolamThe risk or severity of adverse effects can be increased when Loprazolam is combined with Levomilnacipran.Experimental
LorazepamThe risk or severity of adverse effects can be increased when Lorazepam is combined with Levomilnacipran.Approved
LorcaserinThe metabolism of Levomilnacipran can be decreased when combined with Lorcaserin.Approved
LormetazepamThe risk or severity of adverse effects can be increased when Lormetazepam is combined with Levomilnacipran.Approved
LosartanThe metabolism of Levomilnacipran can be decreased when combined with Losartan.Approved
LovastatinThe metabolism of Levomilnacipran can be decreased when combined with Lovastatin.Approved, Investigational
LoxapineThe risk or severity of adverse effects can be increased when Loxapine is combined with Levomilnacipran.Approved
LuliconazoleThe serum concentration of Levomilnacipran can be increased when it is combined with Luliconazole.Approved
LumacaftorThe serum concentration of Levomilnacipran can be increased when it is combined with Lumacaftor.Approved
LumefantrineThe metabolism of Levomilnacipran can be decreased when combined with Lumefantrine.Approved
LumiracoxibLevomilnacipran may increase the antiplatelet activities of Lumiracoxib.Approved, Investigational
LurasidoneThe risk or severity of adverse effects can be increased when Lurasidone is combined with Levomilnacipran.Approved
Magnesium SulfateThe risk or severity of adverse effects can be increased when Magnesium Sulfate is combined with Levomilnacipran.Approved, Vet Approved
ManidipineThe metabolism of Levomilnacipran can be decreased when combined with Manidipine.Approved, Investigational
MebicarThe risk or severity of adverse effects can be increased when Mebicar is combined with Levomilnacipran.Experimental
MedazepamThe risk or severity of adverse effects can be increased when Medazepam is combined with Levomilnacipran.Experimental
MedetomidineThe risk or severity of adverse effects can be increased when Medetomidine is combined with Levomilnacipran.Vet Approved
MelatoninThe risk or severity of adverse effects can be increased when Melatonin is combined with Levomilnacipran.Approved, Nutraceutical, Vet Approved
MelperoneThe risk or severity of adverse effects can be increased when Melperone is combined with Levomilnacipran.Approved, Investigational
MepindololThe serum concentration of Mepindolol can be increased when it is combined with Levomilnacipran.Experimental
MepivacaineThe risk or severity of adverse effects can be increased when Mepivacaine is combined with Levomilnacipran.Approved, Vet Approved
MeprobamateThe risk or severity of adverse effects can be increased when Meprobamate is combined with Levomilnacipran.Approved, Illicit
MeptazinolMeptazinol may increase the serotonergic activities of Levomilnacipran.Experimental
MesoridazineThe risk or severity of adverse effects can be increased when Mesoridazine is combined with Levomilnacipran.Approved, Investigational
MethadoneThe metabolism of Methadone can be decreased when combined with Levomilnacipran.Approved
Methadyl AcetateMethadyl Acetate may increase the serotonergic activities of Levomilnacipran.Approved, Illicit
MethapyrileneThe risk or severity of adverse effects can be increased when Methapyrilene is combined with Levomilnacipran.Withdrawn
MethaqualoneThe risk or severity of adverse effects can be increased when Methaqualone is combined with Levomilnacipran.Illicit, Withdrawn
MethohexitalThe risk or severity of adverse effects can be increased when Methohexital is combined with Levomilnacipran.Approved
MethotrimeprazineThe metabolism of Levomilnacipran can be decreased when combined with Methotrimeprazine.Approved
MethoxyfluraneThe risk or severity of adverse effects can be increased when Methoxyflurane is combined with Levomilnacipran.Approved, Investigational, Vet Approved
MethyclothiazideLevomilnacipran may increase the hyponatremic activities of Methyclothiazide.Approved
MethylecgonineThe risk or severity of adverse effects can be increased when Methylecgonine is combined with Levomilnacipran.Experimental
Methylene blueLevomilnacipran may increase the serotonergic activities of Methylene blue.Approved, Investigational
MethylphenobarbitalThe risk or severity of adverse effects can be increased when Methylphenobarbital is combined with Levomilnacipran.Approved
MetipranololThe serum concentration of Metipranolol can be increased when it is combined with Levomilnacipran.Approved
MetoclopramideThe risk or severity of adverse effects can be increased when Metoclopramide is combined with Levomilnacipran.Approved, Investigational
MetolazoneLevomilnacipran may increase the hyponatremic activities of Metolazone.Approved
MetoprololThe metabolism of Levomilnacipran can be decreased when combined with Metoprolol.Approved, Investigational
MetyrosineThe risk or severity of adverse effects can be increased when Metyrosine is combined with Levomilnacipran.Approved
MexiletineThe metabolism of Mexiletine can be decreased when combined with Levomilnacipran.Approved
MidazolamThe risk or severity of adverse effects can be increased when Midazolam is combined with Levomilnacipran.Approved, Illicit
MidostaurinThe metabolism of Levomilnacipran can be decreased when combined with Midostaurin.Approved
MifepristoneThe serum concentration of Levomilnacipran can be increased when it is combined with Mifepristone.Approved, Investigational
MilnacipranMilnacipran may increase the serotonergic activities of Levomilnacipran.Approved
MinaprineMinaprine may increase the serotonergic activities of Levomilnacipran.Approved
MirabegronThe metabolism of Levomilnacipran can be decreased when combined with Mirabegron.Approved
MitotaneThe serum concentration of Levomilnacipran can be decreased when it is combined with Mitotane.Approved
MoclobemideThe metabolism of Levomilnacipran can be decreased when combined with Moclobemide.Approved
ModafinilThe metabolism of Levomilnacipran can be decreased when combined with Modafinil.Approved, Investigational
MolindoneThe risk or severity of adverse effects can be increased when Molindone is combined with Levomilnacipran.Approved
MoricizineThe risk or severity of adverse effects can be increased when Moricizine is combined with Levomilnacipran.Approved, Investigational, Withdrawn
MorphineMorphine may increase the serotonergic activities of Levomilnacipran.Approved, Investigational
NabiloneThe risk or severity of adverse effects can be increased when Nabilone is combined with Levomilnacipran.Approved, Investigational
NabumetoneLevomilnacipran may increase the antiplatelet activities of Nabumetone.Approved
NadololThe serum concentration of Nadolol can be increased when it is combined with Levomilnacipran.Approved
NalbuphineNalbuphine may increase the serotonergic activities of Levomilnacipran.Approved
NebivololThe serum concentration of Nebivolol can be increased when it is combined with Levomilnacipran.Approved, Investigational
NefazodoneThe serum concentration of Levomilnacipran can be increased when it is combined with Nefazodone.Approved, Withdrawn
NelfinavirThe serum concentration of Levomilnacipran can be increased when it is combined with Nelfinavir.Approved
NetupitantThe serum concentration of Levomilnacipran can be increased when it is combined with Netupitant.Approved
NevirapineThe metabolism of Levomilnacipran can be increased when combined with Nevirapine.Approved
NialamideNialamide may increase the serotonergic activities of Levomilnacipran.Withdrawn
NicardipineThe metabolism of Levomilnacipran can be decreased when combined with Nicardipine.Approved
NicomorphineNicomorphine may increase the serotonergic activities of Levomilnacipran.Experimental
NilotinibThe metabolism of Levomilnacipran can be decreased when combined with Nilotinib.Approved, Investigational
NitrazepamThe risk or severity of adverse effects can be increased when Nitrazepam is combined with Levomilnacipran.Approved
Nitrous oxideThe risk or severity of adverse effects can be increased when Nitrous oxide is combined with Levomilnacipran.Approved, Vet Approved
NorfluraneThe risk or severity of adverse effects can be increased when Norflurane is combined with Levomilnacipran.Investigational
NormethadoneNormethadone may increase the serotonergic activities of Levomilnacipran.Approved, Illicit
OlanzapineLevomilnacipran may increase the serotonergic activities of Olanzapine.Approved, Investigational
OlaparibThe metabolism of Levomilnacipran can be decreased when combined with Olaparib.Approved
OmeprazoleThe metabolism of Levomilnacipran can be decreased when combined with Omeprazole.Approved, Investigational, Vet Approved
OndansetronThe risk or severity of adverse effects can be increased when Ondansetron is combined with Levomilnacipran.Approved
OpiumOpium may increase the serotonergic activities of Levomilnacipran.Approved, Illicit
OsanetantThe risk or severity of adverse effects can be increased when Osanetant is combined with Levomilnacipran.Investigational
OsimertinibThe serum concentration of Levomilnacipran can be increased when it is combined with Osimertinib.Approved
OxazepamThe risk or severity of adverse effects can be increased when Oxazepam is combined with Levomilnacipran.Approved
OxethazaineThe risk or severity of adverse effects can be increased when Oxethazaine is combined with Levomilnacipran.Approved, Investigational
OxprenololThe serum concentration of Oxprenolol can be increased when it is combined with Levomilnacipran.Approved
OxybuprocaineThe risk or severity of adverse effects can be increased when Oxybuprocaine is combined with Levomilnacipran.Approved
OxycodoneOxycodone may increase the serotonergic activities of Levomilnacipran.Approved, Illicit, Investigational
OxymorphoneOxymorphone may increase the serotonergic activities of Levomilnacipran.Approved, Investigational, Vet Approved
PalbociclibThe serum concentration of Levomilnacipran can be increased when it is combined with Palbociclib.Approved
PaliperidoneThe risk or severity of adverse effects can be increased when Paliperidone is combined with Levomilnacipran.Approved
PanobinostatThe serum concentration of Levomilnacipran can be increased when it is combined with Panobinostat.Approved, Investigational
PantoprazoleThe metabolism of Levomilnacipran can be decreased when combined with Pantoprazole.Approved
ParaldehydeThe risk or severity of adverse effects can be increased when Paraldehyde is combined with Levomilnacipran.Approved, Investigational
ParecoxibLevomilnacipran may increase the antiplatelet activities of Parecoxib.Approved
PargylinePargyline may increase the serotonergic activities of Levomilnacipran.Approved
ParoxetineThe metabolism of Levomilnacipran can be decreased when combined with Paroxetine.Approved, Investigational
Peginterferon alfa-2bThe serum concentration of Levomilnacipran can be decreased when it is combined with Peginterferon alfa-2b.Approved
PenbutololThe serum concentration of Penbutolol can be increased when it is combined with Levomilnacipran.Approved, Investigational
PenfluridolThe risk or severity of adverse effects can be increased when Penfluridol is combined with Levomilnacipran.Experimental
PentazocinePentazocine may increase the serotonergic activities of Levomilnacipran.Approved, Vet Approved
PentobarbitalThe metabolism of Levomilnacipran can be increased when combined with Pentobarbital.Approved, Vet Approved
PerazineThe risk or severity of adverse effects can be increased when Perazine is combined with Levomilnacipran.Investigational
PerospironeThe risk or severity of adverse effects can be increased when Perospirone is combined with Levomilnacipran.Approved
PerphenazineThe risk or severity of adverse effects can be increased when Perphenazine is combined with Levomilnacipran.Approved
PethidinePethidine may increase the serotonergic activities of Levomilnacipran.Approved
PhenazocinePhenazocine may increase the serotonergic activities of Levomilnacipran.Experimental
PhenibutThe risk or severity of adverse effects can be increased when Phenibut is combined with Levomilnacipran.Experimental
PhenindioneThe risk or severity of adverse effects can be increased when Levomilnacipran is combined with Phenindione.Approved, Investigational
PhenobarbitalThe metabolism of Levomilnacipran can be increased when combined with Phenobarbital.Approved
PhenoperidinePhenoperidine may increase the serotonergic activities of Levomilnacipran.Experimental
PhenoxyethanolThe risk or severity of adverse effects can be increased when Phenoxyethanol is combined with Levomilnacipran.Approved
PhenprocoumonThe risk or severity of adverse effects can be increased when Levomilnacipran is combined with Phenprocoumon.Approved, Investigational
PhenytoinThe metabolism of Levomilnacipran can be increased when combined with Phenytoin.Approved, Vet Approved
PimozideThe risk or severity of adverse effects can be increased when Pimozide is combined with Levomilnacipran.Approved
PindololThe serum concentration of Pindolol can be increased when it is combined with Levomilnacipran.Approved
PioglitazoneThe metabolism of Levomilnacipran can be decreased when combined with Pioglitazone.Approved, Investigational
PipamperoneThe risk or severity of adverse effects can be increased when Pipamperone is combined with Levomilnacipran.Approved, Investigational
PiritramidePiritramide may increase the serotonergic activities of Levomilnacipran.Investigational
PirlindolePirlindole may increase the serotonergic activities of Levomilnacipran.Approved
Platelet Activating FactorThe serum concentration of Platelet Activating Factor can be increased when it is combined with Levomilnacipran.Experimental
PolythiazideLevomilnacipran may increase the hyponatremic activities of Polythiazide.Approved
PosaconazoleThe serum concentration of Levomilnacipran can be increased when it is combined with Posaconazole.Approved, Investigational, Vet Approved
PractololThe serum concentration of Practolol can be increased when it is combined with Levomilnacipran.Approved
PramocaineThe risk or severity of adverse effects can be increased when Pramocaine is combined with Levomilnacipran.Approved
PrazepamThe risk or severity of adverse effects can be increased when Prazepam is combined with Levomilnacipran.Approved, Illicit
PregabalinThe risk or severity of adverse effects can be increased when Pregabalin is combined with Levomilnacipran.Approved, Illicit, Investigational
PrilocaineThe risk or severity of adverse effects can be increased when Prilocaine is combined with Levomilnacipran.Approved
PrimidoneThe metabolism of Levomilnacipran can be increased when combined with Primidone.Approved, Vet Approved
ProcaineThe risk or severity of adverse effects can be increased when Procaine is combined with Levomilnacipran.Approved, Investigational, Vet Approved
ProchlorperazineThe risk or severity of adverse effects can be increased when Prochlorperazine is combined with Levomilnacipran.Approved, Vet Approved
PromazineThe metabolism of Levomilnacipran can be decreased when combined with Promazine.Approved, Vet Approved
PromethazineThe risk or severity of adverse effects can be increased when Promethazine is combined with Levomilnacipran.Approved
PropanididThe risk or severity of adverse effects can be increased when Propanidid is combined with Levomilnacipran.Experimental
ProparacaineThe risk or severity of adverse effects can be increased when Proparacaine is combined with Levomilnacipran.Approved, Vet Approved
PropiopromazineThe risk or severity of adverse effects can be increased when Propiopromazine is combined with Levomilnacipran.Vet Approved
PropofolThe risk or severity of adverse effects can be increased when Propofol is combined with Levomilnacipran.Approved, Investigational, Vet Approved
PropoxycaineThe risk or severity of adverse effects can be increased when Propoxycaine is combined with Levomilnacipran.Approved
PropranololThe serum concentration of Propranolol can be increased when it is combined with Levomilnacipran.Approved, Investigational
ProxibarbalThe risk or severity of adverse effects can be increased when Proxibarbal is combined with Levomilnacipran.Experimental
PSD502The risk or severity of adverse effects can be increased when PSD502 is combined with Levomilnacipran.Investigational
QuazepamThe risk or severity of adverse effects can be increased when Quazepam is combined with Levomilnacipran.Approved, Illicit
QuetiapineThe risk or severity of adverse effects can be increased when Quetiapine is combined with Levomilnacipran.Approved
QuinethazoneLevomilnacipran may increase the hyponatremic activities of Quinethazone.Approved
QuinidineThe metabolism of Levomilnacipran can be decreased when combined with Quinidine.Approved
QuinineThe metabolism of Levomilnacipran can be decreased when combined with Quinine.Approved
QuinisocaineThe risk or severity of adverse effects can be increased when Quinisocaine is combined with Levomilnacipran.Experimental
RabeprazoleThe metabolism of Levomilnacipran can be decreased when combined with Rabeprazole.Approved, Investigational
RacloprideThe risk or severity of adverse effects can be increased when Raclopride is combined with Levomilnacipran.Investigational
RanolazineThe serum concentration of Levomilnacipran can be increased when it is combined with Ranolazine.Approved, Investigational
RemifentanilRemifentanil may increase the serotonergic activities of Levomilnacipran.Approved
RemoxiprideThe risk or severity of adverse effects can be increased when Remoxipride is combined with Levomilnacipran.Approved, Withdrawn
ReserpineThe risk or severity of adverse effects can be increased when Reserpine is combined with Levomilnacipran.Approved, Investigational
RifabutinThe metabolism of Levomilnacipran can be increased when combined with Rifabutin.Approved
RifampicinThe metabolism of Levomilnacipran can be increased when combined with Rifampicin.Approved
RifapentineThe metabolism of Levomilnacipran can be increased when combined with Rifapentine.Approved
RisperidoneThe metabolism of Risperidone can be decreased when combined with Levomilnacipran.Approved, Investigational
RitanserinThe risk or severity of adverse effects can be increased when Ritanserin is combined with Levomilnacipran.Investigational
RitonavirThe metabolism of Levomilnacipran can be decreased when combined with Ritonavir.Approved, Investigational
RofecoxibLevomilnacipran may increase the antiplatelet activities of Rofecoxib.Investigational, Withdrawn
RolapitantThe metabolism of Levomilnacipran can be decreased when combined with Rolapitant.Approved
RomifidineThe risk or severity of adverse effects can be increased when Romifidine is combined with Levomilnacipran.Vet Approved
RopiniroleThe metabolism of Levomilnacipran can be decreased when combined with Ropinirole.Approved, Investigational
RopivacaineThe risk or severity of adverse effects can be increased when Ropivacaine is combined with Levomilnacipran.Approved
RosiglitazoneThe metabolism of Levomilnacipran can be decreased when combined with Rosiglitazone.Approved, Investigational
RucaparibThe metabolism of Levomilnacipran can be decreased when combined with Rucaparib.Approved, Investigational
SaquinavirThe serum concentration of Levomilnacipran can be increased when it is combined with Saquinavir.Approved, Investigational
SarilumabThe therapeutic efficacy of Levomilnacipran can be decreased when used in combination with Sarilumab.Approved
SecobarbitalThe metabolism of Levomilnacipran can be increased when combined with Secobarbital.Approved, Vet Approved
SepranoloneThe risk or severity of adverse effects can be increased when Sepranolone is combined with Levomilnacipran.Investigational
SertindoleThe risk or severity of adverse effects can be increased when Sertindole is combined with Levomilnacipran.Approved, Investigational, Withdrawn
SertralineLevomilnacipran may increase the serotonergic activities of Sertraline.Approved
SevofluraneThe risk or severity of adverse effects can be increased when Sevoflurane is combined with Levomilnacipran.Approved, Vet Approved
SildenafilThe metabolism of Levomilnacipran can be decreased when combined with Sildenafil.Approved, Investigational
SiltuximabThe serum concentration of Levomilnacipran can be decreased when it is combined with Siltuximab.Approved
SimeprevirThe serum concentration of Levomilnacipran can be increased when it is combined with Simeprevir.Approved
Sodium oxybateThe risk or severity of adverse effects can be increased when Sodium oxybate is combined with Levomilnacipran.Approved
SotalolThe serum concentration of Sotalol can be increased when it is combined with Levomilnacipran.Approved
St. John's WortThe serum concentration of Levomilnacipran can be decreased when it is combined with St. John's Wort.Investigational, Nutraceutical
StiripentolThe serum concentration of Levomilnacipran can be increased when it is combined with Stiripentol.Approved
SufentanilSufentanil may increase the serotonergic activities of Levomilnacipran.Approved, Investigational
SulfamethoxazoleThe metabolism of Levomilnacipran can be decreased when combined with Sulfamethoxazole.Approved
SulfisoxazoleThe metabolism of Levomilnacipran can be decreased when combined with Sulfisoxazole.Approved, Vet Approved
SulpirideThe risk or severity of adverse effects can be increased when Sulpiride is combined with Levomilnacipran.Approved, Investigational
SultoprideThe risk or severity of adverse effects can be increased when Sultopride is combined with Levomilnacipran.Experimental
TacrolimusThe metabolism of Tacrolimus can be decreased when combined with Levomilnacipran.Approved, Investigational
TalinololThe serum concentration of Talinolol can be increased when it is combined with Levomilnacipran.Investigational
TamoxifenThe metabolism of Levomilnacipran can be decreased when combined with Tamoxifen.Approved
TandospironeThe risk or severity of adverse effects can be increased when Tandospirone is combined with Levomilnacipran.Investigational
TapentadolTapentadol may increase the serotonergic activities of Levomilnacipran.Approved
TelaprevirThe serum concentration of Levomilnacipran can be increased when it is combined with Telaprevir.Approved, Withdrawn
TelithromycinThe serum concentration of Levomilnacipran can be increased when it is combined with Telithromycin.Approved
TemazepamThe risk or severity of adverse effects can be increased when Temazepam is combined with Levomilnacipran.Approved
TerbinafineThe metabolism of Levomilnacipran can be decreased when combined with Terbinafine.Approved, Investigational, Vet Approved
TeriflunomideThe metabolism of Levomilnacipran can be decreased when combined with Teriflunomide.Approved
TertatololThe serum concentration of Tertatolol can be increased when it is combined with Levomilnacipran.Experimental
TetracaineThe risk or severity of adverse effects can be increased when Tetracaine is combined with Levomilnacipran.Approved, Vet Approved
TetrahydropalmatineThe risk or severity of adverse effects can be increased when Tetrahydropalmatine is combined with Levomilnacipran.Investigational
TetrodotoxinThe risk or severity of adverse effects can be increased when Tetrodotoxin is combined with Levomilnacipran.Investigational
ThiamylalThe risk or severity of adverse effects can be increased when Thiamylal is combined with Levomilnacipran.Approved, Vet Approved
ThiazinamThe risk or severity of adverse effects can be increased when Thiazinam is combined with Levomilnacipran.Experimental
ThiethylperazineThe risk or severity of adverse effects can be increased when Thiethylperazine is combined with Levomilnacipran.Withdrawn
ThiopentalThe risk or severity of adverse effects can be increased when Thiopental is combined with Levomilnacipran.Approved, Vet Approved
ThioridazineThe metabolism of Levomilnacipran can be decreased when combined with Thioridazine.Approved, Withdrawn
ThiothixeneThe risk or severity of adverse effects can be increased when Thiothixene is combined with Levomilnacipran.Approved
TiaprideThe risk or severity of adverse effects can be increased when Tiapride is combined with Levomilnacipran.Approved, Investigational
TiclopidineThe metabolism of Levomilnacipran can be decreased when combined with Ticlopidine.Approved
TiletamineThe risk or severity of adverse effects can be increased when Tiletamine is combined with Levomilnacipran.Vet Approved
TilidineTilidine may increase the serotonergic activities of Levomilnacipran.Experimental
TimololThe serum concentration of Timolol can be increased when it is combined with Levomilnacipran.Approved
TioclomarolThe risk or severity of adverse effects can be increased when Levomilnacipran is combined with Tioclomarol.Experimental
TipranavirThe metabolism of Levomilnacipran can be decreased when combined with Tipranavir.Approved, Investigational
TocilizumabThe serum concentration of Levomilnacipran can be decreased when it is combined with Tocilizumab.Approved
ToloxatoneToloxatone may increase the serotonergic activities of Levomilnacipran.Approved
TopiramateThe metabolism of Levomilnacipran can be decreased when combined with Topiramate.Approved
TopiroxostatThe metabolism of Levomilnacipran can be decreased when combined with Topiroxostat.Approved, Investigational
TramadolLevomilnacipran may increase the neuroexcitatory activities of Tramadol.Approved, Investigational
Trans-2-PhenylcyclopropylamineThe risk or severity of adverse effects can be increased when Trans-2-Phenylcyclopropylamine is combined with Levomilnacipran.Experimental
TranylcypromineThe metabolism of Levomilnacipran can be decreased when combined with Tranylcypromine.Approved
TrazodoneLevomilnacipran may increase the serotonergic activities of Trazodone.Approved, Investigational
TriazolamThe risk or severity of adverse effects can be increased when Triazolam is combined with Levomilnacipran.Approved
Tricaine methanesulfonateThe risk or severity of adverse effects can be increased when Tricaine methanesulfonate is combined with Levomilnacipran.Vet Approved
TrichlormethiazideLevomilnacipran may increase the hyponatremic activities of Trichlormethiazide.Approved, Vet Approved
TrichloroethyleneThe risk or severity of adverse effects can be increased when Trichloroethylene is combined with Levomilnacipran.Approved
TrifluoperazineThe risk or severity of adverse effects can be increased when Trifluoperazine is combined with Levomilnacipran.Approved
TrifluperidolThe risk or severity of adverse effects can be increased when Trifluperidol is combined with Levomilnacipran.Experimental
TriflupromazineThe risk or severity of adverse effects can be increased when Triflupromazine is combined with Levomilnacipran.Approved, Vet Approved
TrimethoprimThe metabolism of Levomilnacipran can be decreased when combined with Trimethoprim.Approved, Vet Approved
ValdecoxibLevomilnacipran may increase the antiplatelet activities of Valdecoxib.Investigational, Withdrawn
Valproic AcidThe risk or severity of adverse effects can be increased when Valproic Acid is combined with Levomilnacipran.Approved, Investigational
VemurafenibThe serum concentration of Levomilnacipran can be increased when it is combined with Vemurafenib.Approved
VenlafaxineVenlafaxine may increase the serotonergic activities of Levomilnacipran.Approved
VeraliprideThe risk or severity of adverse effects can be increased when Veralipride is combined with Levomilnacipran.Experimental
VerapamilThe metabolism of Levomilnacipran can be decreased when combined with Verapamil.Approved
VilazodoneLevomilnacipran may increase the serotonergic activities of Vilazodone.Approved
Vinyl etherThe risk or severity of adverse effects can be increased when Vinyl ether is combined with Levomilnacipran.Experimental
VoriconazoleThe serum concentration of Levomilnacipran can be increased when it is combined with Voriconazole.Approved, Investigational
VortioxetineLevomilnacipran may increase the serotonergic activities of Vortioxetine.Approved
WarfarinThe risk or severity of adverse effects can be increased when Levomilnacipran is combined with Warfarin.Approved
XenonThe risk or severity of adverse effects can be increased when Xenon is combined with Levomilnacipran.Experimental
XylazineThe risk or severity of adverse effects can be increased when Xylazine is combined with Levomilnacipran.Vet Approved
ZaleplonThe risk or severity of adverse effects can be increased when Zaleplon is combined with Levomilnacipran.Approved, Illicit, Investigational
ZimelidineLevomilnacipran may increase the serotonergic activities of Zimelidine.Withdrawn
ZiprasidoneThe metabolism of Levomilnacipran can be decreased when combined with Ziprasidone.Approved
ZolazepamThe risk or severity of adverse effects can be increased when Zolazepam is combined with Levomilnacipran.Vet Approved
ZolpidemThe risk or severity of adverse effects can be increased when Zolpidem is combined with Levomilnacipran.Approved
ZopicloneThe risk or severity of adverse effects can be increased when Zopiclone is combined with Levomilnacipran.Approved
ZotepineThe risk or severity of adverse effects can be increased when Zotepine is combined with Levomilnacipran.Approved, Investigational
ZucapsaicinThe metabolism of Levomilnacipran can be decreased when combined with Zucapsaicin.Approved
ZuclopenthixolThe risk or severity of adverse effects can be increased when Zuclopenthixol is combined with Levomilnacipran.Approved, Investigational
Food Interactions
Not Available

References

General References
Not Available
External Links
KEGG Drug
D10072
PubChem Compound
6917779
PubChem Substance
175427154
ChemSpider
5293005
BindingDB
50032379
ChEBI
136040
ChEMBL
CHEMBL99946
Wikipedia
Levomilnacipran
AHFS Codes
  • 28:16.04.92 — Miscellaneous Antidepressants
FDA label
Download (530 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
1CompletedTreatmentSubject1
2CompletedTreatmentMajor Depressive Disorder (MDD)1
3CompletedTreatmentMajor Depressive Disorder (MDD)4
3CompletedTreatmentStroke, Ischemic1
3RecruitingTreatmentMajor Depressive Disorder (MDD)3
4Active Not RecruitingTreatmentMajor Depressive Disorder (MDD)1
Not AvailableCompletedOtherTobacco Use Disorders1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage forms
FormRouteStrength
Capsule, extended releaseOral120 mg/1
Capsule, extended releaseOral120 mg
Capsule, extended releaseOral20 mg/1
Capsule, extended releaseOral20 mg
Capsule, extended releaseOral40 mg/1
Capsule, extended releaseOral40 mg
Capsule, extended releaseOral80 mg
Capsule, extended releaseOral80 mg/1
KitOral
Prices
Not Available
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)
USRE43879No2003-06-032023-06-03Us
US8481598No2011-03-022031-03-02Us
US8865937No2012-05-232032-05-23Us

Properties

State
Solid
Experimental Properties
Not Available
Predicted Properties
PropertyValueSource
logP1.42ChemAxon
pKa (Strongest Basic)9.83ChemAxon
Physiological Charge1ChemAxon
Hydrogen Acceptor Count2ChemAxon
Hydrogen Donor Count1ChemAxon
Polar Surface Area46.33 Å2ChemAxon
Rotatable Bond Count5ChemAxon
Refractivity73.81 m3·mol-1ChemAxon
Polarizability28.33 Å3ChemAxon
Number of Rings2ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterYesChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleNoChemAxon
Predicted ADMET features
PropertyValueProbability
Human Intestinal Absorption+1.0
Blood Brain Barrier+0.9889
Caco-2 permeable+0.5914
P-glycoprotein substrateSubstrate0.5928
P-glycoprotein inhibitor INon-inhibitor0.902
P-glycoprotein inhibitor IINon-inhibitor0.8787
Renal organic cation transporterNon-inhibitor0.8119
CYP450 2C9 substrateNon-substrate0.8494
CYP450 2D6 substrateNon-substrate0.9116
CYP450 3A4 substrateNon-substrate0.6514
CYP450 1A2 substrateNon-inhibitor0.6383
CYP450 2C9 inhibitorNon-inhibitor0.7697
CYP450 2D6 inhibitorNon-inhibitor0.7718
CYP450 2C19 inhibitorNon-inhibitor0.8587
CYP450 3A4 inhibitorNon-inhibitor0.6327
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.7004
Ames testNon AMES toxic0.8013
CarcinogenicityNon-carcinogens0.5456
BiodegradationNot ready biodegradable0.9972
Rat acute toxicity2.6162 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.993
hERG inhibition (predictor II)Non-inhibitor0.6823
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted GC-MS Spectrum - GC-MSPredicted GC-MSNot Available
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSNot Available

Taxonomy

Description
This compound belongs to the class of organic compounds known as phenylacetamides. These are amide derivatives of phenylacetic acids.
Kingdom
Organic compounds
Super Class
Benzenoids
Class
Benzene and substituted derivatives
Sub Class
Phenylacetamides
Direct Parent
Phenylacetamides
Alternative Parents
Aralkylamines / Cyclopropanecarboxylic acids and derivatives / Tertiary carboxylic acid amides / Amino acids and derivatives / Organopnictogen compounds / Organic oxides / Monoalkylamines / Hydrocarbon derivatives / Carbonyl compounds
Substituents
Phenylacetamide / Aralkylamine / Cyclopropanecarboxylic acid or derivatives / Tertiary carboxylic acid amide / Amino acid or derivatives / Carboxamide group / Carboxylic acid derivative / Organopnictogen compound / Organic oxygen compound / Primary amine
Molecular Framework
Aromatic homomonocyclic compounds
External Descriptors
Not Available

Targets

Kind
Protein
Organism
Human
Pharmacological action
Yes
Actions
Inhibitor
General Function
Serotonin:sodium symporter activity
Specific Function
Serotonin transporter whose primary function in the central nervous system involves the regulation of serotonergic signaling via transport of serotonin molecules from the synaptic cleft back into t...
Gene Name
SLC6A4
Uniprot ID
P31645
Uniprot Name
Sodium-dependent serotonin transporter
Molecular Weight
70324.165 Da
Kind
Protein
Organism
Human
Pharmacological action
Yes
Actions
Inhibitor
General Function
Norepinephrine:sodium symporter activity
Specific Function
Amine transporter. Terminates the action of noradrenaline by its high affinity sodium-dependent reuptake into presynaptic terminals.
Gene Name
SLC6A2
Uniprot ID
P23975
Uniprot Name
Sodium-dependent noradrenaline transporter
Molecular Weight
69331.42 Da

Enzymes

Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Substrate
General Function
Vitamin d3 25-hydroxylase activity
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation react...
Gene Name
CYP3A4
Uniprot ID
P08684
Uniprot Name
Cytochrome P450 3A4
Molecular Weight
57342.67 Da
Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Substrate
General Function
Steroid hydroxylase activity
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally un...
Gene Name
CYP2C8
Uniprot ID
P10632
Uniprot Name
Cytochrome P450 2C8
Molecular Weight
55824.275 Da
Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Substrate
General Function
Steroid hydroxylase activity
Specific Function
Responsible for the metabolism of a number of therapeutic agents such as the anticonvulsant drug S-mephenytoin, omeprazole, proguanil, certain barbiturates, diazepam, propranolol, citalopram and im...
Gene Name
CYP2C19
Uniprot ID
P33261
Uniprot Name
Cytochrome P450 2C19
Molecular Weight
55930.545 Da
Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Substrate
General Function
Steroid hydroxylase activity
Specific Function
Responsible for the metabolism of many drugs and environmental chemicals that it oxidizes. It is involved in the metabolism of drugs such as antiarrhythmics, adrenoceptor antagonists, and tricyclic...
Gene Name
CYP2D6
Uniprot ID
P10635
Uniprot Name
Cytochrome P450 2D6
Molecular Weight
55768.94 Da
Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Substrate
General Function
Steroid hydroxylase activity
Specific Function
This enzyme metabolizes arachidonic acid predominantly via a NADPH-dependent olefin epoxidation to all four regioisomeric cis-epoxyeicosatrienoic acids. One of the predominant enzymes responsible f...
Gene Name
CYP2J2
Uniprot ID
P51589
Uniprot Name
Cytochrome P450 2J2
Molecular Weight
57610.165 Da

Transporters

Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Substrate
General Function
Xenobiotic-transporting atpase activity
Specific Function
Energy-dependent efflux pump responsible for decreased drug accumulation in multidrug-resistant cells.
Gene Name
ABCB1
Uniprot ID
P08183
Uniprot Name
Multidrug resistance protein 1
Molecular Weight
141477.255 Da

Drug created on August 01, 2013 14:17 / Updated on January 15, 2018 08:58