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levomilnacipran vs tranylcypromine

Side-by-side comparison of levomilnacipran and tranylcypromine. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.

moderate Known Drug Interaction

Examples: selegiline, tranylcypromine, isocarboxazid, phenelzine, linezolid, methylene blue Other Serotonergic Drugs Clinical Impact: Concomitant use of FETZIMA with other serotonergic drugs increases the risk of serotonin syndrome.

Recommendation: Avoid using these two drugs together to prevent a potentially dangerous reaction.

Drug Class
levomilnacipran Serotonin-Norepinephrine Reuptake Inhibitor (SNRI)
tranylcypromine Monoamine Oxidase Inhibitor (MAOI)
Type
levomilnacipran Prescription
tranylcypromine Prescription
Summary
levomilnacipran

Fetzima is a medicine used to treat major depressive disorder (MDD) in adults. It helps to improve your mood by affecting certain chemicals in the brain.

tranylcypromine

Tranylcypromine (Parnate) is a medicine used to treat major depression in adults. It is used when other antidepressants have not worked well enough.

What It Treats
levomilnacipran

Fetzima is used to treat major depressive disorder (MDD) in adults. MDD can cause you to feel sad, lose interest in activities, and have trouble with daily life. Fetzima can help improve your mood and reduce these symptoms.

tranylcypromine

Tranylcypromine is used to treat major depressive disorder (MDD) in adults. You should only use it if other antidepressants haven't helped. It is not for the first treatment of depression because it can cause serious side effects and has many drug and food interactions.

How It Works
levomilnacipran

Fetzima is a type of drug called a serotonin-norepinephrine reuptake inhibitor (SNRI). It works by increasing the levels of serotonin and norepinephrine in your brain. These chemicals can help improve your mood and reduce symptoms of depression.

tranylcypromine

Tranylcypromine belongs to a class of drugs called MAO inhibitors. It works by increasing the levels of certain chemicals in your brain. These chemicals can help improve your mood.

Common Side Effects
levomilnacipran
  • Nausea
  • Constipation
  • Increased sweating
  • Increased heart rate
  • Erectile dysfunction
tranylcypromine
  • Dry mouth
  • Dizziness
  • Trouble sleeping
  • Feeling sleepy
  • Headache
FAERS Reports
levomilnacipran
  • Pain 210
  • Throwing up 208
  • Trouble remembering things 189
  • Numbness or tingling 179
  • Reduced sense of touch 178
tranylcypromine
  • Interaction between medicines 68
  • Feeling sad or hopeless 36
  • Too much serotonin in the body 27
  • Head pain 24
  • High blood pressure 24
Serious Warnings
levomilnacipran

Antidepressants may increase the risk of suicidal thoughts and behaviors in young adults. Your doctor should closely watch you for worsening depression or suicidal thoughts. Fetzima is not approved for use in children.

tranylcypromine

Tranylcypromine can increase the risk of suicidal thoughts and behaviors in young adults. It can also cause a dangerous increase in blood pressure if you eat foods high in tyramine or take certain medicines. Make sure to follow all food and drug restrictions.

Pregnancy
levomilnacipran

Tell your doctor if you are pregnant or plan to become pregnant. Using Fetzima in the last months of pregnancy may cause problems in the newborn. There is a pregnancy registry for women who take antidepressants during pregnancy.

tranylcypromine

There is limited information about the safety of tranylcypromine during pregnancy. Talk to your doctor if you are pregnant or plan to become pregnant. It is not recommended to breastfeed while taking this medicine because it can harm the baby.

Also Compare, Nearby Drugs

How to Read This levomilnacipran vs tranylcypromine Comparison

levomilnacipran is classified in the Serotonin-Norepinephrine Reuptake Inhibitor (SNRI) drug class, while tranylcypromine sits within the Monoamine Oxidase Inhibitor (MAOI) class. Drugs from different classes work through distinct mechanisms, so a head-to-head comparison illustrates trade-offs rather than equivalence. Both drugs are prescription-only, so a licensed provider must authorize use.

Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, levomilnacipran has 964 submissions while tranylcypromine has 179. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. These two drugs have a known moderate interaction flagged in FDA labeling, attributed to these drugs both raise serotonin levels, and using them at the same time can cause too much serotonin to build up in your body.. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.

A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between levomilnacipran and tranylcypromine - always consult your physician or pharmacist first.

Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.