What the FDA labels say about taking them together
Clomipramine and milnacipran
Milnacipran's FDA label of September 10, 2025 names clomipramine in its drug interactions section; clomipramine's label does not name milnacipran itself but warns about its class (SNRIs (serotonin and norepinephrine reuptake inhibitors)). The milnacipran label: “Clomipramine: In a drug-drug interaction study, an increase in euphoria and postural hypotension was observed in patients who switched from clomipramine to SAVELLA.”
Check it at the source: the clomipramine FDA label on DailyMed (effective November 26, 2024); the milnacipran FDA label on DailyMed (effective September 10, 2025, Allergan, Inc.).
What does the clomipramine label say about milnacipran?
Clomipramine's label does not name milnacipran itself; it warns about its class (SNRIs (serotonin and norepinephrine reuptake inhibitors)):
Clomipramine label, warningsSerotonin Syndrome The development of a potentially life-threatening serotonin syndrome has been reported with SNRIs and SSRIs, including clomipramine hydrochloride capsules, alone but particularly with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, and St. …
Source: FDA drug label (CLOMIPRAMINE HYDROCHLORIDE), SpecGx LLC, effective November 26, 2024 (SPL set d7cee3fa-d05c-4702-8f75-f446627bdb49), via openFDA; the full label on DailyMed
What does the milnacipran label say about clomipramine?
Milnacipran label, drug interactionsClomipramine: In a drug-drug interaction study, an increase in euphoria and postural hypotension was observed in patients who switched from clomipramine to SAVELLA.
Source: FDA drug label (Savella), NDA022256 (Abbvie), as published by Allergan, Inc., effective September 10, 2025 (SPL set 16a4a314-f97e-4e91-95e9-576a3773d284), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Clomipramine | Milnacipran | |
|---|---|---|
| Labeled for | n/a | Nerve pain and fibromyalgia |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | $0.189 per capsule 25 mg capsule | $2.82 per tablet 100 mg tablet |
| Shortage now | No current entry | No current entry |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once