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What the FDA labels say about taking them together

Escitalopram and meperidine

Escitalopram's FDA label of October 1, 2023 names meperidine in its warnings and precautions section; meperidine's label does not name escitalopram itself but warns about its class (serotonin reuptake inhibitors). The escitalopram label: “The risk is increased with concomitant use of other serotonergic drugs and with drugs that impair metabolism of serotonin, i.e., MAOIs.”

Check it at the source: the escitalopram FDA label on DailyMed (effective October 1, 2023, Allergan, Inc.); the meperidine FDA label on DailyMed (effective November 29, 2025, EPIC PHARMA, LLC).

What does the escitalopram label say about meperidine?

Escitalopram label, warnings and precautions

The risk is increased with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, meperidine, methadone, lithium, tramadol, tryptophan, buspirone, amphetamines, and St. John’s Wort) and with drugs that impair metabolism of serotonin, i.e., MAOIs [see Contraindications ( 4 ) and Drug Interactions ( 7 )].

Source: FDA drug label (Lexapro), NDA021323 (Abbvie), as published by Allergan, Inc., effective October 1, 2023 (SPL set 13bb8267-1cab-43e5-acae-55a4d957630a), via openFDA; the full label on DailyMed

What does the meperidine label say about escitalopram?

Meperidine's label does not name escitalopram itself; it warns about its class (serotonin reuptake inhibitors):

Meperidine label, warnings and precautions

If ‎a patient is suspected to be experiencing OIH, carefully consider appropriately ‎decreasing the dose of the current opioid analgesic or opioid rotation (safely ‎switching the patient to a different opioid moiety) [see Dosage and ‎Administration (2), Warnings and Precautions (5.15) ] .‎ 5.8 Serotonin Syndrome with Concomitant Use of Serotonergic Drugs Cases of serotonin syndrome, a potentially life-threatening condition, have been reported during concomitant use of meperidine with serotonergic drugs. …

Meperidine label, warnings and precautions

Syndrome with Concomitant Use of Serotonergic Drugs Cases of serotonin syndrome, a potentially life-threatening condition, have been reported during concomitant use of meperidine hydrochloride tablets with serotonergic drugs. Serotonergic drugs include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), St John’s wort, tricyclic antidepressants (TCAs), triptans, 5-HT3 receptor antagonists, drugs that affect the serotonergic neurotransmitter system (e.g. …

Source: FDA drug label (Meperidine Hydrochloride), EPIC PHARMA, LLC, effective November 29, 2025 (SPL set fae5cc34-5917-4445-9516-25f97ffca8db), 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

43Escitalopram generic labelers
3Meperidine generic labelers
EscitalopramMeperidine
Labeled forDepression, AnxietyPain
Boxed warningYesYes
Pharmacy cost (NADAC)$0.0632 per tablet 20 mg tablet$0.157 per mL 50 mg/5 mL solution
Shortage nowNo current entryListed; available

Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)

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